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Hanson C, Lyden E, Anderson-Berry A, Kocmich N, Rezac A, Delair S, Furtado J, Van Ormer M, Izevbigie N, Olateju EK, Akaba GO, Anigilaje EA, Yunusa T, Obaro S. Status of Retinoids and Carotenoids and Associations with Clinical Outcomes in Maternal-Infant Pairs in Nigeria. Nutrients 2018; 10:E1286. [PMID: 30213044 PMCID: PMC6165164 DOI: 10.3390/nu10091286] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 09/07/2018] [Accepted: 09/10/2018] [Indexed: 01/22/2023] Open
Abstract
Vitamin A is an essential nutrient in pregnancy, and other carotenoids have been independently associated with maternal-infant outcomes. The objective of this study was to quantify the status of vitamin A and carotenoids in Nigerian maternal-infant pairs at delivery, compare these to a cohort from a developed nation, and determine the impact on clinical outcomes. Maternal and cord blood samples were collected in 99 Nigerian mother-infant pairs. Concentrations of lutein + zeaxanthin, β-cryptoxanthin, lycopene, α- and β-carotenes, and retinol were measured using HPLC. Descriptive statistics were calculated and Spearman coefficients were used to assess correlations between maternal and cord measurements; Mann-Whitney tests were used to compare median plasma values between dichotomous variables. Linear regression models were used to adjust for relevant confounders. A p < 0.05 was considered statistically significant. Thirty-five percent of mothers had plasma retinol concentrations ≤0.70 µmol/L; 82% of infants had plasma retinol concentrations ≤0.70 µmol/L at delivery. Maternal and infant concentrations of vitamin A compounds were highly correlated and were associated with newborn growth and Apgar scores. Despite plasma concentrations of pro-vitamin A carotenoids higher than those reported in other populations, pregnant Nigerian women have a high prevalence of vitamin A deficiency. As vitamin A related compounds are modifiable by diet, future research determining the clinical impact of these compounds is warranted.
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Affiliation(s)
- Corrine Hanson
- College of Allied Health Professions Medical Nutrition Education, University of Nebraska Medical Center, Omaha, NE 68198-4045, USA.
| | - Elizabeth Lyden
- College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198-4375, USA.
| | - Ann Anderson-Berry
- Pediatrics 981205 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE 68198-1205, USA.
| | - Nicholas Kocmich
- Pediatrics 981205 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE 68198-1205, USA.
| | - Amy Rezac
- Pediatrics 981205 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE 68198-1205, USA.
| | - Shirley Delair
- Pediatrics 981205 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE 68198-1205, USA.
| | - Jeremy Furtado
- Department of Nutrition, Harvard School of Public Health 655 Huntington Avenue, Boston, MA 02215, USA.
| | - Matthew Van Ormer
- Pediatrics 981205 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE 68198-1205, USA.
| | - N Izevbigie
- University of Abuja Teaching Hospital Gwagwalada-Zuba, Gwagwalada P.M.B. 228, Nigeria.
| | - E K Olateju
- University of Abuja Teaching Hospital Gwagwalada-Zuba, Gwagwalada P.M.B. 228, Nigeria.
| | - Godwin O. Akaba
- University of Abuja Teaching Hospital Gwagwalada-Zuba, Gwagwalada P.M.B. 228, Nigeria.
| | - E A Anigilaje
- University of Abuja Teaching Hospital Gwagwalada-Zuba, Gwagwalada P.M.B. 228, Nigeria.
| | - Thairu Yunusa
- University of Abuja Teaching Hospital Gwagwalada-Zuba, Gwagwalada P.M.B. 228,
| | - Stephen Obaro
- Pediatrics 981205 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE 68198-1205, USA.
