Vitamin A in pregnancy: Impact on maternal and neonatal health

Abstract

Vitamin A is an essential nutrient, for which there is a slightly increased requirement during the third trimester of pregnancy, with even greater requirements for lactating women. Serum retinol levels decline during pregnancy, especially during the third trimester, followed by a rapid increase postpartum. Hemodilution and inadequate nutritional status contribute to this pattern. Night-blindness is more common in the third trimester of pregnancy, and night-blind pregnant women have lower mean serum retinol concentrations. Increased morbidity is associated with night-blindness in women, especially during pregnancy. Vitamin A supplementation during pregnancy in deficient populations reduces night-blindness, low serum retinol levels, and nutritional anemia during pregnancy and substantially reduces maternal postpartum infections. A substantial reduction in maternal mortality has been observed in malnourished vitamin A-deficient women following vitamin A or β-carotene supplementation. Infant cord blood retinol and birthweight appear to be resistant to maternal supplementation with vitamin A during pregnancy. No studies have reported an impact of maternal vitamin A supplementation on neonatal morbidity or mortality.