Other B Vitamins

Several B vitamin deficiencies cause homocysteine-mia, notably folic acid, vitamin B12, riboflavin, and vitamin B6. Importantly, homocysteinemia is associated with adverse pregnancy outcomes. In a large retrospective study in Norway, for example, women in the highest 25% of plasma homocysteine concentrations had significantly more placental abruption, stillbirths, very low-birth-weight and pre-term infants, preeclampsia, club foot, and NTDs in their offspring compared to women with values in the lowest 25%. Supplementation with folic acid up to 500-600 mg/day lowers plasma homocysteine, but few studies have been done on the other B vitamins. Of these, it is most difficult for poor women to obtain their dietary vitamin B12 requirement because this vitamin in found only in animal source foods, such as meat and dairy products.

The recommended intakes of most B vitamins and choline are increased above nonpregnant values as shown in Table 1 The increases are based on evidence for higher maternal requirements (in the case of thiamin, riboflavin, niacin, and vitamin B6) and for fetal and placental deposition of the vitamin (thiamin, riboflavin, niacin, vitamin B6, vitamin B12, and choline). UL values, the same as for non-pregnant women, have been set for niacin when consumed as nicotinic acid in supplements based on a 'flushing' reaction and for choline based on cholinergic reactions and a fishy body odor.

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