Poster Topical Area: Maternal, Perinatal and Pediatric Nutrition

Location: Hall D

Poster Board Number: 280

P13-022 - Cobalamin and folate status among breastfed infants in Bhaktapur, Nepal

Sunday, Jun 10
8:00 AM – 6:00 PM

Objectives:

The objectives of this study are to explore cobalamin and folate status and describe its determinants among breastfed infants of 6-11 months residing in Bhaktapur municipality of Nepal.


Methods:


We collected plasma samples from 6-11 months-old breastfed infants with a length-for-age of z-score less than -1 and analyzed plasma for folate, cobalamin, methylmalonic acid (MMA) and total homocysteine (tHcy) concentrations. We also calculated a combined indicator of cobalamin (3cB12) because individual biomarkers of cobalamin have their limitations in terms of sensitivity or specificity. Multiple linear regression analyses were done to explore socio-demographic and nutritional characteristics associated with 3cB12.


Results:


Among total 316 infants, marginal cobalamin deficiency (plasma cobalamin 148-221 pmol/L) was found in 24% whereas 11% were cobalamin deficient (plasma cobalamin <148 pmol/L). Based on 3cB12, 58% had poor cobalamin status. Elevated total homocysteine (>10 µmol/L) or methylamlonic acid (>0.28 µmol/L) were found among 53% and 75% infants, respectively. However, folate deficiency (<10 nmol/L) was not found in this population as the lowest value of plasma folate was 20.7 nmol/L. The 3cB12 increased with increasing age of the infants in the unadjusted regression analysis. Being born at low birth weight, exclusively breastfeeding for at least 3 months, and stunting were associated with lower 3cB12. Except for ownership of own residence, none of other variables were associated with 3cB12 when we adjusted for possible confounding variables


Conclusions:


More than 50% of the infants had poor cobalamin status, which is probably due to sub-optimal maternal status and the predominantly vegetarian complementary feeding. The consequences of poor cobalamin status should be a prioritized research question and strategies to improve maternal and child status should be considered.




Funding Source: Thrasher Research Fund

CoAuthors: Manjeswori Ulak – Child Health Research Project; Mari Hysing – Uni Research Health, Bergen, Norway; Ingrid Kvestad – Uni Research Health, Bergen, Norway; Merina Shrestha – Institute of Medicine; Suman Ranjitkar – Child Health Research Project; Laxman Shrestha – Institute of Medicine; Tor Strand – University of Bergen, Norway

Ram KRISHNA.. Chandyo

Ass Professor
Kathmandu Medical College
Bhaktapur, Bagmati, Nepal