Vitamin A and β-carotene in pregnant and breastfeeding post-bariatric women in an urban population

J Perinat Med. 2019 Feb 25;47(2):183-189. doi: 10.1515/jpm-2018-0142.

Abstract

Background As breastfeeding awareness and social acceptance are increased, maternal nutritional deficiency requires more investigation. Methods A prospective cohort study was conducted to determine if vitamin A deficiency is more common in pregnant, lactating post-bariatric surgery women in an inner city population. Antepartum, women after bariatric surgery and controls with no history of malabsorption were recruited. Third trimester, postpartum maternal blood and cord blood were collected as well as three breast milk samples: colostrum, transitional and mature milk. A nutritional survey of diet was completed. Each serum sample was analyzed for total retinol and β-carotene; breast milk samples were analyzed for retinol and retinyl esters, total retinol and β-carotene. Results Fifty-three women after bariatric surgery and 66 controls were recruited. Postpartum serum retinol was significantly higher in women after bariatric surgery in the univariate analysis (P<0.0001) and confirmed in the multiple linear mixed model (P=0.0001). Breast milk colostrum retinol and transitional milk total retinol were significantly greater in the bariatric surgery group in the univariate analysis (P=0.03 and P=0.02, respectively), but not after adjusting for confounders. Serum β-carotene in the third trimester and postpartum were lower (P<0.0001 and P=0.003, respectively) in the bariatric surgery group but not after adjusting for confounders. Vitamin A deficiency was high in both groups in serum and breast milk samples. Conclusion Nutritional deficiencies in breastfeeding women after bariatric surgeries may in fact be less common than in control women in an inner city.

Keywords: bariatric surgery; breast milk; nutrition; pregnancy; vitamin A; vitamin A deficiency; β-carotene.

MeSH terms

  • Adult
  • Bariatric Surgery / adverse effects*
  • Bariatric Surgery / methods
  • Breast Feeding / statistics & numerical data*
  • Female
  • Humans
  • Lactation / physiology
  • Milk, Human / chemistry*
  • Nutrition Assessment
  • Nutrition Disorders / diagnosis
  • Nutrition Disorders / epidemiology
  • Nutrition Disorders / etiology
  • Obesity / surgery
  • Perinatal Care / methods
  • Perinatal Care / statistics & numerical data
  • Pregnancy
  • Pregnancy Trimester, Third / blood
  • United States / epidemiology
  • Urban Population / statistics & numerical data
  • Vitamin A Deficiency* / diagnosis
  • Vitamin A Deficiency* / epidemiology
  • Vitamin A Deficiency* / etiology
  • Vitamin A* / analysis
  • Vitamin A* / blood
  • beta Carotene* / analysis
  • beta Carotene* / blood

Substances

  • beta Carotene
  • Vitamin A