Maternal mental health in late pregnancy and longitudinal changes in postpartum serum vitamin B-12, homocysteine, and milk B-12 concentration among Brazilian women

Authors: BATALHA, MONICA - Universidade Federal Do Rio De Janeiro; DOS REIS COSTA, PAULA - Universidade Federal Do Rio De Janeiro; FERREIRA, ANA - Universidade Federal Do Rio De Janeiro; FREITAS-COSTA, NATHALIA - Universidade Federal Do Rio De Janeiro; FIGUEIREDO, AMANDA - Universidade Federal Do Rio De Janeiro; Shahab-Ferdows, Setareh; HAMPEL, DANIELA - University Of California, Davis; Allen, Lindsay; PEREZ-ESCAMILLA, RAFAEL - Yale University; KAC, GILBERTO - Universidade Federal Do Rio De Janeiro

Submitted to: Frontiers in Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/9/2022
Publication Date: 7/11/2022
Citation: Batalha, M.A., dos Reis Costa, P.N., Ferreira, A.L., Freitas-Costa, N.C., Figueiredo, A.C., Shahab-Ferdows, S., Hampel, D., Allen, L.H., Perez-Escamilla, R., Kac, G. 2022. Maternal mental health in late pregnancy and longitudinal changes in postpartum serum vitamin B-12, homocysteine, and milk B-12 concentration among Brazilian women. Frontiers in Nutrition. 9. Article 923569. https://doi.org/10.3389/fnut.2022.923569.
DOI: https://doi.org/10.3389/fnut.2022.923569

Interpretive Summary: Depression and anxiety are a public health concern for new mothers, but we know little about the relationships of these symptoms with maternal vitamin B-12 status and B-12 milk concentrations. Here, we evaluated such relationships in 88 women from a prospective cohort with information at the third trimester of pregnancy (baseline) and two postpartum time-points (TP) visits: 2–8 (TP1) and 28–50 (TP2) postpartum days. Milk and maternal serum B-12 was measured as well as serum homocysteine concentrations (which are elevated in B-12 deficiency) at all 3 time points. Information about depression and anxiety were extracted from the Edinburgh Postnatal Depression Scale and the State-Trait Anxiety Inventory at baseline and TP2. We found that at TP2, milk B12 was positively associated with serum B-12 concentrations and negatively with homocysteine concentrations. Moreover, an increase in anxiety was related to higher serum homocysteine and lower milk B-12 milk concentrations at the same time point. Therefore, maternal anxiety in the first two months postpartum was associated with maternal biomarkers of B12 status as well as milk B12 concentrations.

Technical Abstract: Background: Perinatal depressive and anxiety symptoms are a public health concern, and little is known regarding their association with maternal biomarkers of B-12 blood status and B-12 milk composition. Objective: To evaluate the association between maternal anxiety and depressive symptoms at the perinatal period and serum B-12 and homocysteine concentrations and B-12 milk concentration. Methods: Eighty-eight women were studied in a prospective cohort with information at the third trimester of pregnancy (baseline) and two postpartum time-points (TP) visits: 2–8 (TP1) and 28–50 (TP2) postpartum days. B-12 milk concentrations were measured by competitive chemiluminescent enzyme immunoassay at TP1 and TP2. Serum B-12 and homocysteine concentrations were evaluated at baseline, TP1, and TP2 by chemiluminescent immunoassays. Depressive and anxiety symptoms were measured with the Edinburgh Postnatal Depression Scale and the State-Trait Anxiety Inventory at baseline and TP2. Spearman's correlation test and multivariate linear regression were performed. Results: The B-12 milk concentrations were positively correlated with B-12 serum concentrations ('= 0.26, P=0.04) and negatively correlated with homocysteine concentrations ('= -0.36, P=0.01) at TP2. Multivariate analysis revealed that for each unit increase in anxiety state score at baseline, serum homocysteine concentrations increased by 0.74% (95% CI: 0.08%, 1.40%; P= 0.03), and B-12 milk concentration decreased by 2.13% (95% CI: -3.89%, -0.34%; P= 0.02) at TP2. Conclusion: The occurrence of anxiety symptoms during pregnancy may be positively associated with maternal serum homocysteine concentration and negatively associated with B-12 milk concentration at the first month postpartum.