Hasan ÖNAL, Taliha ÖNER, Zerrin ÖNAL, Erdal ADAL, Ahmet AYDIN

Gelişmekte olan ülkelerde önemli bir sorun: Annede ve yenidoğanda B12 vitamini eksikliği

Amaç: Son yıllarda yaşamın ilk altı aylık dönemi içinde nörolojik bulgular ile hastanemize başvuran ve B12 eksikliği tanısı alan olgularda ciddi bir artış dikkat çekmiştir. Bundan dolayı hastanemizde doğan bebeklerde annede ve bebekte B12 eksikliğinin araştırılması gereği duyulmuştur. Gereç ve Yöntem: Çalışma grubu hastanemizde doğum yapan 250 anne ve doğum sonrası 48 saatini doldurmuş term bebeklerden oluşturuldu. Annede B12, bebekte B12 ve homosistein düzeyi ölçüldü. Hiperhomosisteinemisi bulunan olgularda B12 yetersizliği ile kobalamin sentez bozukluğu ayırıcı tanısı yapıldı. B12 eksikliği tanısının konulmasında annede B12 eşik değeri 300 pg/ml, bebekte 200 pg/ml olarak alındı. Bulgular: Annelerin %81,6’sında bebeklerin %42’sinde B12 yetersizliği saptandı. B12 eksikliği bulunan olguların ortalama homosistein düzeyi B12 düzeyi normal olan olgulara göre anlamlı olarak yüksek bulundu. Kobalamin sentez bozukluğu hiçbir olguda saptanmadı. Çıkarımlar: Sosyoekonomik seviyenin düşük olması nedeni ile hayvansal proteinlerin anneler tarafından yeterince tüketilememesi, hem anne hem de bebek için B12 vitamin eksikliği açısından önemli bir neden olarak gözükmektedir. Bu çalışma bizim gibi gelişmekte olan ülkelerde gebelik döneminde B12 desteğinin kas içine uygulanarak karşılanması gerekliliğini tartışmaya açmaktadır.

An important problem in developing countries: Maternal and neonatal vitamin B12 deficiency

Aim: A significant increase has been noted in the number of infants admitted to our hospital due to neurologic findings and diagnosed as vitamin B12 deficiency within the first 6 months of life. Therefore, the aim of the present study was to determine the presence of maternal and neonatal vitamin B12 deficiency in infants born in our hospital. Material and Method: The study population consisted of 250 women giving birth in our hospital and term newborns completing 48 hours after birth. Serum vitamin B12 levels were measured in mothers and vitamin B12 and homocysteine levels were measured in their newborns. The differential diagnosis between vitamin B12 deficiency and impaired cobalamin synthesis was made in infants with hyperhomocysteinemia. The diagnostic threshold for vitamin B12 deficiency was 300 pg/mL in mothers and 200 pg/mL in newborns. Results: Vitamin B12 deficiency was found in 81.6% of the mothers and 42% of the infants. The mean homocysteine level in infants with vitamin B12 deficiency was significantly higher compared to those with normal vitamin B12 levels. Impaired cobalamin synthesis was not observed in any cases. Conclusions: Inadequate consumption of animal proteins during pregnancy due to low socioeconomic status appears to be a significant risk factor for vitamin B12 deficiency both in the mother and the infant. The present study draws attention to the need for parenteral vitamin B12 replacement during pregnancy in developing countries, such as Turkey.

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