Food and Behaviour Research

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Vitamin A and beta-carotene supply of women with gemini or short birth intervals: A pilot study

Schulz C, Engel U, Kreienberg R, Biesalski HK. (2007) European Journal of Nutrition 46(1) 12-20 Steinkopff Darmstadt

Web URL: View this and related abstracts via PubMed here


BACKGROUND: An adequate supply of vitamin A during pregnancy and breastfeeding plays an important role for development of foetus and neonate, especially in lung development and function.

AIM OF THE STUDY: Aim of this pilot study was to analyze vitamin A and beta-carotene status and to investigate the contribution of nutrition to the vitamin A and beta-carotene supply in mother-infant pairs of gemini or births within short birth intervals.

METHODS: Twenty-nine volunteers aged between 21 and 36 years were evaluated for 48 h after delivery. During this time frame a food frequency protocol considering 3 months retrospective was obtained from all participants. In order to establish overall supply retinol and beta-carotene levels were determined in maternal plasma, cord blood and colostrum via HPLC analysis.

RESULTS: Regardless of the high to moderate socio-economic background, 27.6% of participants showed plasma retinol levels below 1.4 mumol/l which can be taken as borderline deficiency. In addition, 46.4% showed retinol intake <66% of RDA and 50.0% did not consume liver at all although liver contributes as a main source for preformed retinol. Despite high total carotenoid intake of 6.9 +/- 3.6 mg/d, 20.7% of mothers showed plasma levels <0.5 micromol/l beta-carotene. Retinol and beta-carotene levels were highly significantly correlated between maternal plasma versus cord blood and colostrum. In addition, significantly lower levels were found in cord blood (31.2 +/- 13.0% (retinol), 4.1 +/- 1.4% (beta-carotene) compared with maternal plasma.

CONCLUSIONS: Despite the fact that vitamin A and beta-carotene rich food is generally available, risk groups for low vitamin A supply exist in the western world.


Pregnant and breastfeeding mothers need an adequate supply of vitamin A for normal development of their babies, both in the womb and after birth. Vitamin A is especially important at these stages for lung development and function.

In this study, Vitamin A status in 29 mothers was assessed just after they gave birth, using blood and first breastmilk samples as well as questionnaires about dietary intake over the previous 3 months. All were mothers of twins, or children born only a short time after a previous child, and they were between 21 and 36 years of age.

More than 25% (one in every four) of these mothers showed borderline deficiency of active Vitamin A (retinol) from blood samples, and food frequency questionnaires showed that almost half had a low dietary intake of this essential nutrient. (Liver is a particularly rich source, but one in two mothers reported that they never ate liver).

Over 20% of mothers (one in every five) showed low blood levels of beta-carotene, despite reporting a dietary intake that appeared satisfactory. (Beta-carotene and other carotenoids are found in many fruits and vegetables, and can be converted within the body into active Vitamin A).

Measures of both active Vitamin A and beta-carotene in the mothers’ blood were directly related to the levels found in umbilical cord blood and first breast milk (colostrum). However, the levels of these nutrients in cord blood were significantly lower than those in the mothers’ general blood circulation.

The researchers emphasized that these mothers were from high- to moderate socio-economic backgrounds, and pointed out that vitamin A and beta-carotene rich food is generally available in the western world (this study was carried out in Germany). Despite this, the findings from this study clearly show that risk groups for low vitamin A supply do exist in developed countries.