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QJM Advance Access published online on March 12, 2008
QJM, doi:10.1093/qjmed/hcn031
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© The Author 2008. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

High rate of maternal vitamin B12 deficiency nearly a decade after Canadian folic acid flour fortification

J.G. Ray1, J. Goodman2, P.R.A. O'Mahoney3, M.M. Mamdani4 and D. Jiang4

From the 1Department of Medicine, Department of Obstetrics and Gynecology and Department of Health Policy Management and Evaluation, St Michael's Hospital University of Toronto, Toronto, 2Strategies and Innovation, Gamma-Dynacare Medical Laboratories, Brampton, Ontario, Canada, 3School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland and 4Applied Health Research Centre, Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada

Address Correspondence to Dr. J.G. Ray, Department of Medicine, Department of Obstetrics and Gynecology and Department of Health Policy Management and Evaluation, and the Division of Endocrinology and Metabolism, St Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, Canada. email: rayj{at}smh.toronto.on.ca

Received 31 December 2007 and in revised form 30 January 2008


  Abstract

Vitamin B12 deficiency may be an independent risk factor for neural tube defects (NTD). We determined the prevalence of biochemical B12 deficiency (<125 pmol/l) among 10 622 Ontarian women aged 15–46 years who underwent concomitant testing of serum bhCG and B12 9 years after the implementation of Canadian folic acid flour fortification. The overall prevalence of biochemical B12 deficiency was 7.4%. Relative to non-pregnant women, the adjusted odds ratio (95% confidence interval) of biochemical B12 deficiency was 0.78 (0.60–1.0) among women pregnant 28 days gestation or less and was 1.4 (1.1–1.8) after 28 days gestation. About 1 in 20 women may be deficient in B12 in early pregnancy. The impact on maternal and fetal well-being, including preventable NTD, should be considered.


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