USE OF VITAMIN B12 IN PREGNANCY

Vitamin B12 refers to a group of cobalt-containing vitamers including hydroxocobalamin and cyanocobalamin. Both of these forms of vitamin B12 have been used in the prophylaxis and treatment of anaemia due to vitamin B12 deficiency. Hydroxocobalamin is also used in much higher doses as an antidote for cyanide poisoning. No specific UK guidelines regarding vitamin B12 supplementation during pregnancy currently exist. The RCOG states that there is no strong evidence to support routine supplementation of the B vitamins (with the exception of folic acid) during pregnancy.

Vitamin B12 is naturally occurring in many foods derived from animal sources. There are limited published data regarding the use of supplemental vitamin B12 (in any form) during pregnancy, however there is no evidence or reason to expect that use would be associated with an increased risk of congenital malformation or other adverse fetal effects. In a woman with a healthy and varied diet, the use of additional vitamin supplements in pregnancy would not usually be required, however where a deficiency state exists, or where vitamin B12 is required in the management of maternal illness or poisoning, treatment should not be withheld.

The use of supplemental vitamin B12 at any stage in pregnancy would not usually be regarded as medical grounds for termination of pregnancy or any additional fetal monitoring. Where use of high-dose vitamin B12 has been administered as an antidote during pregnancy in maternal poisoning, enhanced antenatal surveillance may be warranted and should be decided on a case-by-case basis. Discussion with UKTIS is recommended in all such cases.