Retinol status of newborn infants with congenital diaphragmatic hernia
D Major1, M Cadenas, L Fournier
1LIAN, Pediatric Research Unit, Laval University Hospital Center, CHUQ, 2705 Blvd. Laurier, room 2200, Sainte-FOY (Québec) G1V 4G2, Canada.
Insights
Infants with congenital diaphragmatic hernia (CDH) show significantly lower vitamin A and retinol-binding protein (RBP) levels. This finding in newborns suggests a potential link between vitamin A deficiency and CDH development.
Area of Science:
- Pediatric Surgery
- Nutritional Science
- Developmental Biology
Background:
- The exact cause of congenital diaphragmatic hernia (CDH) remains unknown.
- Previous animal studies suggest a link between maternal vitamin A deficiency and CDH.
- Recent research explores correlations between retinoid-binding proteins and vitamin A deficiency effects.
Purpose of the Study:
- To investigate the potential association between vitamin A deficiency and CDH in human newborns.
- To compare vitamin A and retinol-binding protein (RBP) levels in infants with CDH and healthy controls.
- To examine maternal vitamin A levels in relation to CDH in their infants.
Main Methods:
- Blood samples collected from 11 newborns with CDH and 11 matched healthy controls within hours of birth.
- Plasma retinol and retinol-binding protein (RBP) levels measured using high-performance liquid chromatography and nephelometry, respectively.
- Maternal blood samples from 7 mothers in each group were also analyzed.
Main Results:
- Newborns with CDH exhibited 50% lower plasma retinol and RBP levels compared to controls (P<0.0002 and P<0.006).
- Mothers of infants with CDH had significantly higher retinol levels than control mothers (P<0.005).
- These findings indicate a significant difference in vitamin A status between CDH infants and controls.
Conclusions:
- Low plasma retinol and RBP concentrations in infants with CDH are clinically significant.
- The observed vitamin A deficiency in CDH newborns may offer insights into the developmental mechanisms of this condition.
- Further research is warranted to confirm the role of vitamin A in CDH etiology.
Abstract:
The etiology of congenital diaphragmatic hernia (CDH) is not yet known. Studies in the literature from 1941 have reported that nutritional deficiency of vitamin A during pregnancy could lead to CDH, associated or not with other malformations in young rats. More recently, possible correlations between expression patterns of cellular retinoid-binding protein and retinoic-acid receptors and morphologic effects of vitamin A deficiency have been suggested. The purpose of this study was to verify in human newborns the possible link between vitamin A deficiency and CDH previously observed in experimental animals. Blood samples were obtained during the first hours after birth from 11 term CDH newborns and 11 healthy controls matched for gestational age, and also from 7 mothers in each group, for a total of 7 newborn-mother pairs of matched CDH-controls. Plasma retinol was measured by high-performance liquid chromatography and retinol-binding protein (RBP) by nephelometry. In the 11 matched CDH-control newborns, plasma retinol and RBP levels in CDH newborns were 50% less than control values (P< 0.0002 and <0.006, respectively); in contrast, retinol levels in CDH mothers were significantly higher than those of control mothers (P < 0.005). The observation that the plasma concentrations of retinol and RBP are low in infants with CDH relative to controls may be clinically very relevant and may help to elucidate the mechanism of development of this congenital anomaly.
