134 - Tocopherol Content of Maternal and Cord Blood at Time of Delivery and Relationships With Neonatal Respiratory Outcomes

Poster Number: 134
Publication Number: 134.436

Madison Han, University of Nebraska College of Medicine, Omaha, NE, United States; Kara Bown, University of Nebraska College of Medicine, Omaha, NE, United States; Braden J. Fink, University of Nebraska Medicine, Omaha, NE, United States; Rose E. McCoy, University of Nebraska Medical Center College of Medicine, Omaha, NE, United States; Denise Torres, University of Nebraska College of Medicine, Omaha, NE, United States; Annie Nguyen, University of Nebraska Medical Center, Omaha, NE, United States; Dannielle J. Schutz, University of Nebraska Medical Center, Otoe, NE, United States; Theresa R. Trautman, University of Nebraska College of Medicine, Omaha, NE, United States; MATTHEW VANORMER, University of Nebraska at Omaha, OMAHA, NE, United States; Rebecca A. Slotkowski, University of Nebraska Medical Center, Papillion, NE, United States; Anum Akbar, University of Nebraska College of Medicine, Omaha, NE, United States; Taija Hahka, UNMC, Omaha, NE, United States; Corrine Hanson, University of Nebraska Medical Center, Omaha, NE, United States; Melissa Thoene, University of Nebraska Medical Center, Omaha, NE, United States; Ann L. Anderson Berry, University of Nebraska Medical Center, OMAHA, NE, United States

Background: Maternal vitamin E can influence fetal development through alteration of oxidative and inflammatory mechanisms. Pro-inflammatory states during pregnancy are associated with preterm labor and disrupted fetal lung development. α-tocopherol and γ-tocopherol are isomers of vitamin E related to anti-inflammatory and pro-inflammatory processes, respectively. α-tocopherols may be protective nutrients during the fetal period due to their anti-inflammatory properties, with evidence indicating a positive effect on birth weights and gestational age at delivery. However, little is known about what effect these antioxidant nutrients have on respiratory outcomes in this vulnerable patient population.  

Objective: The purpose of this study was to evaluate the relationship between plasma α- and γ-tocopherol concentrations in mother-infant dyads and neonatal respiratory outcomes. 

Design/Methods: An IRB-approved study enrolled 333 mother-infant pairs at delivery. Maternal blood was collected during labor and cord blood samples following delivery to be analyzed for α- and γ-tocopherol concentrations. A Mann-Whitney U test compared median plasma tocopherol content between neonatal outcome groups, including respiratory distress syndrome (RDS) and intubation upon NICU admission. Spearman correlations related plasma tocopherol levels with corrected gestational age (CGA) and continuous neonatal respiratory outcomes. A p-value < 0.05 was considered statistically significant. 

Results: Median levels of α-tocopherol in maternal and cord plasma samples were 14972 (mcg/L) and 2329 (mcg/L), respectively. Median levels of γ-tocopherol in maternal and cord plasma samples were 1504 (mcg/L) and 198 (mcg/L), respectively. Mothers with infants intubated upon admission had significantly lower plasma α-tocopherol than those with non-intubated infants (10366 vs 14830, p = 0.014). Maternal plasma α-tocopherol concentration was negatively correlated with days on ventilation and positively correlated with 5-min APGAR (p = 0.004 and 0.044, respectively). 

Conclusion(s): This study suggests a positive relationship between maternal blood tocopherol levels with improved respiratory outcomes whereas levels in cord blood had an inverse relationships. Further research should explore a larger sample for analysis of maternal and fetal blood tocopherol levels throughout pregnancy and at different post-partum stages to understand their relationship with fetal development.