Retinol status and associated factors in mother–newborn pairs

Abstract

Background Vitamin A deficiency is still considered to be a nutritional problem during pregnancy, lactation and early childhood. The present study aimed to assess the vitamin A status of women and their newborns in the Brazilian Northeast and to determine the association between retinol in the maternal serum, umbilical cord blood and colostrum. Methods Vitamin A status in 65 pairs of women and newborns was assessed from samples of the mother’s serum, umbilical cord serum and colostrum using high‐performance liquid chromatography. The inadequacy of the vitamin A status of mothers and infants was identified if the retinol values were <0.7 µmol L−1 in maternal serum or umbilical cord blood or <1.05 µmol L−1 in colostrum. Results The prevalence of inadequate maternal vitamin A status was 21.5% (95% CI: 11.5%–31.5%) and 13.8% [95% confidence interval (CI) = 5.4%–22.2%] based on maternal serum and colostrum, respectively. Among newborns, 41.5% (95% CI = 29.3%–53.5%) presented a low status of vitamin A based on cord serum. Multiple linear regression analysis identified that maternal serum retinol is a predictor of umbilical cord retinol (P = 0.005). Retinol in maternal serum was lower in mothers who were less educated (P = 0.04) and colostrum retinol was higher in older (P = 0.04) and multiparous (P = 0.002) mothers. Conclusions Vitamin A deficiency is a common problem among mothers attended in public hospitals in Northeast Brazil and maternal retinol concentrations are associated with retinol status in newborns. Maternal age, parity and educational level were related to the maternal vitamin A status.

Changes in Vitamin A Levels and the Effect of Early Vitamin A Supplementation on Vitamin A Levels in Infants Throughout the First 6 Months of Life: A Prospective Cohort Study in Chongqing, China

“…In this study, we found very low VA levels (0.499 µmol/L) and a high percentage of infants with VA <0.70 µmol/L (88.6%) among healthy infants at birth. This is consistent with previous results about neonatal VA status from our group and most other research groups (13)(14)(15)(16)(17). Previous studies have found that diet, geography, culture, age, preterm birth and infectious disease were important factors affecting vitamin A levels (6,27).…”

“…At present, as living standards have improved, the VAD rates of adults and older children have fallen significantly worldwide (12). However, the percentage of neonates with VAD remains as high as 42-82% according to some studies (13)(14)(15)(16). In a previous study, we also found a high incidence of neonatal VAD (60.1%) in areas where VAD was uncommon (17,18).…”

“…Is VAD in newborns truly that prevalent? Other studies have suggested that the biological levels of neonatal VA at birth may be much lower than the level of VA in adults (13)(14)(15), speculating that the application of existing VAD diagnostic criteria for older children may overestimate the rate of VAD in newborns (16). However, this hypothesis was not validated in that study.…”

“…These results suggested that the low VA levels of neonates at birth may be a normal physiological state that then increases with age. However, it may be inappropriate to use the VAD diagnostic criteria for adults and older children aged 6-70 months (6) to diagnose VAD in neonates, as this could lead to overestimation of the condition in young infants (16). It is not difficult to explain why in places not known for their high prevalences of VAD, the prevalence of neonatal VAD was so high, as reported in our previous study (17).…”

“…The neonates included in this study were all healthy and born full term (16,17), indicating that infection and preterm birth were not the determining factors for the high prevalence of VA levels below 0.70 µmol/L (16). However, pregnant women (23.3%) in this study, or pregnant women (12.8%) (17) and older children (13.8%) (18) in other studies from Chongqing, China, were much less likely to have a VA level <0.70 µmol/L than neonates.…”