In adults with vitamin B12 deficiency, an inverse correlation between the severity of megaloblastic anemia and the degree of neurological dysfunction has been reported. We aimed to evaluate the association between hematological findings and the results of neurodevelopmental assessment in infants. Denver-II developmental screening test (DDST II) was performed in vitamin B12-deficient infants (n = 122), and its relationship with hematological findings was evaluated. DDST II was abnormal in 15 (12.3%), suspect in 20 (16.4%) and normal in 87 (71.3%) cases. Among the infants aged ≥ 4 months (n = 89), cases with an abnormal DDST II had lower levels of hemoglobin (7.49 ± 3.13 vs. 9.87 ± 1.77 g/dL; P = 0.015), whereas they had higher levels of mean corpuscular volume (MCV) (90.05 ± 19.31 vs. 69.90 ± 10.51 fL; P = 0.002), mean corpuscular hemoglobin (MCH) (28.96 ± 7.50 vs. 22.03 ± 4.58 pg; P = 0.001), homocysteine (44.31 ± 11.51 vs. 21.05 ± 9.23 µmol/L; P < 0.001), transferrin saturation index (25.84 ± 17.72 vs. 9.55 ± 6.38%; P = 0.004) and ferritin (87.28 ± 82.21 vs. 26.59 ± 31.67 ng/mL; P = 0.040) than those with a normal DDST II. The receiver operator characteristic analysis could distinguish infants with an abnormal DDST II from those with a normal DDST II by using a hemoglobin level < 8.75 g/dL [sensitivity: 71.4%, specificity: 76.4%; area under curve (AUC): 0.744], an MCV > 88.4 fL (sensitivity: 76.9%, specificity: 98.2%; AUC 0.813), an MCH > 28.5 pg (sensitivity: 76.9%, specificity: 96.4%; AUC: 0.822), and a homocysteine level > 27.35 µmol/L (sensitivity: 92.9%, specificity: 85.5%; AUC: 0.907). Even mild abnormalities of some commonly evaluated laboratory variables (such as MCV and MCH) in an infant should alert the physicians for the possibility of an underlying vitamin B12 deficiency with some degree of neurological impairment.

中文翻译：

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与维生素 B12 缺乏症婴儿神经发育迟缓相关的血液学发现。

据报道，在维生素 B12 缺乏的成年人中，巨幼红细胞性贫血的严重程度与神经功能障碍的程度呈负相关。我们旨在评估血液学发现与婴儿神经发育评估结果之间的关联。在缺乏维生素 B12 的婴儿 (n = 122) 中进行了 Denver-II 发育筛查试验 (DDST II)，并评估了它与血液学结果的关系。DDST II异常15例（12.3%），疑似20例（16.4%），正常87例（71.3%）。在 ≥ 4 个月的婴儿 (n = 89) 中，DDST II 异常的病例血红蛋白水平较低（7.49 ± 3.13 对 9.87 ± 1.77 g/dL；P = 0.015），而平均红细胞水平较高体积 (MCV)（90.05 ± 19.31 对比 69.90 ± 10.51 fL；P = 0.002），平均红细胞血红蛋白 (MCH)（28.96 ± 7.50 vs. 22.03 ± 4.58 pg；P = 0.001），同型半胱氨酸（44.31 ± 11.51 vs. 21.05 ± 9.23 µmol/L；P < 0.001），转铁蛋白饱和指数（25.84 ± 17.72 vs. 9.55 ± 6.38%；P = 0.004) 和铁蛋白（87.28 ± 82.21 对比 26.59 ± 31.67 ng/mL；P = 0.040）与正常 DDST II 相比。接受者操作特征分析可以通过血红蛋白水平 < 8.75 g/dL 区分 DDST II 异常婴儿和 DDST II 正常婴儿 [敏感性：71.4%，特异性：76.4%；曲线下面积 (AUC)：0.744]，MCV > 88.4 fL（灵敏度：76.9%，特异性：98.2%；AUC 0.813），MCH > 28.5 pg（灵敏度：76.9%，特异性：96.4%；AUC：0.822） , 以及同型半胱氨酸水平 > 27.35 µmol/L（灵敏度：92.9%，特异性：85.5%；AUC：0.907）。