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Congenital B12 deficiency following maternal gastric bypass

M Y Celiker1, A Chawla

  • 1Division of Pediatric Hematology/Oncology, Department of Pediatrics, Stony Brook University Medical Center, Stony Brook, NY 11794, USA. mceliker@stonybrook.edu

Journal of Perinatology : Official Journal of the California Perinatal Association
|August 28, 2009
PubMed

Insights

Maternal B12 deficiency after gastric bypass can cause severe infant deficiency, leading to developmental delays and neurological issues. Early screening and treatment are crucial for affected infants.

Area of Science:

  • Pediatric Nutrition
  • Maternal Health
  • Neurology

Background:

  • Gastric bypass surgery can lead to long-term nutrient deficiencies, including vitamin B12.
  • Exclusive breastfeeding transmits nutrient status from mother to infant.
  • Severe vitamin B12 deficiency can manifest in infancy with significant health consequences.

Observation:

  • An exclusively breastfed infant presented with pancytopenia and developmental delay at 4 months.
  • The infant's mother had a history of gastric bypass surgery 6 years prior.
  • Clinical evaluation revealed physical and neurological developmental delay, pancytopenia with macrocytosis, and cerebral atrophy on imaging.

Findings:

  • Serum studies confirmed low vitamin B12 levels, with normal folate and iron.
  • Parenteral vitamin B12 treatment resolved pancytopenia and improved neurological status and weight gain.
  • Despite treatment, the child exhibits significant gross motor and speech developmental delays at 16 months.

Implications:

  • Maternal vitamin B12 deficiency post-gastric bypass poses a risk for severe infant deficiency and long-term neurological sequelae.
  • Routine screening for vitamin B12 deficiency in pregnant women and infants with a history of maternal gastric bypass is essential.
  • Prompt diagnosis and intervention are critical to mitigate severe developmental outcomes in affected infants.

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