Gebe Popülasyonunda Vitamin B12 Düzeyinin Değerlendirilmesi ve Beslenme Yetersizliği ile İlişkisi

Year 2022, Volume: 17 Issue: 3, 77 - 82, 02.11.2022

Muhammed Mustafa Beyoğlu , Bülent Köstü

https://doi.org/10.17517/ksutfd.971131

Cited By: 2

Abstract

Özet
Amaç: Gebe popülasyonunda trimesterlere göre vitamin B12 düzeyini incelemek, yetersizlik ve eksiklik durumlarında beslenme bozukluğu ile ilişkisini araştırmak, erken teşhisle takviyesini başlamak.
Gereç ve Yöntemler: Üçüncü basamak bir üniversite hastanesi tıp fakültesi Kadın Hastalıkları ve Doğum Anabilim dalına başvuran gebelerin sosyodemografik anket verileri, ultrasonografi verileri, hemogram, biyokimya ve vitamin B12 düzeyleri bakıldı. Verilerin değerlendirilmesinde SPSS 22.0 istatistik programı kullanıldı. P<0.05 anlamlı kabul edildi.
Bulgular: Araştırmamıza 250 gebe dâhil edildi. Yaş ortalaması 26.42±5.86 (18-40 yaş) idi. Katılımcıların ortalama vitamin B12 düzeyi 214.45±83.99 ng/ml (80-656) idi. Katılımcıların vitamin B12 düzeyleri postoc duncan testine göre 1.trimester 2 ve 3 ile anlamlı farklılık içermekte (p<0.05), 2.trimester ve 3.trimester kendi içerisinde anlamlı farklılık içermemekteydi (p=0.968). Sosyoekonomik düzeylere göre vitamin B12 düzeyleri karşılaştırıldığında aylık geliri 3001 Türk Lirası ve üzeri olan grupta 228.336±63.665 ng/ml, aylık geliri 3000 Türk Lirası ve altı olan grup 199.016±45.630 ng/ml olarak bulundu. İki grup arasında anlamlı farklılık mevcuttu (p<0.05). Vitamin B12 düzeylerinin beslenme yetersizliğiyle ilişkisine bakıldığında günlük tam ve/veya yarım porsiyon hayvansal gıda tüketen grubun vitamin B12 düzeyleri 268.27±86.96 ng/ml; dörtte bir porsiyon tüketen ve/veya tüketmeyenlerin 166.34±41.60 ng/ml bulundu.
İki grup birbiriyle kıyaslandığında anlamlı farklılık bulundu (p<0.05).
Sonuç: Gebelikte vitamin ve mineral dengesi anne ve fetüs sağlığı açısından çok önemlidir. Vitamin B12 eksiklik ve/veya yetersizlik durumları azımsanmayacak sayılardadır. Gerekli durumlarda erken teşhisle bireye hemen doğru beslenme açısından eğitim verilmelidir. Kar-zarar oranına göre elzem durumlarda folik asit-vitamin B12 kombine ilaçlardan destek tedavisi düşünülmelidir

Keywords

Gebelik, vitamin B12 eksikliği, malnütrisyon

Evaluation of Vitamin B12 Levels in Pregnant Population and Relationship with Nutritional Deficiency

Abstract

Abstract
Objective: This study aims to examine the level of vitamin B12 according to trimesters in the pregnant population, to investigate its relationship with malnutrition in cases of insufficiency and deficiency, and to start supplementation with early diagnosis.
Material and Methods: Sociodemographic survey data, ultrasonography data, hemogram, biochemistry and vitamin B12 levels of pregnant women who applied to the department of obstetrics and gynecology of a reginal university hospital were examined. SPSS 22.0 statistics program was used to evaluate the data. P<0.05 was considered significant.
Results: Two hundred and fifty pregnant women were included in our study. The mean age was 26.42±5.86 (18-40 years). The mean vitamin B12 level of the participants was 214.45±83.99 ng/ml (80-656). According to the postoc duncan test, the vitamin B12 levels of the participants showed a significant difference with the 1st trimester 2 and 3 (p<0.05), while the 2nd and 3rd trimesters did not show a significant difference in themselves (p=0.968). When compared according to socioeconomic levels, vitamin B12 levels of the group with a monthly income of 3001 turkish lira and above was found to be 228.336±63.665 ng/ml,
and the group with a monthly income of 3000 turkish lira and below was 199.016±45.630 ng/ml. There was a significant difference between the two groups (p<0.05). Considering the relationship between vitamin B12 levels and nutritional deficiency, vitamin B12 levels were found 268.27±86.96 ng/ml in the group consuming full and/or half servings of animal food daily, and 166.34±41.60 ng/ml in those consuming and/or not consuming a quarter serving. When the two groups were compared with each other, a significant difference was found (p<0.05).
Conclusion: Vitamin and mineral balance during pregnancy is very important for maternal and fetal health. Vitamin B12 deficiency and/or insufficiency are in considerable numbers. When necessary, the individual should be trained in terms of proper nutrition immediately with early diagnosis. Supportive treatment from folic acid-vitamin B12 combined drugs should be considered in essential cases according to the profit-loss ratio.

