Maternal Vitamin B12 status during pregnancy:Association of low vitamin B12 with markers of oxidative stress- MPO,Ox-LDL and IsoPs

A.    Background- Nutritional deficiencies among pregnant women is a public health problem of global concern. It is the most frequently encountered problem in pregnant women in India, & is a major cause of maternal and fetal complications including mortality. Vitamin B12 deficiency is an important contributor to deficiency manifestations, in addition to iron and folate deficiency. In India, anemia during pregnancy is a significant public health problem, with 45.7% of pregnant women in urban areas and 52.1% in rural areas having hemoglobin levels <11 g/dl.

B.    Objectives- a) To measure levels of oxidative stress markers – MPO, Ox-LDL & IsoPs in pregnant females having a vitamin B12 deficiency b) To detect vitamin B12-mediated oxidative damage in the mothers.

C.     Methodology- It is a hospital-based cross-sectional study. The study will be carried out in the Clinical Biochemistry lab in collaboration with the Department of Obstetrics & Gynecology & Department of Pathology at AIIMS, Rajkot. The pregnant females coming for their antenatal visits will be selected from the outpatient department of Obstetrics & Gynecology. Patients showing signs & symptoms of anemia will be the main target group of this study. Diagnosis of anemia will be made using the following WHO criteria: hemoglobin levels less than 11.0 g/dl in the first and third trimesters and less than 10.5 g/dl in the second trimester with the presence of signs and symptoms. The patients having Vitamin B12 deficiency (Vit B12 levels - 1st trimester 118 - 438 pg/ml, 2nd trimester 130 - 656 pg/ml, 3rd trimester 99 - 526 pg/ml) will be differentiated from patients having Iron deficiency (Ferritin levels <10 Microgm/L). Inclusion criteria: All pregnant females (age group 18 – 40 years) with Vitamin B12 deficiency, irrespective of their gestational age. All subjects will be undergoing interviews using questionnaires. The sample size will be of 385.