Skip to main content Accessibility help
×
Home

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

  • Paulo A. R. Neves (a1), Chiara A. S. Campos (a1), Maíra B. Malta (a1), Bárbara H. Lourenço (a1), Márcia C. Castro (a2), Marly A. Cardoso (a1) and for the MINA-Brazil Study Group (a1) (a2)...

Abstract

Determining the predictors of serum retinol at mid-pregnancy is relevant for planning interventions aimed at improving vitamin A status of pregnant women and their offspring. This prospective study assessed predictors of serum retinol at the beginning of the third trimester of pregnancy. We enrolled 442 pregnant women living in the urban area of Cruzeiro do Sul, Western Brazilian Amazon. Demographic, socio-economic, environmental and clinical characteristics as well as obstetric history, anthropometric, dietary and biochemical data, including serum retinol, were gathered between 16 and 20 gestational weeks. Serum retinol also measured at the beginning of the third trimester of pregnancy (approximately 28 gestational weeks) was the outcome of interest. Multiple linear regression models were used to evaluate associations with the outcome. Overall, the following variables explained serum retinol at the beginning of the third trimester of pregnancy in the adjusted model (R2 = 11·1 %): seasonality (winter season – November to April; β=0·134; 95 % CI 0·063, 0·206), weekly consumption of Amazonian fruits (β=0·087; 95 % CI 0·012, 0·162) and retinol concentrations between 16 and 20 gestational weeks (β=0·045; 95 % CI 0·016, 0·074) were positively associated, whereas having a smoker in the house was negatively associated (β=–0·087; 95 % CI: –0·166, –0·009). Consumption of pro-vitamin A-rich fruits by pregnant women should be encouraged. Passive smoking may play a role in decreasing vitamin A status as a proxy of smoking exposure during pregnancy.

Copyright

Corresponding author

*Corresponding author: M. A. Cardoso, email marlyac@usp.br

Footnotes

Hide All

A full list of the MINA-Brazil Study Group members is presented in the Acknowledgements.

