Vitamin A and Pregnancy: A Narrative Review
Nutrients 2019, 11(3), 681; https://doi.org/10.3390/nu11030681
Sabina Bastos Maia 1,2,*, Alex Sandro Rolland Souza 1,3,4, Maria de Fátima Costa Caminha 1,5, Suzana Lins da Silva 1,5, Rachel de Sá Barreto Luna Callou Cruz 6, Camila Carvalho dos Santos 7 and Malaquias Batista Filho 1
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- The digestion and absorption of vitamin A are associated with the absorption of lipids. Therefore, critically low dietary fat content (less than 5–10 g/day) or conditions such as pancreatic and hepatic diseases and frequent gastroenteritis that interfere with the digestion or absorption of lipids, resulting in steatorrhea, can interfere with the absorption of vitamin A
- VAD(Vitamin D Deficiency) is more frequent in the last quarter of pregnancy because of the physiological increase in maternal blood volume and accelerated fetal development in the final phase of pregnancy
- Pregnant women may be more prone to developing VAD during periods in which there is a shortage of foods rich in vitamin A or in the presence of infections, diabetes mellitus, or gestational diabetes
- In a meta-analysis, Thurnham et al. concluded that the increase in CRP is associated with a decrease of 25% in the serum retinol level
- In practice, in areas where night blindness is common, VAD is still often seen as widespread
- VAD in the second trimester of pregnancy was found to be associated with a three-fold increased risk of schizophrenia and other schizophrenia spectrum disorders in children in a large cohort study including 19,044 live births
- WHO...During pregnancy, there is an increase of approximately 10% to 20% in the need for vitamin A, with the recommended dose being 800 µg/day. It may be difficult to obtain this dose through diet alone, particularly in populations affected by VAD
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Vitamin A is a crucial micronutrient for pregnant women and their fetuses. In addition to being essential for morphological and functional development and for ocular integrity, vitamin A exerts systemic effects on several fetal organs and on the fetal skeleton. Vitamin A requirements during pregnancy are therefore greater. Vitamin A deficiency (VAD) remains the leading cause of preventable blindness in the world. VAD in pregnant women is a public health issue in most developing countries. In contrast, in some developed countries, excessive vitamin A intake during pregnancy can be a concern since, when in excess, this micronutrient may exert teratogenic effects in the first 60 days following conception. Routine prenatal vitamin A supplementation for the prevention of maternal and infant morbidity and mortality is not recommended; however, in regions where VAD is a public health issue, vitamin A supplementation is recommended to prevent night blindness. Given the importance of this topic and the lack of a complete, up-to-date review on vitamin A and pregnancy, an extensive review of the literature was conducted to identify conflicting or incomplete data on the topic as well as any gaps in existing data.
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