Pre-conceptional Maternal Vitamin B12 Supplementation Improves Offspring Neurodevelopment at 2 Years of Age: PRIYA Trial.

Autor:	D'souza N; Diabetes Unit, King Edward Memorial Hospital Research Center, Pune, India., Behere RV; Diabetes Unit, King Edward Memorial Hospital Research Center, Pune, India., Patni B; Terre des Hommes Rehabilitation and Morris Child Development Centre at KEM Hospital, Pune, India., Deshpande M; Terre des Hommes Rehabilitation and Morris Child Development Centre at KEM Hospital, Pune, India., Bhat D; Diabetes Unit, King Edward Memorial Hospital Research Center, Pune, India., Bhalerao A; Diabetes Unit, King Edward Memorial Hospital Research Center, Pune, India., Sonawane S; Diabetes Unit, King Edward Memorial Hospital Research Center, Pune, India., Shah R; Diabetes Unit, King Edward Memorial Hospital Research Center, Pune, India., Ladkat R; Diabetes Unit, King Edward Memorial Hospital Research Center, Pune, India., Yajnik P; Diabetes Unit, King Edward Memorial Hospital Research Center, Pune, India., Bandyopadhyay SK; Strategic Consulting, Cytel Inc., Cambridge, MA, United States., Kumaran K; Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom., Fall C; Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom., Yajnik CS; Diabetes Unit, King Edward Memorial Hospital Research Center, Pune, India.
Jazyk:	angličtina
Zdroj:	Frontiers in pediatrics [Front Pediatr] 2021 Dec 07; Vol. 9, pp. 755977. Date of Electronic Publication: 2021 Dec 07 (Print Publication: 2021).
DOI:	10.3389/fped.2021.755977
Abstrakt:	Background: The first thousand days window does not include the pre-conceptional period. Maternal pre-conceptional health has a profound influence on early embryonic development (implantation, gastrulation, placentation etc). Nutrition provided by B-complex vitamins is important for fetal growth, especially neural development. We report effects of a maternal pre-conceptional vitamin B12 and multi micronutrient (MMN) supplementation on offspring neurodevelopmental performance. Methods: In the Pune Rural Intervention in Young Adolescents trial (PRIYA), adolescents ( N = 557, 226 females) were provided with vitamin B12 (2 μg/day) with or without multiple micronutrients, or a placebo, from preconception until delivery. All groups received mandatory iron and folic acid. We used the Bayley's Scale of Infant Development (BSID-III) at 24-42 months of age to investigate effects on offspring neurodevelopment. Results: Participants had similar baseline B12 levels. The levels improved in the B12 supplemented groups during pre-conception and pregnancy (28 weeks gestation), and were reflected in higher cord blood holotranscobalamin (holo-TC) levels compared to the placebo group. Neurodevelopmental outcomes in the B12 alone group ( n = 21) were better than the placebo ( n = 27) in cognition ( p = 0.044) and language ( p = 0.020) domains (adjusted for maternal baseline B12 levels). There was no difference in neurodevelopmental outcomes between the B12 + MMN ( n = 26) and placebo group. Cord blood Brain Derived Neurotrophic Factor (BDNF) levels were highest in the B12 alone group, though not significant. Conclusion: Pre-conceptional vitamin B12 supplementation improved maternal B12 status and offspring neurodevelopment at 2 years of age. The usefulness of cord BDNF as a marker of brain development needs further investigation. Our results highlight the importance of intervening during pre-conception. Competing Interests: SKB was employed by Cytel Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2021 D'souza, Behere, Patni, Deshpande, Bhat, Bhalerao, Sonawane, Shah, Ladkat, Yajnik, Bandyopadhyay, Kumaran, Fall and Yajnik.)
Databáze:	MEDLINE
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