B12 in pregnancy

Supplementation of vitamin B12 in pregnancy and postpartum on growth and cognitive functioning in early childhood

Globally, vitamin B12 deficiency is one of the most common micronutrient deficiencies. The only relevant source of vitamin B12 is animal-source foods; in addition poor gut function may decrease absorption. Vitamin B12 is crucial for normal cell division and differentiation, and necessary for the development and myelination of the central nervous system. Deficiency is also associated with impaired fetal and infant growth. In this randomized controlled trial we measure the effect of daily oral vitamin B12 supplementation to pregnant women on the neurodevelopment and growth of their children. This is an individually randomized double-blind placebo controlled trial in pregnant Nepalese women at risk of poor vitamin B12 status. We will randomize 800 women in a 1:1 ratio as early as possible during pregnancy, and no later than in week 15. Enrolled women will receive 50 µg of vitamin B12, or a placebo, daily until 6 months after birth. The main outcomes of the study are neurodevelopment in children, measured at 6 and 12 months of age, and growth in children measured by weight and length at 12 months. The results of this study will inform revised dietary guidelines for South Asian women that can lead to improved pregnancy outcomes as well as improved child neurodevelopment and cognitive functioning.

Project Management Team

Principal Investigators
SUDHA BASNET is a pediatrician with considerable clinical and research experience in child health in Nepal. Basnet has made significant contributions to the design, implementation, analyses and dissemination of two large randomized controlled trials (community based and hospital based) on zinc as adjunct treatment of pneumonia in young children. Basnet is currently a Postdoctoral fellow at the Centre for International Health/Department of Global Public Health and Primary Care, UiB and Associate Professor of Pediatrics, Tribhuvan University Institute of Medicine, Nepal.
LAXMAN PRASAD SHRESTHA is a medical doctor specializing in pediatrics with a degree from All India Institute of Medical Sciences, New Delhi. He is the principal investigator and co-principal investigator of multiple studies focusing on child health issues in Nepal, including pneumococcal vaccination, zinc supplementation, enteric infections, Hib vaccination, community newborn health and health networks. Shrestha has co-authored a wide range of research papers published in peer-reviewed journals. Shrestha is currently Professor and Head of Department of Paediatrics at Thribhuvan University Teaching Hospital, Kathmandu, Nepal.
Co-Principal Investigator
TOR A STRAND has a longstanding research interest in immunity, infection and nutrition. His work has focused on zinc, B vitamins and vitamin D and common childhood infections such as diarrhea and pneumonia. He has undertaken clinical trials of micronutrient supplementation to prevent diarrheal and respiratory infections, as well as studies on the aetiology, natural history and risk factors of pneumonia and severe bacterial illnesses. Micronutrient deficiencies, inflammation and infections are all risk factors for poor neurodevelopment and growth in young children, and these are the focus of many of his ongoing studies. He is a research professor at Innlandet Hospital Trust, University of Bergen, and Innlandet University of Applied Sciences.


Ram Krishna Chandyo


Suman Ranjitkar



Geeta Gurung



Merina Shrestha



Mari Hysing


Manjeswori Ulak



Ingrid Kvestad