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Lymperaki E, Tsikopoulos A, Makedou K, Paliogianni E, Kiriazi L, Charisi C, Vagdatli E. Impact of iron and folic acid supplementation on oxidative stress during pregnancy. J OBSTET GYNAECOL 2015; 35:803-6. [DOI: 10.3109/01443615.2015.1011102] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Cohen JM, Kahn SR, Platt RW, Basso O, Evans RW, Kramer MS. Small-for-gestational-age birth and maternal plasma antioxidant levels in mid-gestation: a nested case-control study. BJOG 2015; 122:1313-21. [PMID: 25677044 DOI: 10.1111/1471-0528.13303] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2014] [Indexed: 11/27/2022]
Abstract
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 pre-eclampsia 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 β-carotene, lutein/zeaxanthin, α- and β-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 α-tocopherol, corrected α-tocopherol (per nmol/l of low-density lipoprotein articles), or γ-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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Affiliation(s)
- J M Cohen
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.,Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - S R Kahn
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.,Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - R W Platt
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.,Department of Pediatrics, McGill University, Montreal, QC, Canada
| | - O Basso
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.,Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada
| | - R W Evans
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - M S Kramer
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.,Department of Pediatrics, McGill University, Montreal, QC, Canada
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Association between vitamin B12intake and EURRECA's prioritized biomarkers of vitamin B12in young populations: a systematic review. Public Health Nutr 2012; 16:1843-60. [DOI: 10.1017/s1368980012003953] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
AbstractObjectiveTo review evidence on the associations between vitamin B12intake and its biomarkers, vitamin B12intake and its functional health outcomes, and vitamin B12biomarkers and functional health outcomes.DesignA systematic review was conducted by searching electronic databases, until January 2012, using a standardized strategy developed in the EURRECA network. Relevant articles were screened and sorted based on title and abstract, then based on full text, and finally included if they met inclusion criteria. A total of sixteen articles were included in the review.SettingArticles covered four continents: America (n4), Europe (n8), Africa (n1) and Asia (n3).SubjectsPopulation groups included healthy infants, children and adolescents, and pregnant and lactating women.ResultsFrom the total number of 5815 papers retrieved from the initial search, only sixteen were eligible according to the inclusion criteria: five for infants, five for children and adolescents, and six for pregnant and lactating women.ConclusionsOnly one main conclusion could be extracted from this scarce number of references: a positive association between vitamin B12intake and serum vitamin B12in the infant group. Other associations were not reported in the eligible papers or the results were not provided in a consistent manner. The low number of papers that could be included in our systematic review is probably due to the attention that is currently given to research on vitamin B12in elderly people. Our observations in the current systematic review justify the idea of performing well-designed studies on vitamin B12in young populations.
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Parker JA, Barroso F, Stanworth SJ, Spiby H, Hopewell S, Doree CJ, Renfrew MJ, Allard S. Gaps in the evidence for prevention and treatment of maternal anaemia: a review of systematic reviews. BMC Pregnancy Childbirth 2012; 12:56. [PMID: 22727258 PMCID: PMC3475131 DOI: 10.1186/1471-2393-12-56] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Accepted: 06/01/2012] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Anaemia, in particular due to iron deficiency, is common in pregnancy with associated negative outcomes for mother and infant. However, there is evidence of significant variation in management. The objectives of this review of systematic reviews were to analyse and summarise the evidence base, identify gaps in the evidence and develop a research agenda for this important component of maternity care. METHODS Multiple databases were searched, including MEDLINE, EMBASE and The Cochrane Library. All systematic reviews relating to interventions to prevent and treat anaemia in the antenatal and postnatal period were eligible. Two reviewers independently assessed data inclusion, extraction and quality of methodology. RESULTS 27 reviews were included, all reporting on the prevention and treatment of anaemia in the antenatal (n = 24) and postnatal periods (n = 3). Using AMSTAR as the assessment tool for methodological quality, only 12 of the 27 were rated as high quality reviews. The greatest number of reviews covered antenatal nutritional supplementation for the prevention of anaemia (n = 19). Iron supplementation was the most extensively researched, but with ongoing uncertainty about optimal dose and regimen. Few identified reviews addressed anaemia management post-partum or correlations between laboratory and clinical outcomes, and no reviews reported on clinical symptoms of anaemia. CONCLUSIONS The review highlights evidence gaps including the management of anaemia in the postnatal period, screening for anaemia, and optimal interventions for treatment. Research priorities include developing standardised approaches to reporting of laboratory outcomes, and information on clinical outcomes relevant to the experiences of pregnant women.
