The association between oxidative stress and pregnancy‐related symptoms of illness among vitamin A‐deficient women

Abstract

BackgroundVitamin A (VA) and beta‐carotene (BC) supplementation reduced pregnancy‐associated mortality and morbidity, as well as oxidative stress levels, in women of rural Nepal. This study examines the link between oxidative stress and symptoms of morbidity during pregnancy.MethodsSerum malondialdehyde (MDA) was measured in a subset (n = 547) of women participating in a maternal VA or BC supplementation trial. Seven‐day frequencies of 21 symptoms were assessed within a month of blood collection. Total number of morbidity symptoms (0, 1, or =2), number of symptom‐days (0, 1‐9, or =10), and symptom clusters were modeled as dependent variables in multivariate logistic regressions.ResultsSerum MDA was lower among women with symptoms <20 weeks gestation, but higher among symptomatic women at =20 weeks. One square‐root unit increase in MDA (μmol/l) was associated with any symptoms (odds ratio [OR], 3.17; 95% CI, 1.04‐9.68) and upper gastrointestinal tract infection or nausea and vomiting (OR, 3.67; 95% CI, 1.07‐12.51) at =20 weeks of gestation. MDA was associated with number of symptoms (OR, 3.76; 95% CI, 1.45‐9.73) and symptom‐days (OR, 3.40; 95% CI, 1.36‐8.49). This trend held in three supplementation groups (VA, BC and placebo), but the effects were diminished in the VA group.ConclusionOxidative stress was associated with morbidity symptoms. Supplementing VA/BC may mitigate the illnesses through reducing oxidative stress in this population. Funded by the Bill and Melinda Gates Foundation, Seattle, WA and the US Agency for International Development (USAID).