The Benefit of Detecting Reduced Intracellular B12 Activity through Newborn Screening Remains Unclear.

IF 4 Q1 GENETICS & HEREDITY
Stella Knöpfli, Bernadette Goeschl, Maximilian Zeyda, Anna Baghdasaryan, Margot Baumgartner-Kaut, Matthias R Baumgartner, Marion Herle, Julian Margreitter, Martin Poms, Saskia B Wortmann, Vassiliki Konstantopoulou, Martina Huemer
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Abstract

Vitamin B12 (B12) deficiency (B12D) can have detrimental effects on early growth and development. The Austrian newborn screening (NBS) program targets inborn errors of cobalamin metabolism and also detects B12D. Of 59 included neonates with B12D suspected by NBS, B12D was not further investigated in 16 (27%) retrospectively identified cases, not confirmed in 28 (48%), and confirmed in 15 (25%) cases. NBS and recall biomarkers were recorded. Age at sampling of the dried blood spots for NBS and the 1st-tier methionine/phenylalanine ratio were the strongest parameters to predict B12D (67.4% correct allocations). No differences between cases with confirmed, unconfirmed, or unknown B12D or differences to norms were observed for growth and psychomotor development (Vineland III scales, phone interviews with parents of children between months 10 and 14 of life). B12 intake was below recommendations in most mothers. NBS can detect reduced intracellular B12 activity. No advantage of NBS detection and treatment regarding infant cognitive development or growth could be proven. Since conspicuous NBS findings cannot be ignored, and to prevent exposing newborns to invasive diagnostics, assessment of maternal B12 status during pregnancy seems advisable.

通过新生儿筛查检测细胞内 B12 活性降低的益处尚不明确。
维生素 B12(B12)缺乏症(B12D)会对早期生长发育造成不利影响。奥地利的新生儿筛查(NBS)项目主要针对钴胺素代谢先天性错误,同时也检测 B12D。在纳入的 59 名通过 NBS 怀疑患有 B12D 的新生儿中,有 16 例(27%)回顾性病例未对 B12D 进行进一步检查,28 例(48%)未确诊,15 例(25%)确诊。记录了 NBS 和回顾性生物标志物。干血斑采样年龄和第一级蛋氨酸/苯丙氨酸比值是预测 B12D 的最强参数(分配正确率为 67.4%)。在生长发育和精神运动发育方面(维尼兰量表 III,对出生后第 10 个月至第 14 个月的儿童家长进行的电话访谈),未观察到确诊、未确诊或 B12D 未知病例之间的差异,也未观察到与常模的差异。大多数母亲的 B12 摄入量低于推荐值。NBS 可检测出细胞内 B12 活性的降低。NBS 检测和治疗对婴儿的认知发展或生长发育并无益处。由于明显的 NBS 结果不容忽视,而且为了避免新生儿接受侵入性诊断,在怀孕期间对母亲的 B12 状态进行评估似乎是明智之举。
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来源期刊
International Journal of Neonatal Screening
International Journal of Neonatal Screening Medicine-Pediatrics, Perinatology and Child Health
CiteScore
6.70
自引率
20.00%
发文量
56
审稿时长
11 weeks
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