Umbilical cord blood plasma vitamin A levels in low birth weight (LBW) babies

The association between umbilical cord blood fat-soluble vitamin concentrations and infant birth weight

Background

Fat-soluble vitamins, including vitamins A, D and E, play an important role in the regulation of glucose and lipid metabolism, and may affect infant birth weight. Evidence on the association of birthweight with fat-soluble vitamins is controversial. Therefore, this study aims is to determine the associations of birthweight with vitamin A, D, and E concentrations in cord blood.

Methods

A total of 199 mother-infant pairs were enrolled in the study. According to gestational age and birth weight, the mother-infant pairs were divided into small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). The Vitamin A, D, and E concentrations in serum were measured by high-performance liquid chromatography tandem-mass spectrometry.

Results

The concentrations of vitamin A in the SGA group were significantly lower than those in the AGA and LGA groups. The concentrations of vitamin E in the SGA group were significantly higher than those in the AGA and LGA groups. However, no significant differences were observed in vitamin D among the three groups. Being male (β = 0.317, p < 0.001) and birth weight (β = 0.229, p = 0.014) were positively correlated with the levels of vitamin A. Birth weight (β = -0.213, p= 0.026) was correlated with lower levels of vitamin E. No correlation was found between influencing Factors and the levels of vitamin D (p> 0.05). After adjusting for gestational age, sex, mother's age, delivery mode, pre-pregnancy BMI, and weight gain during pregnancy, the levels of cord blood vitamin A were positively correlated with birth weight (p=0.012).

Conclusion

The infant's birth weight is associated with the levels of cord blood vitamins A and E. The dysregulation of vitamins A and E in infants may be a risk factor for fetal growth and future metabolic diseases.

Breast milk retinol concentration in mothers of preterm newborns

BACKGROUND

Preterm newborns have low vitamin A reserves at birth, which increases their risk of morbidity and mortality. In the absence of supplementation, breast milk is the only source of this nutrient for exclusively breastfed infants.

AIMS

To assess retinol concentration in preterm milk and the relationship between this retinol concentration and lactation phase, degree of prematurity, and maternal serum retinol level.

STUDY DESIGN

Longitudinal study.

SUBJECTS

Fifty-eight preterm mothers.

OUTCOME MEASURES

Colostrum (1-3d), transitional (7-15d), and mature human milk (30-55d) samples were collected. Maternal blood was collected once at postpartum. Retinol level was measured using high-performance liquid chromatography.

RESULTS

Milk retinol concentration was statistically different between lactation phases (p<0.001): 2.84±1.05μmol/L in colostrum (58), 3.47±1.28μmol/L in transitional (58), and 2.03±0.61μmol/L in mature milk (30). No difference was found in milk retinol levels between groups with different degrees of prematurity (p>0.05). Maternal serum retinol (1.82±0.50μmol/L) did not correlate with milk levels (p>0.05).

CONCLUSIONS

Retinol level in preterm milk seems to be independent of the degree of prematurity and maternal serum status. A significant increase in micronutrient levels in transitional milk was observed, which is likely to contribute to reserves in the premature liver.

Antioxidant Levels in Cord Blood of Term Neonates and Its Association with Birth Weight

OBJECTIVE

Due to excessive production of free radicals and antioxidants evolved mechanisms against oxidative stress, infants are very vulnerable. As there was a significant relation between antioxidant levels and birth weight, we aimed verify this relationship.

MATERIALS & METHODS

In this descriptive analytical study we evaluated the antioxidant status of 40 healthy term newborns (gestation age 38-42 wk) with weight >2500 g (AGA) and 40 healthy term newborns (gestation age 38-42 wk) with LBW babies (weight < 2500 g) (SGA) in Ardabil Buali Hospital, Ardabil, northwest Iran in 2014. About 15 Ml of cord blood was collected after the second stage of labor. The levels of vitamin A, E, and C, catalase, glutathione peroxidase (GPX), bilirubin and serum uric acid were measured by standard methods. Informed consent was obtained from newborn mothers and study protocol was approved by university Ethics Committee. Data were analyzed using SPSS.19.

RESULTS

The mean levels of bilirubin, vitamin C, E, catalase and GPX in AGA group were significantly higher than SGA group but the mean of serum uric acid in SGA group was more than AGA. In addition, the mean of vitamin A was similar in two groups. There was a significant relation between antioxidant levels and birth weight in term newborns.

CONCLUSION

In line with other studies the amounts of antioxidant levels except serum uric acid in AGA group was significantly more than SGA group.

Vitamin A for preterm infants; where are we now?

In the 35 years since low plasma vitamin A levels were first described in premature infants, much effort has gone into attempting to describe the functional consequences of vitamin A deficiency in this population. Supplementation of extremely low birth weight infants with intramuscular (i.m.) vitamin A has a significant but modest beneficial effect upon the development of chronic lung disease (NNT 13), most likely due to reduced production of pro-inflammatory cytokines. Early high dose i.m. vitamin A also improves retinal development and there are limited clinical and laboratory data suggesting a role for vitamin A in prevention of retinopathy of prematurity. Despite evidence of benefit, there is reluctance to give routine i.m. vitamin A in the neonatal intensive care unit, but current intravenous supplementation is almost certainly inadequate. Further work is required to identify the optimal dose and most appropriate route of administration of vitamin A for preterm infants.