# Oral Methylcobalamin Treatment Effectiveness of Newborn with Vitamin B12 Deficiency

## Authors

- Sinan Tufekci ([ORCID](https://orcid.org/0000-0003-0367-3828)) — Department of Pediatrics, Division of Neonatology, Faculty of Medicine, Tekirdağ Namık Kemal University
- Ozgur Kizilca ([ORCID](https://orcid.org/0000-0003-1587-7051)) — Department of Pediatrics, Division of Pediatric Cardiology, Faculty of Medicine, Namık Kemal University
- Ozge Yerlioglu ([ORCID](https://orcid.org/0000-0003-0879-3300)) — Department of Pediatrics, Faculty of Medicine, Tekirdağ Namık Kemal University,

## Article information

- **Journal:** The Ulutas Medical Journal (Ulutas Med J), ISSN 2149-388X
- **Issue:** Volume 7, Issue 1 (2021), pages 31–37
- **Article type:** Original Article
- **Published online:** 2021-03-23
- **DOI:** [10.5455/umj.20210222023948](https://doi.org/10.5455/umj.20210222023948)
- **Licence:** [CC BY-NC 4.0](https://creativecommons.org/licenses/by-nc/4.0/)
- **Article page:** https://www.ulutasmedicaljournal.com/?mno=58231
- **PDF:** https://www.ulutasmedicaljournal.com/pdf/58231.pdf

## Abstract

Introduction: Vitamin B12 (Vit-B12) levels between the mothers and their infants in a neonatology unit were investigated and the effectiveness of oral methylcobalamin treatment in neonatal Vit-B12 deficiency was evaluated. Materials and Methods: Eighty patients born between July 2018 and April 2020 at 34-42 weeks of gestation and who were found to have Vit-B12 deficiency were included in this cross-sectional study. Oral methylcobalamin was given to 40 patients, and 40 patients were followed up. Vit-B12 level and blood gas were measured in the umbilical cord blood of the infants, and a complete blood count was performed on the first day. Vit-B12 levels of the mothers were assessed. Complete blood count and Vit-B12 level were measured on the postnatal 30th day in patients who were followed up without treatment and 5 days after treatment in patients who received oral methylcobalamin treatment for 1 month. Results: In the treatment group, the mean umbilical cord Vit-B12 level was 155.5 (±29.1) pg/ml, and the mean Vit-B12 level of the mothers was 158.8 (±57.6) pg/ml. The mean follow-up Vit-B12 level was 801.8 (±394.7) pg/ml. In the untreated group, the mean umbilical cord Vit-B12 level was 159.3 (±34.1) pg/ml, and the mean Vit-B12 level in mothers was 146.2 (±49.7) pg/ml. The mean follow-up Vit-B12 level was 189.2 (±57.6) pg/ml. Conclusion: There was a positive correlation between umbilical cord Vit-B12 and mothers' Vit-B12 levels. Oral methylcobalamin treatment was found to be effective and safe in Vit-B12 deficiency.

## Keywords

Maternal vitamin B12 deficiency; newborn vitamin B12 deficiency; oral methylcobalamin treatment; umbilical cord

## How to cite

Tufekci S, Kizilca O, Yerlioglu O. Oral Methylcobalamin Treatment Effectiveness of Newborn with Vitamin B12 Deficiency. Ulutas Med J. 2021;7(1):31-37. doi:10.5455/umj.20210222023948

