The importance of
folate in reproduction can be appreciated by considering that the existence of the
vitamin was first suspected from efforts to explain a potentially fatal
megaloblastic anemia in young pregnant women in India. Today, low maternal
folate status during pregnancy and lactation remains a significant cause of maternal morbidity in some communities. The
folate status of the neonate tends to be protected at the expense of maternal stores; nevertheless, there is mounting evidence that inadequate maternal
folate status during pregnancy may lead to low infant
birthweight, thereby conferring risk of developmental and long-term adverse health outcomes. Moreover,
folate-related
anemia during childhood and adolescence might predispose children to further
infections and disease. The role of
folic acid in prevention of
neural tube defects (NTD) is now established, and several studies suggest that this protection may extend to some other
birth defects. In terms of maternal health, clinical
vitamin B12 deficiency may be a cause of
infertility or recurrent
spontaneous abortion. Starting pregnancy with an inadequate
vitamin B12 status may increase risk of
birth defects such as NTD, and may contribute to preterm delivery, although this needs further evaluation. Furthermore, inadequate
vitamin B12 status in the mother may lead to frank deficiency in the infant if sufficient fetal stores of
vitamin B12 are not laid down during pregnancy or are not available in breastmilk. However, the implications of starting pregnancy and lactation with low
vitamin B12 status have not been sufficiently researched.