Vitamin B-12 status in infancy is positively associated with development and cognitive functioning 5 y later in
Ingrid Kvestad1, Mari Hysing1, Merina Shrestha2
1Regional Center for Child and Youth Mental Health and Child Welfare, West, Uni Research Health, Bergen, Norway.
Insights
Infant vitamin B-12 status impacts child development and cognitive skills at age five. Poor vitamin B-12 (cobalamin) levels in infancy are linked to developmental delays and lower cognitive scores later in childhood.
Area of Science:
- Nutritional Neuroscience
- Developmental Pediatrics
Background:
- Vitamin B-12 (cobalamin) deficiency is prevalent in South Asia.
- Inadequate vitamin B-12 status in early life is associated with impaired neurodevelopment in young children.
Purpose of the Study:
- To investigate the association between infant vitamin B-12 status and neurodevelopmental outcomes at age five in Nepalese children.
- To assess the long-term impact of early-life cobalamin levels on cognitive functioning and overall development.
Main Methods:
- Vitamin B-12 status in 320 infants (2-12 months) was determined using plasma cobalamin, total homocysteine (tHcy), and methylmalonic acid (MMA).
- At age five, child development was assessed using the Ages and Stages Questionnaire (ASQ-3), and cognitive functioning using the Developmental Neuropsychological Assessment (NEPSY II).
- Regression models analyzed the relationship between a combined vitamin B-12 indicator (3cB12) and ASQ-3/NEPSY II scores.
Main Results:
- Except for plasma cobalamin, all infant vitamin B-12 markers correlated significantly with total ASQ-3 scores.
- Higher 3cB12 scores in infancy predicted better ASQ-3 scores at age five (increase of 4.88 points per unit increase).
- Elevated plasma tHcy and MMA (indicating deficiency) were linked to lower NEPSY II scores in affect recognition and geometric puzzle tasks. Higher 3cB12 scores correlated with improved scores in affect recognition, geometric puzzles, and block construction.
Conclusions:
- Infant vitamin B-12 status is significantly associated with developmental progress and cognitive abilities, including social perception and visuospatial skills, at age five.
- The findings highlight the critical role of adequate vitamin B-12 during infancy for long-term neurodevelopmental outcomes.
- Further research, including randomized controlled trials, is warranted to confirm the long-term effects of early vitamin B-12 status.
Abstract:
Background: Poor vitamin B-12 (cobalamin) status is widespread in South Asia. Insufficient vitamin B-12 status has been linked to poor neurodevelopment in young children.Objective: We measured the associations between vitamin B-12 status in infancy (2-12 mo) and the development and cognitive functioning in Nepalese children 5 y later.Design: Vitamin B-12 status was assessed in infancy with the use of plasma cobalamin, total homocysteine (tHcy), and methylmalonic acid (MMA). At 5 y of age, we measured development with the use of the Ages and Stages Questionnaire, 3rd edition (ASQ-3), and cognitive functioning by using the Developmental Neuropsychological Assessment, 2nd edition (NEPSY II), in 320 children. In regression models, we estimated the associations between vitamin B-12 status, including a combined indicator of vitamin B-12 status (3cB12) and scores on the ASQ-3 and NEPSY II subtests.Results: All markers of vitamin B-12 status with the exception of plasma cobalamin were significantly associated with the total ASQ-3 scores in the multiple regression models. A 1-unit increase in the 3cB12 score was associated with an increase in the total ASQ-3 score of 4.88 (95% CI: 2.09, 7.68; P = 0.001). Increases in both plasma tHcy and MMA (indicating poorer status) were associated with a decrease in scores on the NEPSY II affect recognition and geometric puzzle subtests. Each unit increment in 3cB12 scores was associated with increases of 0.82 (95% CI: 0.49, 1.14; P < 0.0005), 0.59 (95% CI: 0.10, 1.09; P = 0.020), and 0.24 (95% CI: 0.02, 0.47; P = 0.035) in the affect recognition, geometric puzzle, and block construction scores, respectively.Conclusions: Vitamin B-12 status in infancy is associated with development and performance on social perception tasks and visuospatial abilities at 5 y of age. The long-term effects of poor vitamin B-12 status in infancy need further investigation in randomized controlled trials.
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