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Adv Nutr. 2017 Nov 15;8(6):971-979. doi: 10.3945/an.117.015628. Print 2017 Nov.

Cobalamin Status from Pregnancy to Early Childhood: Lessons from Global Experience.

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Aarhus Institute of Advanced Studies, University of Aarhus, Aarhus, Denmark.
Area of Preventive Medicine and Public Health, Department of Basic Medical Sciences, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, Pere Virgili Institute for Health Research, Reus, Spain.
Centros de Investigación Biomédica en Red (CB06/03), Instituto de Salud Carlos III, Pune, India.
Diabetes Unit, King Edward Memorial Hospital Research Centre, Pune, India.


Low cobalamin intake and status during pregnancy or lactation have been linked to adverse maternal and perinatal health outcomes, whereas low cobalamin status during early childhood is associated with impaired development in children. Women who begin pregnancy with depleted stores (low or very low plasma cobalamin) will give birth to depleted infants who are likely to develop deficiency symptoms during the first few weeks or months postpartum. Newly ingested cobalamin during pregnancy and lactation (from diet or supplements) is transferred to the child and is not likely to correct cobalamin status in depleted women. The prevalence of low cobalamin status is high especially in low-income settings or in populations with a low intake of animal products. Folate and cobalamin play interdependent roles in one-carbon metabolism. Although folic acid supplementation during early pregnancy is widely recommended and practiced, cobalamin supplementation during pregnancy and lactation has received little attention. Furthermore, the intake recommendations for pregnant and lactating women and in early life need reevaluation in the light of newly available evidence in the field.


child development; cobalamin; cord blood; infants; lactation; pregnancy; recommended intake; supplementation

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