Predictors of vitamin A status among pregnant women in Western Brazilian Amazon

Abstract

Determining the predictors of serum retinol at mid-pregnancy is relevant for planning interventions aimed at improving vitamin A status of pregnant women and their offspring. This prospective study assessed predictors of serum retinol at the beginning of the third trimester of pregnancy. We enrolled 442 pregnant women living in the urban area of Cruzeiro do Sul, Western Brazilian Amazon. Demographic, socio-economic, environmental and clinical characteristics as well as obstetric history, anthropometric, dietary and biochemical data, including serum retinol, were gathered between 16 and 20 gestational weeks. Serum retinol also measured at the beginning of the third trimester of pregnancy (approximately 28 gestational weeks) was the outcome of interest. Multiple linear regression models were used to evaluate associations with the outcome. Overall, the following variables explained serum retinol at the beginning of the third trimester of pregnancy in the adjusted model (R2 = 11·1 %): seasonality (winter season – November to April; β=0·134; 95 % CI 0·063, 0·206), weekly consumption of Amazonian fruits (β=0·087; 95 % CI 0·012, 0·162) and retinol concentrations between 16 and 20 gestational weeks (β=0·045; 95 % CI 0·016, 0·074) were positively associated, whereas having a smoker in the house was negatively associated (β=–0·087; 95 % CI: –0·166, –0·009). Consumption of pro-vitamin A-rich fruits by pregnant women should be encouraged. Passive smoking may play a role in decreasing vitamin A status as a proxy of smoking exposure during pregnancy.

Geographic and socio-demographic determinants of plasma retinol concentrations in Chinese pregnant and lactating women

“…In our study, the median plasma retinol for women in mid-pregnancy (1.26 µmol/L) and late pregnancy (1.07 µmol/L) was similar to those from a Beijing study (1.29 and 1.15 µmol/L) [24], but lower than those from a Chinese national survey (1.64 and 1.52 µmol/L) [10], likely due to differences in population characteristics related to the sample selections. Two international studies reported retinol concentration by trimester of pregnancy [14,25], 1.90 µmol/L for Brazilian women during mid-pregnancy [14] and 1.33 µmol/L for English women during late pregnancy [25]. Our study showed that the prevalence of vitamin A deficiency was 2.6% for pregnant women.…”

“…Reports on vitamin A by trimester of pregnancy were limited [10,14,23,24]. In our study, the median plasma retinol for women in mid-pregnancy (1.26 µmol/L) and late pregnancy (1.07 µmol/L) was similar to those from a Beijing study (1.29 and 1.15 µmol/L) [24], but lower than those from a Chinese national survey (1.64 and 1.52 µmol/L) [10], likely due to differences in population characteristics related to the sample selections.…”

“…and provitamin A carotenoids from plant sources (such as most green, yellow and orange fruits and vegetables) [11]. Despite dietary intakes, periods of pregnancy and maternal socio-demographic factors might influence vitamin A status in pregnant women [12][13][14] or women of childbearing age [15], but related data are scarce for pregnant women [10] and lacking for lactating women in China. In addition, given the distinct dietary patterns across China, vitamin A status might be sensitive to the region sampled.…”

Cohort profile: the Maternal and Child Health and Nutrition in Acre, Brazil, birth cohort study (MINA-Brazil)

“…To date, we have published few papers on baseline data 10 11 31–34. Key reports included poor serum retinol status observed throughout pregnancy31 found to be negatively associated with maternal haemoglobin (β −3.30 g/L; 95% CI −6.4 to –0.20) and newborn birth weight (β −0.10 kg; 95% CI −0.20 to –0.00) 11. According to WHO, 7.8% and 41.8% of all pregnancies worldwide are affected by gestational night blindness and anaemia, respectively 35 36.…”

Bebês com choro excessivo no início da vida: ocorrência e fatores associados na coorte de nascimentos MINA-Brasil

“…iii) fatores relacionados à mulher: situação conjugal (casada ou mora com companheiro), presença do pai da criança no domicílio; iv) obstétricos e de saúde: tipo de parto, número de gestações, paridade (número de gestações), anemia no parto, peso pré gestacional, ganho de peso na gestação, xeroftalmia na gestação avaliada por meio de entrevista padronizada proposta pela OMS e adaptada para o Brasil ( NEVES et al, 2019); v) fatores relacionados ao bebê: sexo, peso e comprimento ao nascer, apgar, idade gestacional de nascimento, se houve aleitamento materno na primeira hora de vida, tipo de aleitamento.…”