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Maternal plasma vitamin B12 concentrations during pregnancy and infant cognitive outcomes at 2 years of age

  • Jun S. Lai (a1), M. Na’im Mohamad Ayob (a1), Shirong Cai (a1) (a2), Phaik Ling Quah (a1), Peter D. Gluckman (a1) (a3), Lynette P. Shek (a1) (a4), Fabian Yap (a5) (a6), Kok Hian Tan (a7), Yap Seng Chong (a1) (a2), Keith M. Godfrey (a8), Michael J. Meaney (a1) (a9), Birit F. P. Broekman (a1) (a10), Anne Rifkin-Graboi (a11) and Mary F. F. Chong (a1) (a12)...


Evidence on long-term influences of maternal vitamin B12 deficiency or concentrations on infant cognition is limited. We examined associations between maternal plasma vitamin B12 and cognitive development in 24-month-old infants. Maternal plasma vitamin B12 concentrations were measured at 26–28 weeks’ gestation; infant cognitive development was assessed with the Bayley Scales of Infant and Toddler Development-III at 24 months, for 443 mother–infant pairs from the Growing Up in Singapore Towards Healthy Outcomes cohort. Linear regressions adjusted for key confounders examined associations of maternal vitamin B12 with cognitive, receptive and expressive language, fine and gross motor subscales. Co-occurrence of maternal vitamin B12 with folate or vitamin B6 insufficiencies on child’s cognition was explored. Average maternal plasma vitamin B12 concentrations was 220·5 ± 80·5 pmol/l; 15 % and 41 % of mothers were vitamin B12 deficient (<148 pmol/l) and insufficient (148–220·9 pmol/l), respectively. Infants of mothers with vitamin B12 deficiency had 0·42 (95 % CI −0·70, −0·14) sd lower cognitive scores, compared with infants of mothers with sufficient vitamin B12. Co-occurrence of maternal vitamins B12 and B6 insufficiencies was associated with 0·37 (95 % CI −0·69, −0·06) sd lower cognitive scores in infants compared with infants of mothers sufficient in both vitamins. No significant associations were observed with other subscales. Study findings suggest the possible need to ensure adequate vitamin B12 during pregnancy. The impact of co-occurrence of maternal B-vitamins insufficiencies on early cognitive development warrants further investigation.


Corresponding author

*Corresponding author: Mary F. F. Chong, email


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J. S. L. and M. N. M. A. are co-first authors.

A. R.-G. and M. F. F. C. are co-last authors.



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