NMU – 175 Optimal Mother’s (Maternal) Vitamin E Status During Pregnancy Helps Reduce Risk of Miscarriage, Brain Development Defects, and Asthma, According to Recent Studies
Lifestyle Medicine Update No 175 (September 29, 2020)
with Dr. James Meschino
Topic: Optimal Mother’s (Maternal) Vitamin E Status During Pregnancy Helps Reduce Risk of Miscarriage, Brain Development Defects, and Asthma, According to Recent Studies
Sources: Multiple Peer-reviewed Medical and Scientific Journals
The importance of vitamin E (alpha-tocopherol) in helping to ensure a successful outcome in pregnancy has been highlighted in several high-profile studies published during the past decade or so. As an example, a 2015 study showed that during the first trimester of pregnancy women who were vitamin E deficient (having a vitamin E blood level below 12 umol/L) had almost double the risk of having a miscarriage.
Why is this? Studies show that during pregnancy the endometrium depends on vitamin E for several important functions. In the first trimester of pregnancy, Vitamin E stimulates the synthesis of Interleukin-6 (IL-6) and VEGF (vascular endothelial-derived growth factor), which are required to bring new blood vessels into the endometrium, improving endometrial conditions for proper implantation of the embryo and to modulate important aspects of immune function so that the embryo won’t be rejected by the mother’s body. During pregnancy, blood flow to the uterus is increased dramatically to meet the rising demands of the growing fetus. The secretion of VEGF is a key factor in facilitating the growth of new blood vessels into the endometrium and VEGF secretion is dependent on adequate vitamin E status within the mother’s body.
As such, inadequate vitamin E status by the mother’s body during the first trimester of pregnancy has been shown to increase the risk of miscarriage. Consistent with this finding are animal models, which have clearly shown that providing animals, who are bred to have a high-risk for miscarriage, with 15 mg of vitamin E daily greatly reduces miscarriage rates, and it increases placental levels of IL-6 and VEGF. Not only does the mother’s body require adequate vitamin E status for a successful pregnancy, but the developing fetus also requires sufficient vitamin E for proper brain development and to decrease the risk of certain respiratory conditions, including asthma. Vitamin E deficiency results in what is known as lipid peroxidation and it increases the turn-over of choline, which robs the fetus of adequate choline for methylation purposes. Most people know that folic acid is required to prevent spina bifida and other neural tube defects during pregnancy. This is because folic acid is required for methylation reactions. The fetal body also needs choline for methylation reactions, and lack of choline due to vitamin E deficiency puts the fetus at risk for many of the same brain and spinal cord problems as insufficient folic acid, according to a 2020 study. Insufficient vitamin E also increases the amount of free radical damage that occurs in the fetal brain and body during its development. Vitamin E is an antioxidant that quenches free radicals to limit their damaging effects.
A 2008 study also showed that the mother’s vitamin E blood level is highly correlated with fetal growth and lung development, meaning that higher vitamin E blood levels were associated with greater fetal growth and improved lung development in utero. Five years after birth children whose mothers had the lowest vitamin E blood levels during the first trimester of pregnancy showed a much higher propensity for the development of asthma and poorer scoring on respiratory (of lung) function tests.
Overall, evidence is accumulating to show the importance of adequate vitamin E status to a successful pregnancy. Vitamin E deficiency and low vitamin E nutritional status in the mother’s body appears to be highly correlated with increased risk of miscarriage, impaired brain and neural tube development, shorter fetal height (crown-rump length or CRL) and increased risk of asthma and compromised lung function. Women who become pregnant or who are planning to become pregnant should request a vitamin E blood test to ensure they have a blood level above 12 umol/L (5.5-18.0 mg/L). One report estimated that 96% of American women ingest too little vitamin E on a daily basis compared to recommended intake levels. (https://www.healthandscience.eu/index.php?option=com_content&view=article&id=1114:lack-of-vitamin-e-is-widespread-and-it-increases-the-risk-of-fetal-damage-and-miscarriage-us&lang=us&Itemid=363)
At the same time, it is important to point out that overt vitamin E deficiency is very rare in modern society. People with malabsorption problems due to intestinal ailments are most susceptible to severe vitamin E deficiency, as a rule. However, the National Health and Nutrition Examination Survey III (NHANES III) reported that about one-third of all American participants had blood concentrations of vitamin E (α-tocopherol) below 20 μmol/L — a cutoff value chosen as values above that level were originally associated with a decreased risk for cardiovascular disease.
In the end, I think that women who are planning to get pregnant or who become pregnant should request a vitamin E blood test (alpha-tocopherol) to ensure that their blood level is above 12 umol/L and more preferentially at or above 20 umol/L.
I have interspersed the references for this information throughout the text.
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