Amniotic Fluid Retinol Concentrations in Late Pregnancy

Koskinen, T; Valtonen, Pirjo; Lehtovaara, I.; Tuimala, Risto

doi:10.1159/000242514

Cited by 11 publications

(5 citation statements)

References 11 publications

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“…One study found that amniotic fluid levels of retinol were higher among normal pregnancies than those with complications such as diabetes and pre‐eclampsia. The authors interpreted their results to suggest that complications may affect transport of retinol into the amniotic fluid, possibly through a mechanism involving poor uteroplacental perfusion . This is consistent with studies by Neel et al., which found that cord serum levels of retinol were positively associated with birthweight, and Ortega‐Senovilla et al., which found that plasma retinol at delivery was higher in mothers with intrauterine growth restriction and that the ratio of umbilical vein plasma levels to maternal levels of retinol were lower in intrauterine growth restriction than appropriate‐for‐gestational‐age controls .…”

Section: Discussionsupporting

confidence: 81%

Small‐for‐gestational‐age birth and maternal plasma antioxidant levels in mid‐gestation: a nested case–control study

Cohen

Kahn

Platt

et al. 2015

BJOG

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Objective To assess whether maternal plasma antioxidant levels in mid-pregnancy are associated with small-for-gestational-age (SGA) birth.Design Case-control study nested within a population-based cohort study.Setting Four hospitals in Montreal, Canada.Population Pregnant women recruited before 24 weeks of gestation, whose pregnancies were not complicated by preeclampsia or preterm delivery.Methods Blood samples were obtained at 24-26 weeks and assayed for nutritionally derived antioxidant levels in SGA cases (n = 324) and randomly selected controls with birthweights between the 25th and 75th centiles (n = 672). We performed logistic regression analyses using the standardised z-score of each antioxidant as the main independent variable, after summing highly correlated antioxidants or combining via principle component analysis. We adjusted for risk factors for SGA that were associated with antioxidant levels.Main outcome measures SGA, birthweight <10th centile for gestational age and sex.Results Retinol was positively associated with risk of SGA (adjusted odds ratio [OR] 1.41; 95% confidence interval [95% CI] 1.22-1.63, per SD increase). Carotenoids (log of the sum of bcarotene, lutein/zeaxanthin, a-and b-cryptoxanthin) were negatively associated with SGA (adjusted OR 0.64; 95% CI 0.54-0.78, per SD increase). We found no significant associations between SGA and lycopene or any of the forms of vitamin E assessed, including a-tocopherol, corrected a-tocopherol (per nmol/l of low-density lipoprotein articles), or c-tocopherol.Conclusions Elevated retinol may be associated with an increased risk of SGA, whereas elevated carotenoid levels may reduce the risk. A better understanding of the nature of these associations is required, however, before recommending specific nutritional interventions in an attempt to prevent SGA birth.

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Section: Discussionsupporting

confidence: 81%

Small‐for‐gestational‐age birth and maternal plasma antioxidant levels in mid‐gestation: a nested case–control study

Cohen

Kahn

Platt

et al. 2015

BJOG

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“…The role of vitamin A and beta‐carotene (provitamin A) in pregnancy‐induced hypertension and PE is also a subject of controversy. Many clinical studies have found significantly lower levels of vitamin A and beta‐carotene in preeclamptic women than in healthy women 181–185 . However, the decreased levels of retinol and beta‐carotene might be secondary to disease as a part of an acute‐phase reaction rather than a causal relationship.…”

Section: Vitamin Amentioning

confidence: 99%

“…Many clinical studies have found significantly lower levels of vitamin A and beta-carotene in preeclamptic women than in healthy women. [181][182][183][184][185] However, the decreased levels of retinol and betacarotene might be secondary to disease as a part of an acute-phase reaction rather than a causal relationship. Further studies are needed to determine the temporal relationship between carotenoids and the risk of adverse pregnancy outcomes.…”

Section: Vitamin Amentioning

confidence: 99%

Role of nutrition in the risk of preeclampsia

Shatenstein

Luo

et al. 2009

Nutrition Reviews

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Preeclampsia (PE) accounts for about one-quarter of the cases of maternal mortality and ranks second among the causes of pregnancy-associated maternal deaths in Canada and worldwide. The identification of an effective strategy to prevent PE is a priority and a challenge for research in obstetrics. Progress has been hampered by inadequate understanding of the underlying etiology of the disease. The role of maternal diet in the etiology of PE has recently received increased attention. The objective of this paper is to provide an overview of the literature concerning 1) the current understanding of the pathogenesis of PE, 2) the biological plausibility and potential mechanisms underlying the associations between maternal dietary exposures, nutrition, and the risk of PE, and 3) the epidemiological findings of maternal nutrient intake in relation to the risk of PE.

