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MATCOBIND (Maternal Cobalamin; Infant NeuroDevelopment)
MATCOBIND is a randomised controlled trial to compare two different doses of maternal B12 supplementation in improving infant B12 deficiency and neurodevelopment. Vitamin B12, also called cobalamin, is a water-soluble vitamin that has a key role in the normal functioning of the brain and nervous system. Well known consequences of the deficiency of this vitamin include megaloblastic anemia, peripheral neuropathy, neuropsychiatric syndromes and subacute combined degeneration of spinal cord. Deficiency of Vitamin B12 is widely reported among children in many low- to middle-income countries (LMIC). Deficiency is also known to be widespread in antenatal mothers with estimates of up to 74%. In recent times, there has been rising interest in the consequences of this deficiency in pregnant mothers. While any nutrient deficiency during antenatal period may lead to adverse outcomes in newborns, deficiency of B12 is particularly important given the role Vitamin B12 plays in neuronal health and could potentially play in the developing fetal and infant brain. Several studies have shown that antenatal Vitamin B12 deficiency in the mother is associated with poorer neurodevelopment of the infants later. Infants who were exclusively breast fed and born to vegetarian mothers were at particularly higher risk. It has also been shown that Vitamin B12 supplementation during pregnancy and early lactation increases maternal, breast milk, and infant measures of vitamin B12 status. Therefore, we are conducting a double blind randomized controlled trial in two different settings (Nepal and India) to evaluate the efficacy of two different doses of supplementation with Vitamin B12 from first trimester to 6 months post-partum and their relative effect on infant neurodevelopment.
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