## References

1. Allen LH. How common is vitamin B-12 deficiency? Am J Clin Nutr. 2009;89(2):693–6 https://doi.org/10.3945/ajcn.2008.26947a
2. Venkatramanan S, Armata IE, Strupp BJ, Finkelstein JL. Vitamin B12 and cognition in children. Adv Nutr. 2016;7(5): 879–88 https://doi.org/10.3945/an.115.012021
3. Dror DK, Allen LH. Effect of vitamin B12 deficiency on neurodevelopment in infants: current knowledge and possible mechanisms. Nutr Rev. 2008;66(5):250– 5 https://doi.org/10.1111/j.1753-4887.2008.00031.x
4. Yilmaz S, Serdaroglu G, Tekgul H, Gokben S. Different neurologic aspects of nutritional B12 deficiency in infancy. J Child Neurol. 2016;31(5):565 –8
5. Tanyildiz HG, Yeşil S, Okur I, Yuksel D, Sahin G. How does B12 deficiency of mothers affect their infants? Iran J Pediatr. 2017;27(5):e12898 https://doi.org/10.5812/ijp.12898
6. Rasmussen SA, Fernhoff PM, Scanlon KS. Vitamin B12 deficiency in children and adolescents. J Pediatr. 2001;138(1): 10–7 https://doi.org/10.1067/mpd.2001.112160
7. Sezer RG, Bozaykut A, Handan A, Akoğlu HA, Özdemir GN. The efficacy of oral vitamin B12 replacement for nutritional vitamin B12 deficiency. J Pediatr Hematol Oncol. 2018;40(2): e69–72 https://doi.org/10.1097/mph.0000000000001037
8. Verma D, Chandra J, Kumar P, Shukla S, Sengupta S. Efficacy of oral methylcobalamin in treatment of vitamin B12 deficiency anemia in children. Pediatr Blood Cancer. 2017; 64(12):e26698 https://doi.org/10.1002/pbc.26698
9. Aparicio-Ugarriza R, Palacios G, Alder M, González-Gross M. A review of the cut off points for the diagnosis of vitamin B12 deficiency in the general population. Clin Chem Lab Med. 2015;53(8):1149– 59 https://doi.org/10.1515/cclm-2014-0784
10. Devalia V, Hamilton MS, Molloy AM, British Committee for Standard in Haematology. Guidelines for the diagnosis and treatment of cobalamin and folate disorders. Br J Haematol. 2014;166(4):496-513 https://doi.org/10.1111/bjh.12959
11. Wintrobe MM. The diagnostic and therapeutic approach to hematologic problems. Wintrobe’s clinical hematology. Lippincott Williams & Wilkins 2008. Vol. 1. p.23–5
12. Winckel MV, Velde SV, Bruyne RD, Biervliet SV. Clinical practice: vegetarian infant and child nutrition. Eur J Pediatr. 2011;170(12):1489– 94
13. Rogne T, Myrte J, Tielemans MJ, Chong MFF, Krishnaveni GV, Poston L, et al. Associations of maternal vitamin B12 concentration in pregnancy with the risks of preterm birth and low birth weight: A systematic review and meta-analysis of individual participant data. Am J Epidemiol. 2017;185(3): 212–23 https://doi.org/10.1093/aje/kww212
14. Bozkaya I, Yarali N, Kizilgün M, Ozkan S, Tunc B. Relationship between the levels of Holotranscobalamin and vitamin B12 in children. Indian J Hematol Blood Transfus. 2017;33(4):537–40
15. Akin F, Yavuz H, Bodur S, Kiyici A. Vitamin B12 levels of subjects aged 0-24 year(s) in Konya, Turkey. J Health Popul Nutr. 2014;32(4):615– 22
16. Stabler SP. Clinical practice. Vitamin B12 deficiency. N Engl J Med. 2013;368(2):149– 60
17. Carmel R. How I treat cobalamin (vitamin B12) deficiency. Blood. 2008;112(6):2214–21 https://doi.org/10.1182/blood-2008-03-040253
18. Wang H, Li L, Qin LL, Song Y, Vidal-Alaball J, Liu TH. Oral vitamin B 12 versus intramuscular vitamin B 12 for vitamin B12 deficiency. Cochrane Database Syst Rev. 2018;3:CD004655 https://doi.org/10.1002/14651858.cd004655.pub3
19. Turkish Hematology Association, B12 vitamin deficiency diagnosis and treatment guidelines. National treatment guidelines; 2011
20. Bahadir A, Reis PG, Erduran E. Oral vitamin B12 treatment is effective for children with nutritional vitamin B12 deficiency. J Paediatr Child Health. 2014;50(9):721–5 https://doi.org/10.1111/jpc.12652
21. Sezer RG, Akoğlu HA, Bozaykut A, Özdemir GN. Comparison of the efficacy of parenteral and oral treatment for nutritional vitamin B12 deficiency in children. Hematology. 2018;23(9): 653–7 https://doi.org/10.1080/10245332.2018.1456023
22. Strong AP, Langdana F, Haeusler S, Weatherall M, Krebs J. Sublingual vitamin B12 compared to intramuscular injection in patients with type 2 diabetes treated with metformin: a randomized trial. N Z Med J. 2016;129(1436):67–7