Breastfed Infants With Spells, Tremor, or Irritability : Rule Out Vitamin B12 Deficiency
(2022) In Pediatric Neurology 131. p.4-12- Abstract
Background: In Norway, 5-10% of neonates and infants have biomarkers suggesting vitamin B12 deficiency from newborn screening tests and unselected clinical screening, respectively. Aims: The aims were to identify risk factors and describe presenting symptoms and biochemical profiles in infants diagnosed with vitamin B12 deficiency. Methods: In this case-control study, we searched hospital medical records for infants younger than one year born in 2011-2018, diagnosed with vitamin B12 deficiency. We compared 85 cases with a control group of 252 infants aged 3-7 months. Parents completed questionnaires. Results: Of the 85 cases with vitamin B12 deficiency, 80% presented with spells (37%) of apneas, motor seizures, or absences within the... (More)
Background: In Norway, 5-10% of neonates and infants have biomarkers suggesting vitamin B12 deficiency from newborn screening tests and unselected clinical screening, respectively. Aims: The aims were to identify risk factors and describe presenting symptoms and biochemical profiles in infants diagnosed with vitamin B12 deficiency. Methods: In this case-control study, we searched hospital medical records for infants younger than one year born in 2011-2018, diagnosed with vitamin B12 deficiency. We compared 85 cases with a control group of 252 infants aged 3-7 months. Parents completed questionnaires. Results: Of the 85 cases with vitamin B12 deficiency, 80% presented with spells (37%) of apneas, motor seizures, or absences within the first two months of life. Tremor (29%) and irritability (18%) were the most common findings at the first examination. Serum total homocysteine ≥10 μmol/L was found in 77% of cases compared to 28% of controls (P < 0.001). None of the mothers were vegetarians, but 25% reported a previous history of vitamin B12 deficiency and 7% had celiac disease. The dose of nitrous oxide given during labor was significantly associated with infant serum total homocysteine level at diagnosis (r = 0.37, 95% confidence interval = 0.16-0.55, P < 0.001) for cases, but not for controls. Conclusion: Spells, tremor, and irritability are common findings in early infant vitamin B12 deficiency. Nitrous oxide given during labor is proposed as a contributing risk factor to the development of early infant vitamin B12 deficiency.
(Less)
- author
- Ljungblad, Ulf Wike ; Astrup, Henriette ; Mørkrid, Lars ; Hager, Helle Borgstrøm ; Lindberg, Morten ; Eklund, Erik A. LU ; Bjørke-Monsen, Anne Lise ; Rootwelt, Terje and Tangeraas, Trine
- organization
- publishing date
- 2022-06
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Apnea, Breastfeeding, Cobalamin, Formula, Infant, Nitrous oxide, Seizure, Vitamin B12
- in
- Pediatric Neurology
- volume
- 131
- pages
- 9 pages
- publisher
- Elsevier
- external identifiers
-
- pmid:35439713
- scopus:85128213289
- ISSN
- 0887-8994
- DOI
- 10.1016/j.pediatrneurol.2022.03.003
- language
- English
- LU publication?
- yes
- id
- 6f45f9de-f20d-4e78-90b0-fa26171ccd8f
- date added to LUP
- 2022-06-17 16:04:43
- date last changed
- 2024-06-13 17:41:26
@article{6f45f9de-f20d-4e78-90b0-fa26171ccd8f,
abstract = {{<p>Background: In Norway, 5-10% of neonates and infants have biomarkers suggesting vitamin B12 deficiency from newborn screening tests and unselected clinical screening, respectively. Aims: The aims were to identify risk factors and describe presenting symptoms and biochemical profiles in infants diagnosed with vitamin B12 deficiency. Methods: In this case-control study, we searched hospital medical records for infants younger than one year born in 2011-2018, diagnosed with vitamin B12 deficiency. We compared 85 cases with a control group of 252 infants aged 3-7 months. Parents completed questionnaires. Results: Of the 85 cases with vitamin B12 deficiency, 80% presented with spells (37%) of apneas, motor seizures, or absences within the first two months of life. Tremor (29%) and irritability (18%) were the most common findings at the first examination. Serum total homocysteine ≥10 μmol/L was found in 77% of cases compared to 28% of controls (P < 0.001). None of the mothers were vegetarians, but 25% reported a previous history of vitamin B12 deficiency and 7% had celiac disease. The dose of nitrous oxide given during labor was significantly associated with infant serum total homocysteine level at diagnosis (r = 0.37, 95% confidence interval = 0.16-0.55, P < 0.001) for cases, but not for controls. Conclusion: Spells, tremor, and irritability are common findings in early infant vitamin B12 deficiency. Nitrous oxide given during labor is proposed as a contributing risk factor to the development of early infant vitamin B12 deficiency.</p>}},
author = {{Ljungblad, Ulf Wike and Astrup, Henriette and Mørkrid, Lars and Hager, Helle Borgstrøm and Lindberg, Morten and Eklund, Erik A. and Bjørke-Monsen, Anne Lise and Rootwelt, Terje and Tangeraas, Trine}},
issn = {{0887-8994}},
keywords = {{Apnea; Breastfeeding; Cobalamin; Formula; Infant; Nitrous oxide; Seizure; Vitamin B12}},
language = {{eng}},
pages = {{4--12}},
publisher = {{Elsevier}},
series = {{Pediatric Neurology}},
title = {{Breastfed Infants With Spells, Tremor, or Irritability : Rule Out Vitamin B12 Deficiency}},
url = {{http://dx.doi.org/10.1016/j.pediatrneurol.2022.03.003}},
doi = {{10.1016/j.pediatrneurol.2022.03.003}},
volume = {{131}},
year = {{2022}},
}