Assessment of RBC Folate and Serum Vitamin B12 Levels in Pakistani Women of Reproductive Age Group: An Approach towards Prevention of Adverse Pregnancy Outcomes

Background: Folate and Vitamin B12 are important micronutrients necessary for fetal growth and development. Deficiencies of these vitamins in women of reproductive age results in adverse pregnancy outcome.

Objective: To determine red blood cell folate and serum Vitamin B12 levels in apparently healthy women of reproductive age group.

Methodology: The study was conducted in Baqai medical university, Karachi. Apparently healthy volunteer women (N=196) between ages of 15 and 49 years residing in different areas of Karachi were selected after fulfilling the inclusion and exclusion criteria. The cut off values for defining Vitamin B12 deficiency, marginal insufficiency and folate insufficiency were <203 pg/mL, 203-299 pg/mL, and <400 ng/mL, respectively. Analysis of red blood cell folate and serum vitamin B12 levels was done after complete blood count and peripheral smear morphology.

Results: The mean serum vitamin B12 and red blood cell folate levels were 233.69 ± 54.10 pg/mL and 540.34 ± 54.04 ng/mL. Percent values of Vitamin B12 deficiency and marginal insufficiency were 42% and 46%. All of the study participants had red blood cell folate levels >400 pg/mL. A significant negative association was present between age and serum vitamin B12 levels.

Conclusion: Low serum levels of vitamin B12 in women of reproductive age group can be considered an important etiologic factor for adverse pregnancy outcomes especially neural tube defects. The need is to asses pre-conceptional level of vitamin B12 and to implement public health program especially food fortification to improve vitamin B12 status.