Footnotes

References

Hide All
1. Mammadova, A, Zhou, H, Carels, CEL, et al. (2016) Retinoic acid signalling in the development of the epidermis, the limbs and the secondary palate. Differentiation 92, 326335.
2. Clagett-Dame, M & Knutson, D (2011) Vitamin A in reproduction and development. Nutrients 3, 385428.
3. Cohen, M, Kahn, SR, Platt, RW, et al. (2015) Small-for-gestational-age birth and maternal plasma antioxidant levels in mid-gestation: a nested case–control study. BJOG 122, 13131321.
4. Checkley, W, West, KP Jr, Wise, RA, et al. (2010) Maternal vitamin A supplementation and lung function in offspring. N Engl J Med 362, 17841794.
5. Handel, MN, Moon, RJ, Titcombe, P, et al. (2016) Maternal serum retinol and β-carotene concentrations and neonatal bone mineralization: results from the Southampton Women’s Survey cohort. Am J Clin Nutr 104, 11831188.
6. Palmer, AC, Schulze, KJ, Khatry, SK, et al. (2015) Maternal vitamin A supplementation increases natural antibody concentrations of preadolescent offspring in rural Nepal. Nutrition 31, 813819.
7. World Health Organization (2009) Global Prevalence of Vitamin A Deficiency in Populations at Risk 1995–2005. WHO Global Database on Vitamin A Deficiency. Geneva: WHO.
8. Van Loo-Bouwman, CA, Naber, THJ & Schaafsma, G (2014) A review of vitamin A equivalency of β-carotene in various food matrices for human consumption. Br J Nutr 111, 21532166.
9. Ministério da Saúde (Brasil) (2009) PNDS 2006 – Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher (Brazilian Demographic Health Survey). Brasília: MS.
10. World Health Organization (2011) Guideline: Vitamin A Supplementation in Pregnant Women. Geneva: WHO. http://apps.who.int/iris/bitstream/10665/44625/1/9789241501781_eng.pdf (accessed February 2017).
11. Thorne-Lyman, AL & Fawzi, WW (2012) Vitamin A and carotenoids during pregnancy and maternal, neonatal and infant health outcomes: a systematic review and meta-analysis. Paediatr Perinat Epidemiol 26, 3654.
12. Tanumihardjo, SA, Russell, RM, Stephensen, CB, et al. (2016) Biomarkers of nutrition for development (BOND) – vitamin A review. J Nutr 146, 1816S1848S.
13. dos Santos, Q, Sichieri, R, Marchioni, DM, et al. (2014) Brazilian pregnant and lactating women do not change their food intake to meet nutritional goals. BMC Pregnancy Childbirth 14, 186.
14. Ramalho, A & Dolinsky, M (2012) Carência de vitamina A no grupo materno-infantil (Maternal and child vitamin A deficiency). In Nutrição em obstetrícia e pediatria, 2nd ed., pp. 5776 [E Accioly, C Saunders and E Lacerda, editors]. Rio de Janeiro: Cultura Médica/Guanabara Koogan.
15. Instituo Brasileiro de Geografia e Estatística (2017) Cidades (Cities). Rio de Janeiro: Instituto Brasileiro de Geografia e Estatística. https://cidades.ibge.gov.br/v4/brasil/ac/cruzeiro-do-sul/panorama (accessed January 2017).
16. Pincelli, A, Neves, PAR, Lourenço, BH, et al. (2018) The hidden burden of Plasmodium vivax malaria in pregnancy in the Amazon: an observational study in Northwestern Brazil. Am J Trop Med Hyg 99, 7383.
17. Burger, SE & Pierre-Louis, JN (2003) A Procedure to Estimate Accuracy and Reliability of HemoCue Measurements of Survey Workers. Washington, DC: ILSI.
18. Gomes, LF, Alves, AF, Sevanian, A, et al. (2004) Role of β2-glycoprotein I, LDL-, and antioxidant levels in hypercholesterolemic elderly subjects. Antioxid Redox Signal 6, 237244.
19. World Health Organization (1995) Expert Committee on Physical Status. Physical Status: The Use and Interpretation of Anthropometry: Report of a WHO Expert Committee. Geneva: WHO.
20. Lohman, TG, Roche, AF & Martorell, R (1988) Anthropometric Standardization Reference Manual. Champaign, IL: Human Kinetics Books.
21. Institute of Medicine (2013) Implementing Guidelines on Weight Gain and Pregnancy. Washington, DC: National Academies Press.
22. Augusto, RA, Cobayashi, F & Cardoso, MA (2015) Associations between low consumption of fruits and vegetables and nutritional deficiencies in Brazilian schoolchildren. Public Health Nutr 18, 927935.
23. Núcleo de Estudos e Pesquisas em Alimentação (2011) Tabela Brasileira de Composição de Alimentos (Brazilian Food Composition Table), 4th ed. Campinas: University of Campinas.
