Miss Natalia Olszewska1, Dr Charlotte Frise2,4, Dr Sheba Jarvis3,4
1Imperial College London, London, United Kingdom, 2Imperial College Healthcare NHS Trust, London, United Kingdom, 3Department of surgery and cancer, Imperial College London, London, United Kingdom, 4Queen’s Charlotte and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
Biography:
Natalia Olszewska is 5th year medical student at Barts and the London School of Medicine and Dentistry who underwent Intercalated BSc Programme at Imperial College London related to Reproductive and Developmental Sciences.
Abstract:
Introduction: Vitamin B12 is essential in pregnancy, with deficiency linked to adverse maternal and fetal outcomes (1). Total B12 assay is the most used test to assess levels despite being unreliable in pregnancy (2). Recommended use of active B12 assay is not routinely implemented. This study investigated clinical practices, prevalence and risk factors for vitamin B12 deficiency among pregnant patients.
Methods: This study was conducted at a tertiary London hospital. An electronic survey (QualtricsXM) was distributed among clinicians to explore practices in B12 assessment and treatment in pregnancy. A retrospective analysis was performed of pregnant women who delivered between Jan 2023-Feb 2024 and had an antenatal assessment of total vitamin B12.
Results: The survey found some awareness of risk factors for deficiency, with anaemia being the primary reason for assessment (33.3% of respondents). Only 50% of respondents felt confident about interventions for low B12 levels.
The retrospective analysis revealed total vitamin B12 testing in 28.4% of the pregnant population (total deliveries n=5223), with 7.4% found deficient. Higher deficiency rates were among Asian women (37.7%), vegetarians or vegans (35.9%), multiparous patients (26.5%), those with autoimmune disease (14.2%), endocrine disease (28.3%) and previous bariatric surgery (11.3%). Over 97% of had anaemia, accompanied by iron (94.3%) and folate (31.6%) deficiencies.
Conclusion: This study revealed high rates of total B12 testing within maternity care, highlighting the need for more robust local guidelines aligned with the NICE recommendations for active B12 assessment. The findings support folate and B12 testing alongside ferritin when anaemia is identified. Enhancing clinician education is crucial due to observed gaps in knowledge. Adopting active B12 assay is recommended to improve results’ reliability. These measures are vital for better diagnosis and management of deficiency and to more reliably understand associations with maternal-fetal outcomes.
Keywords
vitamin B12, pregnancy, active B12 assay
References
1. Sobowale OI, Khan MR, Roy AK, Raqib R, Ahmed F. Prevalence and Risk Factors of Vitamin B12 Deficiency among Pregnant Women in Rural Bangladesh. Nutrients [Internet]. 2022 May 1 [cited 2024 May 20];14(10). Available from: /pmc/articles/PMC9144522/
2. NICE. National Institute for Health and Care Excellence. 2015. Active B12 assay for diagnosing vitamin B12 deficiency.