Serum vitamin B12 and brain development levels in small for gestational age infants

doi:10.3877/cma.j.issn.1674-0785.2020.05.010

Abstract

Abstract:

Objective

To investigate the differences in levels of serum vitamin B12 (VB12) and homocysteine (Hcy) between small for gestational age infants and appropriate for gestational age infants and perform behavioral neurological assessment of full term infants, in order to understand the impact of VB12 and Hcy on fetal development and brain development levels in small for gestational age infants.

Methods

According to the relationship between gestational age and birth weight, the subjects enrolled in the study were divided into a small for gestational age infant group (including subgroups of preterm small for gestational age infants and full-term small for gestational age infants) and an appropriate for gestational age infant group (including subgroups of preterm appropriate for gestational age infants and full-term appropriate for gestational age infants). The levels of VB12 and Hcy in serum were measured, and the relationship of serum VB12 and Hcy levels with birth weight and gestational age at birth were analyzed. The differences in serum levels of VB12 and Hcy were compared between small for gestational age infants and appropriate for gestational age infants. Neonatal behavioral neurological assessment (NBNA) was used for the assessment and comparison of behavioral neurological scores in the subgroup of full-term small for gestational age infants and subgroup of full-term appropriate for gestational age infants in 2 to 3 days after birth.

Results

The levels of serum vitamin B12 at birth were positively correlated with birth weight (r=0.564, P<0.05), while the levels of serum Hcy were negatively correlated with birth weight (r=-0.569, P<0.05). The subgroup of preterm appropriate for gestational age infants had significantly higher levels of serum VB12 and lower levels of serum Hcy compared to the subgroup of preterm small for gestational age infants [VB12: (262.07±62.25) pg/ml vs (228.21±67.27) pg/ml, P<0.05; Hcy: (8.47±3.81) μmol/L vs (17.53±10.56) μmol/L, P<0.05]. The subgroup of full-term appropriate for gestational age infants had significantly higher levels of serum VB12 and lower levels of serum Hcy compared with the subgroup of full-term small for gestational age infants [VB12: (431.03±113.82) pg/ml vs (254.80±72.35) pg/ml, P<0.05; Hcy: (4.61±2.88) μmol/L vs (13.60±9.29) μmol/L, P<0.05]. Compared with full-term appropriate for gestational age infants, full-term small for gestational age infants had significantly lower total NBNA score and scores of capacity, passive muscle tension, active muscle tension, and primitive reflexes (P<0.05).

Conclusion

The levels of serum vitamin B12 at birth positively correlate with birth weight and gestational age, while the levels of serum homocysteine negatively correlates with birth weight and gestational age. The levels of serum vitamin B12 in small for gestational age infants are lower than those of appropriate for gestational age infants, while the levels of serum homocysteine are higher than those appropriate for gestational age infants, which indicates that VB12 may affect fetal growth and development. Full-term small for gestational age infants have significantly lower NBNA scores than full-term appropriate for gestational age infants, indicating that the behavioral neuroscience capacity of small for gestational age infants is affected at birth.

Key words: Small for gestational age infant, Vitamin B12, Homocysteine, Neonatal behavioral neurological assessment, Brain development

Caimei Li, Xiaochun Ding. Serum vitamin B12 and brain development levels in small for gestational age infants[J]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(05): 370-375.

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Figures/Tables 6

References 14

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组别	例数	胎龄（周）	出生体质量（g）	身长（cm）	头围（cm）	胸围（cm）
小于胎龄儿组	100	36.36±2.81	1953.50±401.73	42.69±3.39	29.88±2.31	27.59±2.75
适于胎龄儿组	104	36.12±3.34	2671.97±716.68	45.85±3.60	31.95±2.30	30.58±3.11
t值	?	0.187	-6.939	-5.099	-4.990	-5.093
P值	?	0.851	<0.01	<0.01	<0.01	<0.01

组别	例数	胎龄（周）	出生体质量（g）	身长（cm）	头围（cm）	胸围（cm）
小于胎龄儿组	100	36.36±2.81	1953.50±401.73	42.69±3.39	29.88±2.31	27.59±2.75
适于胎龄儿组	104	36.12±3.34	2671.97±716.68	45.85±3.60	31.95±2.30	30.58±3.11
t值	?	0.187	-6.939	-5.099	-4.990	-5.093
P值	?	0.851	<0.01	<0.01	<0.01	<0.01

组别	例数（例）	胎龄（周）	出生体质量（g）	身长（cm）	头围（cm）	胸围（cm）
早产小于胎龄儿亚组	50	34.02±1.68	1693.60±375.99	41.06±3.52	28.91±2.48	26.54±3.10
早产适于胎龄儿亚组	52	33.29±2.18	2068.75±444.49^a	43.07±3.02^a	30.31±2.05^a	28.29±2.58^a
足月小于胎龄儿亚组	50	38.71±1.35	2213.40±216.43	44.80±1.60	31.95±3.72	28.78±1.65
足月适于胎龄儿亚组	52	38.96±1.18	3275.19±312.63^b	48.63±1.08^b	33.58±1.02^b	32.87±1.52^b
F值	?	171.235	194.688	84.784	62.523	72.110
P值	?	<0.05	<0.05	<0.05	<0.05	<0.05

组别	例数（例）	胎龄（周）	出生体质量（g）	身长（cm）	头围（cm）	胸围（cm）
早产小于胎龄儿亚组	50	34.02±1.68	1693.60±375.99	41.06±3.52	28.91±2.48	26.54±3.10
早产适于胎龄儿亚组	52	33.29±2.18	2068.75±444.49^a	43.07±3.02^a	30.31±2.05^a	28.29±2.58^a
足月小于胎龄儿亚组	50	38.71±1.35	2213.40±216.43	44.80±1.60	31.95±3.72	28.78±1.65
足月适于胎龄儿亚组	52	38.96±1.18	3275.19±312.63^b	48.63±1.08^b	33.58±1.02^b	32.87±1.52^b
F值	?	171.235	194.688	84.784	62.523	72.110
P值	?	<0.05	<0.05	<0.05	<0.05	<0.05

组别	例数	VB12（pg/ml）	Hcy（μmol/L）
早产小于胎龄儿亚组	50	228.21±67.27	17.53±10.56
早产适于胎龄儿亚组	52	262.07±62.25^a	8.47±3.81^a
足月小于胎龄儿亚组	50	254.80±72.35	13.60±9.29
足月适于胎龄儿亚组	52	431.03±113.82^b	4.61±2.88^b
F值	?	65.965	30.262
P值	?	<0.01	<0.01

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