Food and Behaviour Research

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10 June 2014 - Nutraingredients - Vitamin A, E, D deficiencies 'dramatically' higher in pre-term babies

Annie-Rose Harrison-Dunn

Pre-term newborns have a far higher risk of Vitamin A, E and D deficiencies than full-term babies, researchers have suggested

FAB RESEARCH COMMENT:

This study reveals a disturbingly high prevalence in Tunisian newborns of deficiencies of the fat soluble vitamins A, D and E, with serious implications for these infants' physical and mental health and development.  It included over 600 babies born at a major maternity hospital in Tunisia serving pregnant women of low to average socioeconomic status.
Even in the control group of babies born at full-term, almost two-thirds were deficient in Vitamin A, over half were deficient in Vitamin E, and over 40% deficient in Vitamin D.  For the premature and very low birth weight infants, around three-quarters of the sample were deficient in Vitamins A and E, and two-thirds were Vitamin D deficient.

As the researchers pointed out, these findings show a clear need for better management of the nutritional status of women during pregnancy, including supplementation if needed.

The World Health Organisation and other global organisations have long emphasised that nutritional deficiencies in early life can permanently damage both physical and mental health and wellbeing, so that the affected individuals never reach their full potential - an effect known as 'stunting'.  The costs of such malnutrition are simply vast compared with the costs of prevention. Furthermore, research into effective methods of intervention has already been done:

See: Mason et al 2014 - The first 500 days of life: policies to support maternal nutrition. Global Health Action 7, 23623 
The study, published in the Journal Pediatrics and Neonatology, looked at the prevalence and risk factors for the deficiencies in Tunisian very low birth weight (VLBW) newborns.

The lower the weight and gestational age - the embryonic or fetal age plus two weeks - the greater the prevalence of Vitamin A, E or D deficiencies, they found. Vitamin D deficiency was significantly higher among twin VLBW babies, they found.

Meanwhile, Vitamin E and D deficiency were significantly more common in neonates whose mothers suffered from pre-eclampsia, a condition that affects some pregnant women during the second half of pregnancy or just after delivery.

Vitamin E deficiency was more frequent in the case of gestational diabetes - a condition whereby women with no previous history of diabetes develop high glucose levels during pregnancy.

Such deficiencies expose infants to increased chances of morbidity and mortality, the Tunisian researchers said.

Supplementing the problem

The study included 607 pre-term VLBW newborns with a birth weight of less than 1500mg and gestational age of less than 37 weeks atmitted to an intensive care unit, and 300 full-term newborns from the same hospital with a birth weight between 2500 and 3500mg as the control group.

Of these two groups, prevalence of Vitamin A deficiency was 75.9%, compared to 63.3% for full-term babies, while for Vitamin E this stood at 71.3% vs 55.5% and for D 65.2% vs 40.4% respectively.

The El Manar University Researchers said sustained efforts should be undertaken to combat vitamin deficienies in newborns. 'The strategy should include improvement of mothers' dietary intake and sun exposure, and vitamin supplementation when needed, as well as a tight control of pre-eclampsia and gestational diabetes.