Serum retinol in post‐partum mothers and newborns from an impoverished South African community where liver is frequently eaten and vitamin A deficiency is absent

Abstract

Serum retinol was assessed in mothers and newborns from an impoverished South African community where liver is frequently eaten and vitamin A deficiency known to be absent. Paired cord and maternal blood (n = 201) were collected after delivery and analysed for serum retinol and C-reactive protein (CRP). Liver intake during pregnancy and intention to breastfeed were also assessed. Mean serum retinol was 1.03 µmol/L ± 0.40 in mothers and 0.73 ± 0.24 µmol/L in newborns, with 21.4% and 49.3% having serum retinol <0.70 µmol/L (<20 µg/dL), respectively. Raised CRP was found in 59.9% of mothers, with a significant negative correlation between serum retinol and CRP (r = -0.273; p < 0.0001). Liver was eaten by 87.6% of mothers, and 99% indicated their intention to breastfeed. Despite consumption of liver, serum retinol was low in both the mother and the newborn. The conventional cut-off for serum retinol, i.e. <0.70 µmol/L may therefore not apply for the mother and newborn in the period immediately after delivery. Serum retinol may be influenced by factors other than vitamin A status, e.g. the haemodilution of pregnancy, as well as the acute phase response induced by the birth process, as suggested by raised CRP in 60% of mothers. In the newborns, the low serum retinol is likely to increase rapidly, as liver is frequently eaten by mothers and practically all of them intended to breastfeed. Our results confirm the need for better indicators of vitamin A status or alternative cut-off values during this period.

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

“…It is also the first prospective investigation of predictors of serum retinol during pregnancy in a lowincome area in Brazil. Literature on the determinants of serum retinol in midgestation is scarce; most available data analysed either the determinants of retinol in the final gestational weeks or VA deficiency during pregnancy or postpartum (26,27) . This study is the first to address this subject in this specific period in a lessdeveloped area of Brazil, which is relevant in view of the physiological characteristics of the forthcoming gestational weeks.…”

The impact of sociodemography, diet, and body size on serum retinol in women 16–35 years of age: SANHANES‐1

“…70,71 Nutrition education regarding purchasing and consumption of low-cost, nutrient-rich foods, such as liver and other organ meats and indigenous green leafy vegetables, should improve the micronutrient status of South Africans, as localized studies have shown that these foods are eaten commonly in poorer segments of South African society. 72 Hence, it was interesting to observe that more than 80% of women in the current study did not consume organ meats and consumed green leafy vegetables fewer than four times a week. By promoting a culture of producing food(s) at a household level instead of relying only on purchasing food(s), access to nutrient dense food(s) could be improved.…”

“…This therefore calls for further studies to monitor the role played by inflammation, as shown by the trend of increasing VAD with an increase in CRP levels in South African women. This relationship between VAD and CRP has been documented in postpartum mothers in South Africa . VAS is still an ongoing program for children aged 0–5 years, but VAS was stopped for postpartum women in 2011 .…”

“…Studies in South Africa and the United States have also shown that the cost of purchasing nutrient‐dense food(s) can be high and, as such, people living in poorer households are more likely to purchase fewer of these nutrient‐dense food(s) and thereby consume less . Nutrition education regarding purchasing and consumption of low‐cost, nutrient‐rich foods, such as liver and other organ meats and indigenous green leafy vegetables, should improve the micronutrient status of South Africans, as localized studies have shown that these foods are eaten commonly in poorer segments of South African society . Hence, it was interesting to observe that more than 80% of women in the current study did not consume organ meats and consumed green leafy vegetables fewer than four times a week.…”

“…This relationship between VAD and CRP has been documented in postpartum mothers in South Africa. 72 VAS is still an ongoing program for children aged 0-5 years, but VAS was stopped for postpartum women in 2011. 14 Alternative interven-tions for alleviating VAD as a public health problem in women of reproductive age should therefore be sought.…”