Effect of Maternal Retinol Status at Time of Term Delivery on Retinol Placental Concentration, Intrauterine Transfer Rate, and Newborn Retinol Status

Abstract

Retinol (vitamin A) is essential, so the objective of this Institutional Review Board approved study is to evaluate retinol placental concentration, intrauterine transfer, and neonatal status at time of term delivery between cases of maternal retinol adequacy, insufficiency, and deficiency in a United States population. Birth information and biological samples were collected for mother–infant dyads (n = 260). Maternal and umbilical cord blood retinol concentrations (n = 260) were analyzed by HPLC and categorized: deficient (≤0.7 umol/L), insufficient (>0.7–1.05 umol/L), adequate (>1.05 umol/L). Intrauterine transfer rate was calculated: (umbilical cord blood retinol concentration/maternal retinol concentration) × 100. Non-parametric statistics used include Spearman’s correlations, Mann–Whitney U, and Kruskal–Wallis tests. p-values <0.05 were statistically significant. Only 51.2% of mothers were retinol adequate, with 38.4% insufficient, 10.4% deficient. Only 1.5% of infants were retinol adequate. Placental concentrations (n = 73) differed between adequate vs. deficient mothers (median 0.13 vs. 0.10 μg/g; p = 0.003). Umbilical cord blood concentrations were similar between deficient, insufficient, and adequate mothers (0.61 vs. 0.55 vs. 0.57 μmol/L; p = 0.35). Intrauterine transfer increased with maternal deficiency (103.4%) and insufficiency (61.2%) compared to adequacy (43.1%), p < 0.0001. Results indicate that intrauterine transfer rate is augmented in cases of maternal retinol inadequacy, leading to similar concentrations in umbilical cord blood at term delivery.

Fetal oxidative stress, micronutrient deficiency and risk of retinopathy of prematurity: a nested case-control study

“…This may explain the association between lower levels of copper/zinc and ROP. Maternal and cord vitamin A levels among controls in our study were comparable to previously published studies [48,49]. Cord vitamin A deficiency was one of the independent predictors of ROP in our study.…”

“…In a systematic review, vitamin A supplementation significantly reduced the risk of ROP (RR 0.67, 95% CI, 0.46-0.97), but failed to have any effect on the incidence of severe ROP or mortality [52]. Theone et al found that maternal serum retinol correlated with placental retinol (r = 0.38, p = 0.001) but not with umbilical cord blood retinol (p = 0.33) [48]. Baydas et al found that cord vitamin A levels were significantly lower than the maternal levels, although the latter were within the normal range [53].…”

Plasma Concentrations and Maternal-Umbilical Cord Plasma Ratios of the Six Most Prevalent Carotenoids across Five Groups of Birth Gestational Age

“…However, these results mimic our prior research where we observed a certain level of intrauterine retinol transfer to the fetus was maintained regardless of maternal plasma retinol status, leading to similar newborn retinol concentrations at time of birth [31]. That said, it is still undetermined if body tissue carotenoid concentrations are more variable than plasma concentrations at disparate birth sizes and gestational ages [31]. Therefore, more research is needed to investigate the mechanisms of intrauterine carotenoid transfer with the goal of identifying reference ranges for dietary intake and plasma concentrations for mothers and both term and preterm infants.…”

“…This is evidenced by a wide range of observed values in our study cohort, thus comparing concentrations within the different birth CGA groups is challenging. However, these results mimic our prior research where we observed a certain level of intrauterine retinol transfer to the fetus was maintained regardless of maternal plasma retinol status, leading to similar newborn retinol concentrations at time of birth [ 31 ]. That said, it is still undetermined if body tissue carotenoid concentrations are more variable than plasma concentrations at disparate birth sizes and gestational ages [ 31 ].…”

Plasma Retinol Concentrations and Dietary Intakes of Mother–Infant Sets in Singleton versus Twin Pregnancy

“…In addition, it should be noted that the status of maternal retinol does not always have an impact on infant retinol stores, as there are several factors that can affect this status [35]. Therefore, increasing dietary retinol intake may not necessarily result in an immediate increase in maternal plasma or infant umbilical cord plasma retinol concentrations, since the metabolism and distribution of the nutrient can vary throughout the body [36]. Nonetheless, it is crucial for pregnant women to meet the recommended intake of retinol to fulfill their physiological needs, decrease the risk of VAD, and provide sufficient supply to their newborn infants during breastfeeding [6].…”