Sublingual methylcobalamin treatment in infants with prolonged jaundice due to vitamin B12 deficiency.

Abstract

Ineffective erythropoiesis resulting from vitamin B12 deficiency leads to hemolysis. The breakdown of erythrocytes increases plasma bilirubin levels, which can cause jaundice in newborns. This descriptive cross-sectional study was conducted at the Department of Pediatric Hematology, Antalya Training and Research Hospital. In total, 103 infants with prolonged neonatal jaundice due to vitamin B12 deficiency, defined as a serum level below 250 ng/L, were included. Participants were divided into two groups based on treatment type: sublingual methylcobalamin (Group 1, n = 72) and intramuscular cyanocobalamin (Group 2, n = 31). The mean gestational ages were 38.36 ± 1.4 weeks in Group 1 and 38.87 ± 0.81 weeks in Group 2. The mean ages at diagnosis were 35.74 ± 13.17 days and 35.9 ± 11.73 days, respectively. The female-to-male ratios were 30:42 in Group 1 and 16:15 in Group 2. Mean serum vitamin B12 levels in Group 1 were 138.82 ± 50.09 ng/L before treatment, 656.86 ± 333.16 ng/L at 1.5 months, and 394.08 ± 169.94 ng/L at 3 months following sublingual methylcobalamin therapy. In Group 2, the mean levels were 165.71 ± 56.07 ng/L before treatment, 502.9 ± 196.07 ng/L at 1.5 months, and 345.77 ± 115.42 ng/L at 3 months after intramuscular cyanocobalamin administration. Vitamin B12 deficiency may be associated with prolonged jaundice in neonates. Early diagnosis of vitamin B12 deficiency enables timely initiation of sublingual methylcobalamin, a non-invasive and effective treatment option.