# Assessment of the maternal key micronutrient supply and its correlation with cord blood parameters in twin pregnancies

## TL;DR

This study examines micronutrient deficiencies in twin pregnancies and their impact on cord blood parameters, finding that supplementation can influence newborn outcomes.

## Contribution

The study provides new insights into the correlation between maternal micronutrient supply and cord blood indicators in twin pregnancies.

## Key findings

- Iron, vitamin B12, and vitamin D deficiencies were found in 20.8%, 13.7%, and 12.5% of twin pregnancies, respectively.
- Maternal supplementation with folic acid and vitamin D was associated with higher cord blood levels of these nutrients.
- Positive correlations were observed between maternal and cord blood concentrations of the studied micronutrients.

## Abstract

Multiple pregnancy constitutes a large metabolic expense, so women with twin pregnancies and neonates born as twins might be at risk for micronutrient deficiencies. Therefore, the aim of the study was to assess the supplementation used and supply with key micronutrients: iron, vitamin B12, folic acid and vitamin D in women with twin pregnancies and the correlations with cord blood indicators.

Maternal and cord blood samples were collected from 51 patients with twin pregnancies and 102 newborns born from those pregnancies between October 2020 and September 2023. Ferritin, vitamin B12, folic acid and vitamin D metabolites concentrations were measured. Additionally, the patients completed a questionnaire regarding pre-and intragestational supplementation.

Iron, vitamin B12, and vitamin D deficiency were diagnosed in 20.8, 13.7 and 12.5% of women with twin pregnancies, respectively. No maternal folate deficiency was identified. Positive weak to moderate correlations were demonstrated between the concentrations of all studied indicators in the maternal and cord blood. Pregestational folic acid and vitamin D supplementation was associated with higher cord blood levels of folic acid and 3-epi-25(OH)D3, respectively. 25(OH)D3 and total 25(OH)D concentrations were higher in newborns whose mothers had supplemented vitamin D during pregnancy.

The problem of iron, vitamin B12 and vitamin D deficiencies in twin pregnancies is still valid. Pre-and intragestational supplementation, as well as maternal micronutrient supply affect the cord blood composition of twins.