Effect of maternal vitamin A deficiency during pregnancy on neonatal kidney size

El-Khashab, Ehab K.; Hamdy, A.; Maher, Karima M.; Fouad, Mohamed; Abbas, Ghada Z.

doi:10.1515/jpm-2012-0026

Cited by 35 publications

(29 citation statements)

References 20 publications

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“…97 A similar finding was reported among Indian and Egyptian infants, where a reduction in kidney size was associated with reduced maternal vitamin A levels (Supplementary Table 1). 98,99 Supplementation with vitamin A during gestation rescued the nephron number in rats with LBW, but a study in preterm baboons did not show an effect on nephrogenesis. 81,100 Numerous studies have demonstrated that maternal vitamin A supplementation in regions where vitamin A deficiency is common has no effect on birth weight, blood pressure, or microalbuminuria in childhood; such supplementation is, however, associated with improved neonatal and infant survival (Supplementary Figure 1 and Tables 2 and 3).…”

Section: Maternal Micronutrient Deficienciesmentioning

confidence: 95%

Birth weight, malnutrition and kidney-associated outcomes—a global concern

2015

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An adverse intrauterine environment is associated with an increased risk of elevated blood pressure and kidney disease in later life. Many studies have focused on low birth weight, prematurity and growth restriction as surrogate markers of an adverse intrauterine environment; however, high birth weight, exposure to maternal diabetes and rapid growth during early childhood are also emerging as developmental risk factors for chronic diseases. Altered programming of nephron number is an important link between exposure to developmental stressors and subsequent risk of hypertension and kidney disease. Maternal, fetal, and childhood nutrition are crucial contributors to these programming effects. Resource-poor countries experience the sequential burdens of fetal and childhood undernutrition and subsequent overnutrition, which synergistically act to augment the effects of developmental programming; this observation might explain in part the disproportionate burden of chronic disease in these regions. Numerous nutritional interventions have been effective in reducing the short-term risk of low birth weight and prematurity. Understanding the potential long-term benefits of such interventions is crucial to inform policy decisions to interrupt the developmental programming cycle and stem the growing epidemics of hypertension and kidney disease worldwide.

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Section: Maternal Micronutrient Deficienciesmentioning

confidence: 95%

Birth weight, malnutrition and kidney-associated outcomes—a global concern

2015

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“…122 Vitamin A is an important regulator of cell proliferation and differentiation and plays a critical role in the determination of nephron mass. [123][124][125] Vitamin A deficiency is also common in premature infants 126 due in part to increased urinary losses of vitamin A. 127 Although vitamin A supplementation appears to be beneficial in the lung, another branching organ that develops in late gestation, in protecting against chronic lung disease, 128 there are no clinical data on renal outcomes in humans.…”

Section: Research Horizons Nephrogenesismentioning

confidence: 99%

Short-Term Gestation, Long-Term Risk: Prematurity and Chronic Kidney Disease

2013

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Thanks to remarkable advances in neonatal intensive care, infants who once had little chance for survival can now enter adulthood. Yet the consequences of premature birth or low birth weight (LBW) on nephrogenesis, final nephron number, and long-term kidney function are unclear. This review focuses on the theory, experimental evidence, and observational data that suggest an increased risk of chronic kidney disease (CKD) for infants born prematurely. Many premature and LBW infants begin life with an incomplete complement of immature nephrons. They are then exposed to a variety of external stressors that can hinder ongoing kidney development or cause additional nephron loss such as hemodynamic alterations, nephrotoxic medications, infections, and suboptimal nutrition. Acute kidney injury, in particular, may be a significant risk factor for the development of CKD. According to Brenner' s hypothesis, patients with decreased nephron number develop hyperfiltration that results in sodium retention, hypertension, nephron loss, and CKD due to secondary focal segmental glomerulosclerosis. Because the risk of CKD in premature and LBW infants has not been accurately determined, there are no evidence-based recommendations for screening or management. Yet with the first generation of infants from the surfactant era only now reaching adulthood, it is possible that there is already an unrecognized epidemic of CKD. We suggest individualized, risk-based assessments of premature and LBW infants due to the increased risk of CKD and call for additional research into the long-term risk for CKD these infants face.

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“…This explains why the retinol of newborns from deficient mothers is in the majority of studies inferior to that of newborns born to non-deficient mothers [12]. This finding was also observed in Vitamin A deficiency during pregnancy is associated with a rise in maternal and infant mortality and morbidity and mortality in the first year of life.…”

Section: Discussionmentioning

confidence: 78%

“…In India, Radhika et al found that 27% of women have Vitamin A deficiency in a population of 736 pregnant women [11]. In Egypt, in a study of a population of 80 mother-child pairs, 20% of mothers had Vitamin A deficiency and a significant difference between mean retinol of newborns from deficient mothers and those from non-deficient mothers [12]. In Egypt, Hamdy et al found a proportion of 23.5% of pregnant women with a low rate of Vitamin A in a population of 736 with a positive correlation with the rate of Vitamin A of newborns [7].…”

Section: Discussionmentioning

confidence: 99%

“…They all agree that Vit A plays an important role in hematopoiesis, and that anemia is a frequent consequence of its deficit, that it is essential for the embryogenesis, the immune system, the regeneration of the epithelial tissues of various organs, the vision and in several metabolic ways of the organism. For example, maternal Vitamin A deficiency is associated with maternal and neonatal anemia, low birth weight, toxemia of pregnancy, premature labor, and susceptibility to infection and renal hypoplasia of the newborn [7] [11] [12] [13] [19].…”

Section: Discussionmentioning

confidence: 99%

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Vitamin A Status in the Mother-Child Couple at the University Teaching Hospital of Angondje in Gabon

Kamgaing¹,

Rogombé²,

Igondjo³

et al. 2018

OJPed

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Introduction: Vitamin A deficiency is responsible for severe disorders, and sometimes irreversible consequences in children. We aimed to evaluate the Vitamin A status of newborns in Gabon. Method: prospective study from August to December 2017 at the maternity of the University Teaching Hospital of Angondje (Gabon). We included at random mother-child pairs. A nutritional inquiry on Vitamin A was ran in the selected parturient. We performed the measurement of serum retinol booth in mother and child according to standardized and strict criteria, in Gabon and in France. World Health Organization defines Vitamin A deficiency by serum retinol < 0.7 µmol/L. Results: We included 75 mother-child couples. The mean age of the mothers was 25.7 ± 7 years, 89.3% of neonates were an age gestational ≥ 36 weeks, and 10.7% were premature. Mango was the most commonly used source of Vitamin A and 27% of women consumed more than 3 times a week. The prevalence of Vitamin A deficiency is quite important in neonates of our investigation, and justifies a systematic supplementation.

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Effect of maternal vitamin A deficiency during pregnancy on neonatal kidney size

Abstract: Maternal VAD during pregnancy may decrease renal size in the infant at birth. The functional implications of this effect warrant further study.

Cited by 35 publications

References 20 publications

Birth weight, malnutrition and kidney-associated outcomes—a global concern

Birth weight, malnutrition and kidney-associated outcomes—a global concern

Short-Term Gestation, Long-Term Risk: Prematurity and Chronic Kidney Disease

Vitamin A Status in the Mother-Child Couple at the University Teaching Hospital of Angondje in Gabon

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