302 - Serum Retinol Concentrations and Dietary Retinol Activity Equivalent (RAE) Intake of Mother-Infant Dyads in Singleton versus Twin Pregnancy at Time of Delivery

Friday, April 28, 2023

5:15 PM – 7:15 PM ET

Poster Number: 302
Publication Number: 302.128

Melissa Thoene, University of Nebraska Medical Center, Omaha, NE, United States; Sarah Duvall, University of Nebraska Medical Center, Crystal Lake, IL, United States; Mariah K. Jackson, University of Nebraska Medical Center, Omaha, NE, United States; Megan Timmerman, University of Nebraska Medical Center, Omaha, NE, United States; Jana Ponce, University of Nebraska Medical Center, Omaha, NE, United States; Matthew VanOrmer, University of Nebraska Medical Center, Omaha, NE, United States; Ann L. Anderson Berry, University of Nebraska Medical Center, OMAHA, NE, United States; Corrine Hanson, University of Nebraska Medical Center, Omaha, NE, United States

Presenting Author(s)

Melissa Thoene, MS, PhD, RD, LMNT (she/her/hers)

Assistant Professor, Division of Neonatology Registered Dietitian
University of Nebraska Medical Center
Omaha, Nebraska, United States

Background: Twin pregnancy may alter maternal nutrient needs due to the demand of extra fetal growth. However, no specific recommendation for vitamin A intake (mcg of Retinol Activity Equivalent, RAE) during twin pregnancy has been established. Considering the association between fetal development and maternal nutrition status, it is important to understand how retinol concentration is impacted by pregnancy type (singleton vs. twin).

Objective: To analyze blood retinol concentrations and dietary RAE intake in singleton vs. twin mother-infant dyads.

Design/Methods: IRB-approved study enrolled 21 mother-infant dyads (14 singleton pregnancies, 7 twin pregnancies) at time of delivery for collection of maternal and umbilical cord (UC) blood. Mothers were >19 years and there was no exclusion based on gestational age. Singleton newborns were strategically matched one–to-one with twin newborns to create groups. LC- MS/MS analyzed blood retinol concentrations and retinol deficiency was categorized per World Health Organization criteria. The Mann-Whitney U test, Spearman's Rank correlation coefficients, and Fisher's exact test or Pearson's Chi Square test evaluated the data and p-value < 0.05 was statistically significant.

Results:

Retinol concentrations did not differ between twin 1 vs. 2 (p=0.383). However, retinol was significantly lower in twin mothers and infants compared to singletons (Table 1), despite no difference in maternal RAE intake between groups (p=0.603) and all mothers meeting minimum recommended RAE intake of 770 mcg/day. 7% of singleton mothers were retinol deficient vs. 57% of twin mothers (p=0.025), 57% of singleton vs. 14% of twin mothers were retinol adequate (p=0.159). Likewise, all twin infants were deficient but no singletons (p< 0.001), and only 7% of singleton infants were adequate (p=1.000). Correlations existed between maternal and UC retinol in singleton, but not twin dyads (Table 2).

Conclusion(s): Twin pregnancy may increase risk for maternal and infant retinol deficiency at time of delivery. Future research should evaluate these findings in a larger sized cohort and also resulting retinol concentrations in breast milk.