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“…This decrease was found both in serum 37±40 as well as amniotic¯uid 41 . The constant association between decreased retinol and b-carotene levels with pre-eclampsia, however, does not prove a causal relationship.…”

Section: Resultsmentioning

confidence: 76%

“…Many observational studies found a signi®cant decrease in vitamin A and b-carotene in pre-eclamptic women when compared with normal pregnant women. This decrease was found both in serum 37±40 as well as amniotic¯uid 41 . The constant association between decreased retinol and b-carotene levels with pre-eclampsia, however, does not prove a causal relationship.…”

Section: Vitamin a And Hypertensive Disorders Of Pregnancymentioning

confidence: 76%

Vitamin A and causes of maternal mortality: association and biological plausibility

Faisel¹,

Pittrof

2000

Public Health Nutr.

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Objective: To review the association between major causes of maternal mortality and vitamin A, trying to determine if these associations are causal in nature, and to highlight possible biological pathways that may explain vitamin A effects. Design: Literature review, observational studies and clinical trials. The strength of association was determined by applying Bradford Hill criteria of causality. Results: In a vitamin A de®cient population, vitamin A is essential for adequate treatment of anaemia. While vitamin A does not seem to be capable of preventing uterine atony, obstetric or surgical trauma, which are important causes of haemorrhage, it might be capable of preventing or decreasing coagulopathy. Possible effects on the placenta as regards implantation, site and size are not clear. As regards pregnancy-related infections, vitamin A supplementation can improve wound healing by decreasing ®brosis and increasing transforming growth factor-b (TFG-b). It can increase resistance to infection by increasing mucosal integrity, increasing surface immunoglobulin A (sIgA) and enhancing adequate neutrophil function. If infection occurs, vitamin A can act as an immune enhancer, increasing the adequacy of natural killer (NK) cells and increasing antibody production. b-carotene in its provitamin form can act as an antioxidant by decreasing endothelial cell damage (the pathognomonic feature of pre-eclampsia) and promote the vasodilator effect of nitric oxide that might bring about a better outcome of toxaemia in pregnancy. It is unlikely that vitamin A or b-carotene has an effect on obstructed labour. Conclusions: Plausible biomedical pathways can only be constructed for obstetric haemorrhage, anaemia in pregnancy, hypertension in pregnancy and pregnancyrelated infections. A 40% reduction in the maternal mortality ratio, as observed in Nepal, is unlikely to be solely explained through the aforementioned pathways. KeywordsVitamin A Maternal mortality Biological plausibility Over the last decade, the role of vitamin A in decreasing the mortality and morbidity of infectious diseases in children has been established. Now, its importance to women of reproductive age has become a focus of interest. The results of a randomized controlled trial of vitamin A and b-carotene supplementation to women aged 15±45 years in Nepal suggest that this supplementation resulted in a signi®cant reduction in maternal mortality (vitamin A, 40% reduction; b-carotene, 50% reduction 1 ). Maternal mortality is a major public health problem in developing countries, and decreasing its burden is vital. Of the estimated 585 000 maternal deaths that occur every year approximately 25% are caused by haemorrhage, 15% by infections, 13% by abortion complications, 12% by complications of hypertensive disease in pregnancy, pre-eclampsia or eclampsia and 8% by obstructed labour 2 . Anaemic women are at higher risk of death if these complications occur.Only if the effect of vitamin A supplementation can be explained through biomedical pathways can we ass...

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Amniotic Fluid Retinol Concentrations in Late Pregnancy

Cited by 11 publications

References 11 publications

Small‐for‐gestational‐age birth and maternal plasma antioxidant levels in mid‐gestation: a nested case–control study

Small‐for‐gestational‐age birth and maternal plasma antioxidant levels in mid‐gestation: a nested case–control study

Role of nutrition in the risk of preeclampsia

Vitamin A and causes of maternal mortality: association and biological plausibility

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