Abstract
Vitamin A affects gene expression and thus influences diverse physiologic processes. Both low and high intakes of Vitamin A are teratogenic in animals. During pregnancy low maternal levels of serum retinol in malnourished populations, are associated with poor fetal growth, preterm delivery and infant mortality. The extent to which either an excess or a deficit of retinol is linked to adverse pregnancy outcomes in other populations is not known. We assayed maternal serum retinol at week 28 gestation by HPLC in 1180 gravidae from Camden, NJ. High levels (highest quintile >54.8ug/dl) correlated (p<0.05) with increased energy adjusted intakes of total vitamin A, beta carotene and carotene. High retinol levels were associated with significantly increased risks of small for gestation birth (Adjusted Odds Ratio (AOR) 1.88, 95% Confidence Interval (CI) 1.19–2.97), preterm delivery (AOR=1.87, 95% CI 1.56–3.02) and very preterm delivery (<32 weeks) AOR=4.15, 95% CI 1.41–12.22). Maternal serum retinol was higher (~ 30%, p=0.029) among gravidae (N=7) with live born neonates who died before day 28. Women in the lowest quintile, where serum retinol levels were low (<30ug/dl) but not suggestive of deficiency, did not show an increase in risk. Thus in populations that are not Vitamin A deficient, high levels of maternal serum retinol are associated with an increased risk of adverse pregnancy outcomes.
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