Horrible, it turns out that the consequences of not paying attention to vitamin A supplementation during pregnancy are so serious?

Vitamin A is a fat-soluble vitamin that is easily oxidized and cannot tolerate oxygen and sunlight
.

The human body cannot synthesize vitamin A and can only take it from fresh food

Physiological effects of vitamin A: Most of the body's vitamin A is stored in the liver, and is continuously and slowly released into the blood to meet the body's growth and development needs [3]
.

Eyes: Vitamin A can be converted into the photosensitive material of the retina to maintain clear vision; maintain the integrity and moisture of the conjunctiva and corneal structure
.

In the early stage of vitamin A deficiency, night blindness (cannot see things in the dark) and dry eyes can occur

Skin and mucous membranes: Vitamin A promotes the growth of skin and mucous membranes all over the body, including the eyes
.

Vitamin A deficiency can cause skin damage (dry, rough skin, peeling, such as keratosis pilaris and acne, etc.

Growth: Vitamin A can promote bone and muscle growth
.

Growth retardation in children with severe vitamin A deficiency

Red blood cells and white blood cells: Vitamin A promotes the release of iron into the blood and promotes the production of red blood cells
.

Therefore, vitamin A deficiency can lead to anemia, and iron supplementation alone cannot be corrected

Since vitamin A is so important, what is the status of vitamin A deficiency in pregnant women in my country? According to a large number of epidemiological survey data [9-12], the marginal subclinical deficiency rate of vitamin A (serum retinol <1.
04 μmol/L) in the first and third trimesters of pregnancy is relatively high, and the deficiency rate in Beijing is above 30%.
The floating population And the lack rate is higher in rural areas
.

Based on China's national conditions, vitamin A supplementation in China should be tailored to local conditions and individualized supplementation

       Significance and risks of vitamin A supplementation during pregnancy

       Domestic and foreign guidelines recommend that vitamin A supplementation during pregnancy is 2400IU retinol equivalent per day
.

β- carotene absorption and conversion rate is very low, and vitamin A overdose β- carotene into vitamin A can not, therefore β- carotene is difficult to cause vitamin A overdose

       A large number of studies have suggested that there is no risk of teratogenicity when the daily vitamin A supplement does not exceed 10,000 IU
.

why? Vitamin A supplements are mainly composed of retinol and retinol esters, which can be stored and buffered in large amounts in the liver and are not teratogenic

       Vitamin A supplementation advice during pregnancy:

       The marginal subclinical deficiency rate of vitamin A in pregnant women in China is relatively high, and vitamin A supplementation should be encouraged during pregnancy
.
Try to choose the domestic version of multi-element supplements during pregnancy.
The foreign version is not suitable for Chinese people, because the content of retinol in the foreign version supplements is low, and even does not contain retinol
.
It is safe to supplement retinol at a dose of 2000-8000IU at any time during pregnancy.
For example, Materna contains 1500IU of retinol, and Ailevi contains 4000IU of retinol
.

       Pregnant women in wealthy families should avoid eating foods with high vitamin A content such as animal liver at the same time
.
If vomiting is severe in the first trimester, vitamin A supplementation should be appropriately increased
.
Vegetarians should add vitamin A supplements appropriately
.
Urban floating population and rural population should increase vitamin A supplementation
.
Poor and rural families can start vitamin A supplementation during pregnancy
.

       Reference materials:

1.
WorldHealthOrganization.
IndicatorsforAssessingVitaminADeficiencyandTheirApplicationinMonitoringandEvaluatingInterventionPrograms;WorldHealthOrganization:Geneva, Switzerland, 1996.

2.
WorldHealthOrganization,TheMicronutrientInitiative.
SafevitaminAdosageduringpregnancyandlactation.
WorldHealthOrganization:Geneva,Switzerland,1998.
WHOreferencenumber:WHO/NUT/98.
4.

3.
RothmanKJ, etal.
TeratogenicityofhighvitaminAintake.
NEnglJMed1995,333:1369-73.

4.
GeraldGB, etal.
Drugsinpregnancyandlactation:areferenceguidetofetalandneonatalrisk.
Tenthedition.
WoltersKluwerHealth, 2015.

5.
JenkinsKJ, etal.
Noninherited riskfactors andcongenitalcardiovascular defects: currentknowledge:ascientificstatementfromtheAmericanHeartAssociationCouncilonCardiovascularDiseaseintheYoung:endorsedbytheAmericanAcademyofPediatrics.
Circulation,2007,115(23):2995-3014.

6.
HouetR,etal.
Effectofmaternalavitaminosisduringpregnancyuponthechild;acaseofdoubleharelipandxerophthalmiainthenewbornofamotherwithAandB2vitamindeficiency.
AnnPaediatr1950:175:378-388.

7.
KeeganBR,etal.
Retinoicacidsignalingrestrictsthecardiacprogenitorpool.
Science,2005,307(5707):247-249.

8.
Hu Yamei, etc.
Zhu Futang Practical Pediatrics, 2015, 8th edition, 553-558.

9.
BonatiM,etal.
VitaminAsupplementationduringpregnancyindevelopedcountries.
Lancet1995:345:736-737.

10.
Jiang Hongqing, etc.
The status of serum vitamin A and E levels under routine health care of pregnant women in Beijing.
Journal of PLA Medical College, 2015, 36(11): 1118-1121.

11.
Yi Meiling et al.
Investigation of serum vitamin A and E levels of pregnant women in early and late pregnancy in Xi'an area under routine health care.
Chinese Journal of Laboratory Diagnosis, 2017, 21(10): 1786-1787.

12.
Zhang Luping.
Clinical observation of serum vitamin A and E levels in early pregnancy.
Journal of Capital Medical University, 2013, 34(5): 756-758.

       Editor in charge | Penicillin