Status of Vitamin B12 Deficiency among Lactating Mothers at Six Weeks Postpartum at a Tertiary Care Hospital, West Bengal, India

Abstract

Introduction: Vitamin B12 (vit B12) deficiency is a preventable disorder and has dire consequences on the neurological development of the infant. The only source of vit B12 for exclusively breastfed newborns is their mother’s milk. So, determining the status of maternal vit B12 levels during early lactation is vital. In India, very few studies have documented vit B12 deficiency among lactating mothers, especially eastern region remains unexplored. Aim: To estimate the prevalence of vit B12 deficiency among healthy lactating mothers attending the postpartum clinic at six weeks at a Tertiary Care Hospital of West Bengal, India and also to compare the haematological values between vit B12 deficient and sufficient groups among the lactating mothers. Materials and Methods: An observational cross-sectional study was conducted in the Department of Biochemistry in collaboration with postpartum clinic of Calcutta National Medical College, West Bengal, India. The study was carried out over a period of two months, from July 2022 to August 2022. Serum vit B12, serum ferritin and haematological parameters {Haemoglobin (Hb), Mean Corpuscular Haemoglobin (MCH), Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin Concentration (MCHC)} were measured in 121 apparently healthy lactating women attending the postpartum clinic for a regular check-up at six weeks. Detailed socioclinical history and dietary history was taken from each participant and these variables were compared between vit B12 deficient and sufficient groups. Pearson’s Chi-square test, Fisher’s-exact test, Mann-Whitney U test were applied to analyse the data. Results: The total study population comprised of 121 mothers with an average age of 25.65±3.71 years and 75% of them consumed non vegetarian diet. A prevalence of 19 (15.7%) deficiency of vit B12 was found among the lactating mothers at six weeks postpartum. Mothers who were vegetarian, multigravida and with complaints of paraesthesia were more associated to cobalamin deficiency. The vit B12 deficient mothers had significantly higher erythrocyte indices than the sufficient group but none of the values were in the megaloblastic range. Conclusion: The vit B12 deficiency was prevalent during early lactation in 19 (15.7%) lactating mothers. The first postnatal visit at six weeks might be the most feasible period to screen and supplement these women to prevent long term sequelae in both mother and child. Haematological parameters were of limited use in identifying vit B12 deficiency during lactation.

Keywords

• cobalamin
• infant
• lactation
• postnatal
• pregnancy