A Comparison of Vitamin E Status and Associated Pregnancy Outcomes in Maternal–Infant Dyads between a Nigerian and a United States Population

Abstract

Oxidative stress is associated with adverse pregnancy outcomes, and vitamin E has powerful anti-oxidant properties with the potential to impact health outcomes. Tocopherol isomers of vitamin E differ in their ability to modulate inflammation and vary in concentration in diets containing high proportions of processed versus unprocessed foods. The purpose of this study was to compare vitamin E status and associated pregnancy outcomes (mode of delivery, chorioamnionitis, APGARs (measure of appearance, pulse, grimace, activity, respiration), gestational age at delivery, and fetal growth) between maternal–infant dyads in a developed and a developing nation to identify potentially modifiable differences that may impact pregnancy and neonatal outcomes and provide a way to improve maternal and neonatal health. Plasma tocopherol levels were evaluated in 189 Midwestern United States (US) mother–infant pairs and 99 Central Nigerian mother–infant pairs. Maternal and infant concentrations of α-, γ-, and δ-tocopherol were measured using HPLC with diode-array detection. Descriptive statistics were calculated and tocopherol concentrations were associated with clinical outcomes such as mode of delivery, chorioamnionitis, APGARS, and fetal growth. Alpha- and γ-tocopherol levels were higher in the US mothers, (alpha: 12,357.9 (175.23–34,687.75) vs. 8333.1 (1576.59–16,248.40) (mcg/L); p < 0.001) (gamma: 340.7 (224.59–4385.95) vs. 357.5 (66.36–1775.31) (mcg/L); p < 0.001), while δ-tocopherol levels were higher in the Nigerian mothers (delta: 261.7 (24.70–1324.71) vs. 368.9 (43.06–1886.47) (mcg/L); p < 0.001). US infants had higher γ-tocopherol levels than Nigerian infants (203.1 (42.53–1953.23) vs. 113.8 (0.00–823.00) (mcg/L); p < 0.001), while both the Nigerian mothers and infants had higher α:γ-tocopherol ratios (8.5 vs. 26.2, and 8.9 vs. 18.8, respectively; p < 0.001). Our results in both populations show associations between increased circulating γ-tocopherol and negative outcomes like Caesarian sections, in contrast to the associations with positive outcomes such as vaginal delivery seen with increased α:γ-tocopherol ratios. Growth was positively associated with α- and γ-tocopherols in cord blood in the US population, and with cord blood δ-tocopherols in the Nigerian population. Tocopherol levels likely impact health outcomes in pregnancy in a complicated metabolism across the maternal–fetal axis that appears to be potentially influenced by culture and available diet.

Lactational changes of fatty acids and fat-soluble antioxidants in human milk from healthy Chinese mothers

“…γ-Tocopherol also decreases lipid peroxidation (weaker than α-tocopherol) and neutrophilic inflammation (stronger than α-tocopherol), but it can promote type 2 inflammation (18,19) . The latest early life study in both Nigerian and American maternal-neonatal dyads reported the association between decreased circulating α-:γ-tocopherol and negative birth outcomes such as Caesarian sections (20) . The ratios of α-:γ-tocopherol could contribute to a more comprehensive understanding of the infant's vitamin E requirements than α-tocopherol alone, but the ratios in human milk still lack investigation.…”

Metabonomics Study on the Infertility Treated With Zishen Yutai Pills Combined With In Vitro Fertilization-embryo Transfer

“…α-Tocopherol, a major composition moiety of vitamin E, is an important compound in the maintenance of reproduction activity and reputed for its antioxidative activity ( Rimbach et al, 2010 ). It could influence the whole process of reproduction, including the health condition of pregnant women, pregnancy outcome, embryotic development, neonatal development, and so on ( Cave et al, 2018 ). However, in the present study, only a modest increase was observed in alpha-tocopherol succinate.…”

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“…In addition, this vitamin is capable to reduce and counteract oxidative stress during pregnancy, lowering the risk of preeclampsia and preterm birth [180]. Vitamin E levels in maternal blood are also correlated with improved fetal growth [181]. However, high doses of vitamin E (≥400 IU/day) are associated with an apparent decrease in birth weight, and its administration is suggested during the first trimester of pregnancy [182].…”