Keywords

Pregnancy, vitamin B12 deficiency, malnutrition

References

• McArdle HJ, Ashworth CJ. Micronutrients in fetal growth and development. Br Med Bull. 1999;55:499-510.
• Kabaran S, Samur G. Maternal Obezite ve Gebelik. Beslenme ve Diyet Dergisi. 2010;38(1-2):45-52.
• Wald NJ, Hackshaw AD, Stone R, Sourial NA. Blood folic acid and vitamin B12 in relation to neural tube defects. Br J Obstet Gynaecol. 1996;103(4):319-324.
• Yates AA, Schlicker SA, Suitor CW. Dietary Reference Intakes: the new basis for recommendations for calcium and related nutrients, B vitamins, and choline. J Am Diet Assoc. 1998 Jun;98(6):699-706.
• Guerra-Shinohara EM, Paiva AA, Rondo PH, Yamasaki K, Terzi CA, D’Almeida V. Relationship between total homocysteine and folate levels in pregnant women and their newborn babies according to maternal serum levels of vitamin B12. BJOG. 2002;109(7):784-791.
• Uzdil Z, Özenoğlu A. Gebelikte çeşitli besin öğeleri tüketiminin bebek sağliği üzerine etkileri. Balıkesir Sağlık Bilimleri Dergisi. 2015;4(2):117-121.
• Ozdemir AA, Gundemir YE. Assessment of the Vitamin B12 status of pregnant women and their infants. Namık Kemal Tıp Dergisi. 2018;6(2):53-60.
• Lai JS, Ayob MN, Cai S, Quah LP, Gluckman PD, Shek LP et al. Maternal plasma vitamin B12 concentrations during pregnancy and infant cognitive outcomes at 2 years of age. Br J Nutr. 2019;121(11):1303-1312.
• Siddiqua TJ, Ahmad SM, Ahsan KB, Rashid M, Roy A, Rahman MS et al. Vitamin B12 supplementation during pregnancy and postpartum improves B12 status of both mothers and infants but vaccine response in mothers only: a randomized clinical trial in Bangladesh. Eur J Nutr. 2016;55(1):281-293.
• Finkelstein JL, Kurpad AV, Thomas T, Srinivasan K, Duggan C. Vitamin B(12) status in pregnant women and their infants in South India. Eur J Clin Nutr. 2017;71(9):1046-1053.
• Du YJ, Li J, Wang HL, Du JY, Qu PF, Zhang R, Guo LQ et al. Epidemiological characteristics of serum vitamin B(12) and folate levels in women awaiting delivery. Zhonghua Liu Xing Bing Xue Za Zhi. 2020;41(8):1359-1364.
• Kabaran S. and Ayaz A. Maternal ve fetal sağlık üzerinde B12, folik asit, a, d, e ve c vitaminlerinin etkileri. Turk Hijyen ve Deneysel Biyoloji Dergisi 2013;70(2):103-112.
• Unsur E, Kinas B. The relationship between maternal and neonatal vitamin B12 and folate levels, anthropometric measurements, and metabolic indicators. J Surg Med 2020;4(1):43-47.
• Dwarkanath P, Barzilay JR, Thomas T, Thomas A, Bhat S, Kurpad VA et al. High folate and low vitamin B-12 intakes during pregnancy are associated with small-for-gestational age infants in South Indian women: a prospective observational cohort study. Am J Clin Nutr 2013;98(6):1450-1458.
• Chéry C, Barbe F, Lequere C, Abdelmouttaleb I, Gerard P, Barbarino P et al. Hyperhomocysteinemia is related to a decreased blood level of vitamin B12 in the second and third trimester of normal pregnancy. Clinical Chemistry and Laboratory Medicine (CCLM). 2002;40(11):1105-1108.
• Koebnick C, Heins UA, Dagnelie PC, Wickramasinghe S, Ratnayaka DI, Hothorn T et al. Longitudinal concentrations of vitamin B12 and vitamin B12-binding proteins during uncomplicated pregnancy. Clinical Chemistry. 2002;48(6):928-933.
• Sukumar N, Venkataraman H, Wilson S, Goljan I, Selvamoni S, Patel V et al. Vitamin B12 status among pregnant women in the UK and ıts associaton with obesity and gestational diabetes. Nutritients.2016;8(12):768.