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Affiliation(s)
- Jacqui A Parker
- Department of Obstetric Anaesthesia, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9BQ, UK
| | - Filipa Barroso
- Department of Haematology, Barts and London Hospitals NHS Trust & NHS Blood & Transplant, London, UK
| | - Simon J Stanworth
- Department of Haematology, John Radcliffe Hospital, NHS Blood & Transplant/Oxford Radcliffe Hospitals Trust, University of Oxford, Oxford, UK
| | - Helen Spiby
- School of Nursing, Midwifery and Physiotherapy, University of Nottingham, Nottingham, UK
| | - Sally Hopewell
- Systematic Review Initiative, NHS Blood & Transplant, John Radcliffe Hospital, Oxford, UK
| | - Carolyn J Doree
- Systematic Review Initiative, NHS Blood & Transplant, John Radcliffe Hospital, Oxford, UK
| | - Mary J Renfrew
- Mother and Infant Research Unit, Dept of Health Sciences, University of York, York, UK
| | - Shubha Allard
- Department of Haematology, Barts and London Hospitals NHS Trust & NHS Blood & Transplant, London, UK
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Abstract
The complex relationship between maternal nutritional and birth outcomes emphasizes the need for consistent and thorough assessments of women's diet throughout pregnancy and individualized nutritional education to promote positive birth outcomes. The purpose of this article is to examine the influence of prenatal nutrition on birth outcomes, describe research on the effects of macro- and micronutrients on birth outcomes, and discuss strategies for monitoring diet and implementing nutrition education during pregnancy.
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Affiliation(s)
- Eileen R Fowles
- Mennonite College of Nursing, Illinois State University, Campus Box 5810, Normal, IL 61790-5810, USA.
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Rao S, Yajnik CS, Kanade A, Fall CH, Margetts BM, Jackson AA, Shier R, Joshi S, Rege S, Lubree H, Desai B. Intake of micronutrient-rich foods in rural Indian mothers is associated with the size of their babies at birth: Pune Maternal Nutrition Study. J Nutr 2001; 131:1217-24. [PMID: 11285330 DOI: 10.1093/jn/131.4.1217] [Citation(s) in RCA: 300] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
One third of the Indian babies are of low birth weight (<2.5 kg), and this is attributed to maternal undernutrition. We therefore examined the relationship between maternal nutrition and birth size in a prospective study of 797 rural Indian women, focusing on macronutrient intakes, dietary quality and micronutrient status. Maternal intakes (24-h recall and food frequency questionnaire) and erythrocyte folate, serum ferritin and vitamin C concentrations were measured at 18 +/- 2 and 28 +/- 2 wk gestation. Mothers were short (151.9 +/- 5.1 cm) and underweight (41.7 +/- 5.1 kg) and had low energy and protein intakes at 18 wk (7.4 +/- 2.1 MJ and 45.4 +/- 14.1 g) and 28 wk (7.0 +/- 2.0 MJ and 43.5 +/- 13.5 g) of gestation. Mean birth weight and length of term babies were also low (2665 +/- 358 g and 47.8 +/- 2.0 cm, respectively). Energy and protein intakes were not associated with birth size, but higher fat intake at wk 18 was associated with neonatal length (P < 0.001), birth weight (P < 0.05) and triceps skinfold thickness (P < 0.05) when adjusted for sex, parity and gestation. However, birth size was strongly associated with the consumption of milk at wk 18 (P < 0.05) and of green leafy vegetables (P < 0.001) and fruits (P < 0.01) at wk 28 of gestation even after adjustment for potentially confounding variables. Erythrocyte folate at 28 wk gestation was positively associated with birth weight (P < 0.001). The lack of association between size at birth and maternal energy and protein intake but strong associations with folate status and with intakes of foods rich in micronutrients suggest that micronutrients may be important limiting factors for fetal growth in this undernourished community.
