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Vitamin E during pre- and postnatal periods
1Institut des Sciences de la Vie, Unité de Biochimie de la Nutrition, Université Catholique de Louvain, Croix du Sud 2/8, B-1348 Louvain-la-Neuve, Belgium.
Insights
Vitamin E is crucial for infant development, supporting placental transfer and offering defense against oxygen toxicity. However, preterm infants struggle to reach adequate vitamin E levels, and its therapeutic use in preeclampsia remains unproven.
Area of Science:
- Perinatal nutrition and development
- Maternal-fetal health
- Oxidative stress mechanisms
Background:
- Vitamin E (alpha-tocopherol) is vital for fetal and infant development.
- Maternal-fetal vitamin E transfer involves specific receptors and proteins.
- Newborns, especially preterm infants, are susceptible to oxidative stress due to lower vitamin E levels.
Purpose of the Study:
- To explore the role of vitamin E in maternal-fetal transfer and infant development.
- To investigate vitamin E status in preterm infants and its implications.
- To review the therapeutic potential of vitamin E in preeclampsia.
Main Methods:
- Review of literature on vitamin E transport mechanisms (lipoprotein receptors, alpha-tocopherol transfer protein).
- Analysis of vitamin E concentrations in maternal and cord blood.
- Examination of studies on vitamin E supplementation in preterm infants and its effects on oxidative stress.
- Evaluation of research on vitamin E in preeclampsia.
Main Results:
- Specific receptors facilitate vitamin E uptake at placental and mammary barriers.
- Lower vitamin E levels are observed in cord blood compared to maternal circulation.
- Preterm infants exhibit prolonged vitamin E depletion despite supplementation.
- Recent studies indicate no benefit of vitamin E in preeclampsia.
Conclusions:
- Vitamin E transfer is critical for fetal development and neonatal defense against oxidative stress.
- Preterm infants require careful monitoring and potentially extended supplementation for vitamin E repletion.
- Vitamin E's role in managing preeclampsia is not supported by current evidence.
Abstract:
Vitamin E is a fat-soluble nutrient that is extremely important during the early stages of life, from the time of conception to the postnatal development of the infant. The mechanisms involved in its placental and mammary uptake appear to be allowed by the presence of lipoprotein receptors (LDL-receptor, VLDL-receptor, scavenger receptor class B type I) together with lipoprotein lipase at the placental and mammary barriers. In addition, alpha-tocopherol transfer protein has been described as playing an essential role in the selective transfer of RRR-alpha-tocopherol across the placenta. Lower alpha-tocopherol concentrations are found in cord blood as compared to maternal circulation. The ingestion of colostrum which contains very high levels of vitamin E is therefore of utmost importance to supply the newborn with an essential defense against oxygen toxicity. Pregnancy is sometimes associated with complications that may lead to a premature delivery of the baby. Preterm infants are usually facing an oxidative stress that is among others related to a deficiency in alpha-tocopherol, as it accumulates mainly during the third trimester of pregnancy. Despite vitamin E supplementation, preterm infants usually require significantly longer to replenish their serum alpha-tocopherol levels than full-term infants. The use of vitamin E as a therapeutic agent in preeclampsia, which induces high maternal and fetal morbidity and mortality, has been discussed in numerous papers. This disorder is indeed associated with an important oxidative stress in the placenta and maternal circulation. However, the most recent studies did not show a beneficial effect of vitamin E administration in this pathology.
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