doctoralThesis
Estado Nutricional em vitaminas e de mães e crianças pré-termo e termo do nascimento aos 3 meses pós-parto
Fecha
2016-06-10Registro en:
RODRIGUES, Karla Danielly da Silva Ribeiro. Estado Nutricional em vitaminas e de mães e crianças pré-termo e termo do nascimento aos 3 meses pós-parto. 2016. 148f. Tese (Doutorado Em Bioquímica) - Centro De Biociências, Universidade Federal do Rio Grande do Norte, Natal, 2016.
Autor
Rodrigues, Karla Danielly Da Silva Ribeiro
Resumen
Vitamin E is a fat-soluble antioxidant micronutrient extremely important for
preterm newborns (< 37 weeks gestation) since it protects the central nervous
system and prevents hemolytic anemia and bronchopulmonary dysplasia. Due to its
limited placental transfer, the provision of vitamin E to the infant through breast milk
is essential to ensure an adequate supply and to prevent/correct deficiencies. There
is limited data on the vitamin E recovery in infants through the lactation period and
the composition of alpha-tocopherol in preterm breast milk. This study aimed to
evaluate the differences in the vitamin E nutritional status of women, preterm and
term infants from birth to 3 months postnatal, their relationships and the
concentration of alpha-tocopherol in breast milk. A prospective study was initially
conducted with 235 postpartum women and infants attending two public maternities
in Rio Grande do Norte, Brazil, 124 allocated in the preterm group and 111 in the
term group (≥ 37 weeks), being followed up until 90 days after delivery. Colostrum,
maternal blood and umbilical cord were collected up to 48 hours after delivery. Breast
milk and dietary data were collected at 7, 30 and 90 days postpartum, as well as
maternal and children’s blood at day 90. Alpha-tocopherol was analyzed by High
Performance Liquid Chromatography. Vitamin E dietary intake of women and the
vitamin supply to the infant were assessed according to consumption
recommendations for the age group. The concentration of maternal serum alphatocopherol
was not different between the groups, and an increase in vitamin E
deficiency was found (< 517 µg/dL) through lactation (from 8.6% to 22.2%), reaching
789.6 (313.1) µg/dL in the preterm group and 875.3 (341.6) µg/dL in the term group
(p = 0.197). All women presented inadequate vitamin E intake during lactation
(<16mg/day). Over 90% of infants presented low alpha-tocopherol levels at birth
(<500µg/dL), and at day 90 the mean concentration of serum alpha-tocoferol was
583.3 (209.4) µg/dL in the preterm group and 884.4 (458.8) µg/dL in the term group
(p < 0.007), evidencing higher percentages of inadequacy in the infants from the
preterm group. There was a positive association in serum alpha-tocopherol levels
between the mother and the infant, and the premature delivery negatively influenced
the infant's serum levels. In the preterm group, alpha-tocopherol levels were lower in
colostrum, yet higher in transitional and mature milk (day 30), in comparison to the
term group (p < 0.0001). Only mature milk did not provide the vitamin E amount
recommended for infants (4 mg/day). Thus, it was found a high inadequacy of vitamin
E at 3 months postpartum in both women and preterm children, differences in
preterm milk composition and a possible supply of small amounts of vitamin E by
mature milk, highlighting the need of greater nutritional assistance during lactation,
especially due to vitamin E deficiency and its effects on children's cognitive
development.