From the Guidelines
The recommended dose of Vitamin B12 (Cobalamin) in cases of deficiency during pregnancy is 1 mg every 3 months via intramuscular depot injection or 1 mg/day orally.
Key Considerations
- The evidence from 1 suggests that postsurgery vitamin B12 regimens should be continued preconception at a dose of 1 mg every 3 months via intramuscular depot injection, and additional vitamin B12 supplementation should be given as needed to maintain serum concentrations within normal limits.
- Alternatively, oral supplementation (1 mg/day) can be used to increase compliance in the patient, but reduced absorption is to be expected as the secretion of intrinsic factor is diminished.
- The study 1 recommends a daily dose of 250–350 μg/d or 1000 μg/wk sublingual, 1000 μg/mo for vitamin B-12 supplementation in adult bariatric surgery patients, but this is not specific to pregnancy.
- However, in the context of pregnancy, the dose recommended by 1 is more relevant and should be prioritized to ensure the health of the mother and the fetus.
Monitoring and Adjustment
- Serum vitamin B12 levels should be monitored at least once per trimester and adjusted as needed to maintain normal concentrations.
- It is essential to note that vitamin B12 deficiency can have severe consequences, especially during pregnancy, and prompt treatment is necessary to prevent complications.
- The patient's overall health, medical history, and other factors should be considered when determining the optimal dose and monitoring schedule.
From the FDA Drug Label
Amounts of vitamin B12 that are recommended by the Food and Nutrition Board, National Academy of Science-National Research Council for pregnant women (4 mcg daily) should be consumed during pregnancy. The recommended dose of Vitamin B12 (Cobalamin) in cases of deficiency during pregnancy is 4 mcg daily 2.
- This dose is based on the recommendations of the Food and Nutrition Board, National Academy of Science-National Research Council.
- It is essential to note that the drug label does not provide a specific dose for treating deficiency, but rather a recommended daily intake for pregnant women.
From the Research
Vitamin B12 Deficiency in Pregnancy
The recommended dose of Vitamin B12 (Cobalamin) in cases of deficiency during pregnancy is not explicitly stated in the provided studies. However, the studies suggest that Vitamin B12 supplementation during pregnancy may reduce the risk of maternal Vitamin B12 deficiency and improve maternal and infant Vitamin B12 status 3.
Dosage of Vitamin B12 Supplementation
The dosage of Vitamin B12 supplementation varied from 5 μg/day to 250 μg/day in the studies reviewed by 3. The administration of Vitamin B12 supplementation began at 8 to 28 weeks' gestation and continued through to delivery or three months' postpartum.
Key Findings
- Vitamin B12 deficiency is a major public health problem worldwide, with the highest burden in elderly people, pregnant women, and young children 3.
- Vitamin B12 supplementation during pregnancy may reduce the risk of maternal Vitamin B12 deficiency compared to placebo or no Vitamin B12 supplementation, but the evidence is very uncertain 3.
- Women who received Vitamin B12 supplements during pregnancy may have higher total Vitamin B12 concentrations compared to placebo or no Vitamin B12 supplementation 3.
- The effects of Vitamin B12 supplementation on other primary outcomes assessed in the review, such as adverse pregnancy outcomes and child cognitive outcomes, were not reported or were not reported in a format for inclusion in quantitative analyses 3.
Importance of Vitamin B12 Supplementation
Vitamin B12 supplementation is crucial for pregnant women, especially those with restricted dietary intake of animal-derived foods, to prevent neurological and neuroradiological findings in infants 4, 5. Vegetarian and vegan mothers should be aware of the severe and not fully-reversible damages caused by insufficient nutritional intake of Vitamin B12 during pregnancy and lactation 5.