Neonatal Hyperbilirubinemia in a Turkish Cohort: Association of Vitamin B₁₂

Abstract

BackgroundDeficiency of vitamin B12 (VitB12) causes failure of erytrocyte maturation leading to cell lysis. Red blood cell lysis causes excess heme production that ends with hyperbilirubinemia. In this study, we aimed to evaluate the role of VitB12 in neonatal hyperbilirubinemia (NNH) with prolonged jaundice and to compare patients with control group who did not develop hyperbilirubinemia.MethodsA total of 20 patients (M/F = 13/7) with jaundice and 20 healthy controls (M/F = 11/9) were included in the study.ResultsThe mean indirect bilirubin level of patient group was 9.91 ± 1.90 mg/dL (6.71 - 15.2 mg/dL) and control group was 3.18 ± 1.24 mg/dL (1.16 - 4.96 mg/dL). The mean VitB12 level of patient group was 119.9 ± 43.9 ng/L (42.35 - 178 ng/L) and the control group was 286.17 ± 97.43 ng/L (207.90 - 624.10 ng/L). There was a statistically significant difference in terms of VitB12 level (< 0.001) between the study groups.ConclusionTo our knowledge, this study is the first study showing that low VitB12 level has been observed as a risk factor in NNH for the first time in the literature. We suggest that prophylactic use of VitB12 by pregnant women so will greatly benefit to prevent VitB12 deficiency and its complications in the first years of life such as NNH.

Correlation Between Maternal and Neonatal Vitamin B12 Serum Levels in Full Term Neonates with Physiologic Jaundice

“…Our result is in agreement with that of Eroglu et al [3] who found that the mean vitB12 level in patients was 119.9 ± 43.9 ng/L (42.35 -178 ng/L) while in controls was 286.17 ± 97.43 ng/L (207.90 -624.10 ng/L). They also stated that low vitB12 level has been observed as a risk factor in neonatal hyperbilirubinemia.…”

“…There is an evidence of increased vitB12 absorption during pregnancy, with the newly absorbed vitB12 being more important to placental transport than maternal liver stores. So that, lack of vitB12 rich diet of the mother may cause vitB12deficiency in newborn [3]. So, it is recommended that vitB12 supplement is necessary to avoid both neonatal vitB12 deficiency and hyperbilirubinemia.…”

“…VitB12 is essential for maturation and proliferation of RBCs [2]. Deficiency of VitB12 causes failure of RBC maturation leading to cell lysis which causes excess heme production resulting in indirect hyperbilirubinemia [3].…”

Vitamin B12 deficiency associated with hyperbilirubinemia and cholestasis in infants

“…It is suggested that ineffective erythropoiesis may cause immature erythrocyte formation increasing hemolysis and indirect hyperbilirubinemia. 10 …”

“…For instance, Dasari S et al 11 reported a patient aged 41 with hyperbilirubinemia who was diagnosed with vitamin B12 deficiency and his hyperbilirubinemia was eliminated following vitamin B12 treatment. In addition, Eroglu N et al 10 compared 20 cases with indirect hyperbilirubinemia of above greater than 5 mg/dL with 20 cases whose indirect bilirubin was below 5 mg/dL and found significant serum vitamin B12 deficiency in the former group. This is the only case control study identified in the literature.…”