Assessment of vitamin B12 status and its determinants in children with Severe acute malnutrition

Abstract

Background: Severe acute malnutrition (SAM) remains a major global health problem, particularly in low- and middle-income countries, and is frequently associated with micronutrient deficiencies, including vitamin B12. Despite its clinical importance, vitamin B12 deficiency is often under-recognized in SAM. Objective: To assess serum vitamin B12 status among children with SAM and to identify associated socio-demographic, clinical and haematological determinants. Methods: This cross-sectional study was conducted at Bangladesh Shishu Hospital & Institute among 98 children aged 6–59 months with SAM. Data on socio-demographic characteristics, feeding practices and anthropometric measurement were collected. Serum vitamin B12 levels were measured using Chemiluminescence Immunoassay, with <203 pg/mL considered deficient. Associations were analyzed using Chi-square and Fisher’s exact tests, and logistic regression was performed to identify independent predictors. Results: Vitamin B12 deficiency was found in 12.2% of children. No significant association was observed with age, gender, or socioeconomic status. Predominant breastfeeding beyond six months (p=0.009) were significantly associated with deficiency. Among clinical and haematological factors, oedema (p=0.011), moderate-to-severe anaemia, and abnormal RBC morphology (both p<0.001) showed strong associations. Multivariate analysis identified prolonged breastfeeding (AOR 4.50), moderate-to-severe anaemia (AOR 22.40), and macrocytic/dimorphic RBC morphology (AOR 35.60) as independent predictors. Conclusion: Vitamin B12 deficiency constitutes a significant micronutrient concern among children with severe acute malnutrition and is significantly associated with feeding patterns, and haematological alterations.

DS (Child) H J 2025; 41(1): 20-24