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Affiliation(s)
- S Rao
- Biometry and Nutrition Unit, Agharkar Research Institute, Pune, India
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Mathews F, Yudkin P, Smith RF, Neil A. Nutrient intakes during pregnancy: the influence of smoking status and age. J Epidemiol Community Health 2000; 54:17-23. [PMID: 10692957 PMCID: PMC1731547 DOI: 10.1136/jech.54.1.17] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
STUDY OBJECTIVE To examine the relation of antioxidant and other nutrient intakes in pregnancy to smoking and sociodemographic variables. DESIGN Cohort study. SETTING St Mary's Maternity Hospital, Portsmouth. PARTICIPANTS Pregnant nulliparous women, with no existing complications of pregnancy, were recruited from antenatal booking clinics. A total of 774 women completed seven day food diaries, and supplied detailed data on their use of nutrient supplements. MAIN RESULTS Smokers had lower intakes of most micronutrients. After adjustment for the confounding effects of maternal age, height, and education, only vitamin C and carotenoid intakes remained significantly depressed. Age was strongly and significantly associated with the intake of most nutrients, including antioxidants, and this association was independent of other maternal factors. Antioxidant intake was therefore lowest in young women who smoked: for example smokers under 24 years had a mean vitamin C intake of 57 mg (SD 35) compared with 106 mg (SD 52) for non-smokers aged 28 and over (difference 49 mg, 95% CI 39, 59). The corresponding intakes of carotenoid equivalents were 1335 micrograms (SD 982) and 2093 micrograms (SD 1283) (difference 758 micrograms, 95% CI 496, 1020). CONCLUSIONS The study has identified, for the first time, young pregnant women as a group at particular risk of low micronutrient intake. The health implications of poor nutrition now need to be evaluated, particularly for those women who smoke.
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Affiliation(s)
- F Mathews
- Division of Public Health and Primary Health Care, University of Oxford
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Mathews F, Yudkin P, Neil A. Influence of maternal nutrition on outcome of pregnancy: prospective cohort study. BMJ (CLINICAL RESEARCH ED.) 1999; 319:339-43. [PMID: 10435950 PMCID: PMC28185 DOI: 10.1136/bmj.319.7206.339] [Citation(s) in RCA: 229] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/25/1999] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To investigate the relations of maternal diet and smoking during pregnancy to placental and birth weights at term. DESIGN Prospective cohort study. SETTING District general hospital in the south of England. PARTICIPANTS 693 pregnant nulliparous white women with singleton pregnancies who were selected from antenatal booking clinics with stratified random sampling. MAIN OUTCOME MEASURES Birth and placental weights at term. RESULTS Placental and birth weights were unrelated to the intake of any macronutrient. Early in pregnancy, vitamin C was the only micronutrient independently associated with birth weight after adjustment for maternal height and smoking. Each ln mg increase in vitamin C was associated with a 50.8 g (95% confidence interval 4.6 g to 97.0 g) increase in birth weight. Vitamin C, vitamin E, and folate were each associated with placental weight after adjustment for maternal characteristics. In simultaneous regression, however, vitamin C was the only nutrient predictive of placental weight: each ln mg increase in vitamin C was associated with a 3.2% (0.4 to 6.1) rise in placental weight. No nutrient late in pregnancy was associated with either placental or birth weight. CONCLUSIONS Concern over the impact of maternal nutrition on the health of the infant has been premature. Maternal nutrition, at least in industrialised populations, seems to have only a small effect on placental and birth weights. Other possible determinants of fetal and placental growth should be investigated.
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Affiliation(s)
- F Mathews
- Division of Public Health and Primary Health Care, Institute of Health Sciences, University of Oxford, PO Box 777, Oxford OX3 7LF.
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