Subclinical vitamin B12 deficiency in pregnant women attending an antenatal clinic in Nigeria

Inadequate vitamin B12 status in a pregnant woman increases the risk for adverse maternal and fetal outcomes. The use of serum vitamin B 12 concentration alone to assess vitamin B 12 status in pregnant women is unreliable because of the decrease in serum vitamin B 12 levels in normal pregnancy. The combination of serum vitamin B 12 and methylmalonic acid (MMA) concentrations may provide a better estimate of vitamin B12 status. We obtained blood samples from 98 pregnant women in the third trimester at an antenatal clinic in Jos, Nigeria. All subjects were taking iron and folate supplements. Twelve of the subjects had a serum vitamin B 12 concentration <148 pmol/l and 18 subjects had a serum MMA level >271 nmol/l. Using a combination of low serum vitamin B12 and elevated MMA concentrations, eight subjects were classified as having subclinical vitamin B 12 deficiency. Because of the potential harmful consequences of vitamin B 12 deficiency in pregnant women, it would be advisable to add vitamin B12 supplements to the existing regimen of folate and iron supplements currently provided to pregnant women in Nigeria.