24. Ministério da Saúde (Brasil) (2015) Alimentos Regionais Brasileiros (Brazilian Regional Foods), 2nd ed. Brasília: MS. http://189.28.128.100/dab/docs/portaldab/publicacoes/livro_alimentos_regionais_brasileiros.pdf (accessed February 2017).
25. Victora, CG, Huttly, SR, Fuchs, SC, et al. (1997) The role of conceptual frameworks in epidemiological analysis: a hierarchical approach. Int J Epidemiol 26, 224227.
26. Kæstel, P, Martinussen, T, Aaby, P, et al. (2012) Serum retinol is associated with stage of pregnancy and the acute phase response in pregnant women in Guinea-Bissau. J Nutr 142, 942947.
27. Van Stuijvenberg, ME, Schoeman, SE, Nel, J, et al. (2017) 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. Matern Child Nutr 13, e12223.
28. Ramakrishnan, U, Grant, F, Goldenberg, T, et al. (2012) Effect of women’s nutrition before and during early pregnancy on maternal and infant outcomes: a systematic review. Paediatr Perinat Epidemiol 26, Suppl. 1, 285301.
29. King, CJ (2000) Physiology of pregnancy and nutrient metabolism. Am J Clin Nutr 71, 1218S1225S.
30. Hanson, C, Lyden, E, Abresch, C, et al. (2016) Serum retinol concentrations, race, and socioeconomic status in of women of childbearing age in the United States. Nutrients 8, 508.
31. Penniston, KL & Tanumihardjo, SA (2006) The acute and chronic effects of vitamin A. Am J Clin Nutr 83, 191201.
32. Girard, AW, Grant, F, Watkinson, M, et al. (2017) Promotion of orange-fleshed sweet potato increased vitamin A intakes and reduced the odds of low retinol-binding protein among postpartum Kenyan women. J Nutr 147, 955963.
33. Medeiros, MC, Aquino, JS, Soares, J, et al. (2015) Buriti oil (Mauritia flexuosa L.) negatively impacts somatic growth and reflex maturation and increases retinol deposition in young rats. Int J Dev Neurosci 46, 713.
34. Aquino, JS, Vasconcelos, MH, Pessoa, DC, et al. (2016) Intake of cookies made with buriti oil (Mauritia flexuosa) improves vitamin A status and lipid profiles in young rats. Food Funct 7, 44424450.
35. Faber, M & Laubscher, R (2008) Seasonal availability and dietary intake of beta-carotene-rich vegetables and fruit of 2-year-old to 5-year-old children in a rural South African setting growing these crops at household level. Int J Food Sci Nutr 59, 4660.
36. Beard, JL, Murray-Kolb, LE, Lawrence, F, et al. (2007) Variation in the diets of Filipino women over 9 months of continuous observation. Food Nutr Bull 28, 206214.
37. ScienceDirect (2018) Retinol. https://www.sciencedirect.com/topics/medicine-and-dentistry/retinol (accessed September 2018).
38. Schreiber, R, Taschler, U, Preiss-Landl, K, et al. (2012) Retinyl ester hydrolases and their roles in vitamin A homeostasis. Biochim Biophys Acta 1821, 113123.
39. Grumet, L, Taschler, U & Lass, A (2016) Hepatic retinyl ester hydrolases and the mobilization of retinyl ester stores. Nutrients 9, 13.
40. World Health Organization (2014) Xerophthalmia and Night Blindness for the Assessment of Clinical Vitamin A Deficiency in Individuals and Populations. Vitamin and Mineral Nutrition Information System. Geneva: WHO. http://apps.who.int/iris/bitstream/10665/133705/1/WHO_NMH_NHD_EPG_14.4_eng.pdf?ua=1 (accessed February 2017).
41. Titova, OE, Ayvazova, EA, Bichkaeva, FA, et al. (2012) The influence of active and passive smoking during pregnancy on umbilical cord blood levels of vitamins A and E and neonatal anthropometric indices. Br J Nutr 108, 13411345.
42. Feltes, BC, Poloni, JF, Notari, DL, et al. (2013) Toxicological effects of the different substances in tobacco smoke on human embryonic development by a systems chemo-biology approach. PLOS ONE 8, e61743.
43. Yang, C, Chen, J, Liu, Z, et al. (2016) Prevalence and influence factors of vitamin A deficiency of Chinese pregnant women. Nutr J 15, 12.
44. Holick, MF (2007) Vitamin D deficiency. N Engl J Med 357, 266281.
45. Saunders, C, Leal, MC, Neves, PAR, et al. (2016) Determinants of gestational night blindness in pregnant women from Rio de Janeiro, Brazil. Public Health Nutr 19, 851860.
46. Barffour, MA, Schulze, KJ, Coles, CL, et al. (2018) Comparability of inflammation-adjusted vitamin A deficiency estimates and variance in retinol explained by C-reactive protein and α1-acid glycoprotein during low and high malaria transmission seasons in rural Zambian children. Am J Trop Med Hyg 98, 334343.

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed