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Trial Lecture – time and place
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Adjudication committee
- First opponent: Professor Martina Huemer, University Children’s Hospital Basel, Switzerland
- Second opponent: Professor Tor Strand, University of Bergen,
- Third member and chair of the evaluation committee: Associate professor Anette Ramm-Pettersen, University of Oslo
Chair of the Defence
Associate Professor Runar Almaas, University of Oslo
Principal Supervisor
Senior Consultant Trine Tangeraas, Oslo University Hospital
Summary
Vitamin B12, derived from animal food products, is vital for neurological function and infant development. The aim was to explore infant vitamin B12 deficiency in a Norwegian population, including its frequency and clinical relevance, risk factors, presenting symptoms, and whether newborn screening could have detected it.
We performed a retrospective study with 85 infant cases diagnosed with B12 deficiency and one prospective, observational study with 252 healthy infants who were also controls for the cases, in addition to 850 newborn screening dried blood spot controls.
Ten percent of presumed healthy infants had tHcy>8 µmol/l and tremor or excessive sleep, suggesting infant B12 deficiency. B12 deficiency often presented with severe symptoms like spells of apneas and seizures in infant cases. None of their mothers were vegans or vegetarians. The combination of nitrous oxide and exclusive breastfeeding was associated with an earlier presentation of infant B12 deficiency. We suggest nitrous oxide during labor as a novel risk factor for infant B12 deficiency. Newborn screening failed to identify ≥90% of infants diagnosed with symptomatic B12 deficiency after the newborn period.
Additional information
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