Effect of vitamin A on the relationship between maternal thyroid hormones in early pregnancy and fetal growth: A prospective cohort study

Using inflammatory biomarkers in early pregnancy to predict subsequent antenatal depression

BACKGROUND

Antenatal depression (AD) is one of the most common pregnancy complications. Recent studies indicated that immune responses during pregnancy may contribute to development of AD.

OBJECTIVES

This study aimed to identify possible inflammatory biomarkers in early pregnancy to predict maternal depressive symptoms before delivery.

METHODS

This case-control study was conducted within the Maternal and Infant Health (MI-Health) birth cohort (Beijing, China) and depressive symptoms were assessed by Zung Self-rating Depression Scale (SDS) in both second and third trimesters. By using immune multi-factors kits, we tested 26 inflammatory factors in the serum of 38 cases with antenatal depression symptoms in both trimesters (SDS ≥ 53) and 38 controls. Logistic regression was used to identify candidate biomarkers, and the predictive capabilities were evaluated by using Receiver Operator Characteristics (ROC) analysis.

RESULTS

The concentrations of ln(CCL24) (p = 0.020), IL-7 (p = 0.006) and IL-10 (p = 0.014) were higher in early pregnancy among women with depressive symptoms comparing to healthy controls. The difference remained statistically significant after adjusting for maternal age, education level, gestational diabetes mellitus, pre-pregnancy BMI and gestational weeks of blood sampling (OR(ln(CCL24)) = 4.625, OR(IL-7) = 1.414, OR(IL-10) = 1.151). In ROC analysis, ln(CCL24), IL-7, and IL-10 achieved discrimination for depressive symptoms antepartum, with the values of AUC estimated at 0.75.

LIMITATIONS

The sample size is limited, and the infectious disease infection records were not collected for control.

CONCLUSION

Higher levels of CCL24, IL-7 and IL-10 may indicate the higher risk of antenatal depression and are potential biomarkers indicating pathogenesis of antenatal depression.

Differences in Vitamin A Levels and Their Association with the Atherogenic Index of Plasma and Subclinical Hypothyroidism in Adults: A Cross-Sectional Analysis in China

BACKGROUND

This study evaluates the association between vitamin A levels, AIP (the atherogenic index of plasma), and subclinical hypothyroidism.

METHODS

A cross-sectional analysis was conducted involving a representative sample of 3530 Chinese adults. Linear and logistic regression models were utilized to evaluate the associations between AIP and subclinical hypothyroidism, stratified by vitamin A levels. These analyses were further differentiated by sex and age groups to identify any demographic-specific associations.

RESULTS

In the vitamin A-sufficient group, an increase in AIP was associated with elevated total triiodothyronine (TT3) levels (β = 0.26, 95%CI: 0.09, 0.41, p = 0.003). Conversely, in the group with severe vitamin A deficiency, higher AIP levels were linked to increased free triiodothyronine (fT3) and TT3 levels and decreased free thyroxine (fT4) levels (β = 0.12, 0.03, and -0.29, respectively). Additionally, severe vitamin A deficiency increased the risk associated with AIP and subclinical hypothyroidism (OR = 1.66, 95%CI: 1.07, 2.58, p = 0.025). This risk was notably more pronounced in women and older adults, with odds ratios of 2.44 (95%CI: 1.55, 3.86, p < 0.001) and 2.14 (95%CI: 1.36, 3.38, p = 0.001), respectively.

CONCLUSIONS

Vitamin A deficiency may increase the risk of the association between AIP and subclinical hypothyroidism, particularly among women and the elderly.

Diet in Thyroid Disorders: A Survey among Clinicians and a Review of the Current Perspective

Physicians and endocrinologists commonly face various questions related to dietary interventions during clinical encounters with their patients with thyroid disorders. Indeed, both patients and treating physicians have various misconceptions regarding thyroid-specific diets, possibly because of misinformation circulated in lay media or grey literature and the misinterpretation of contradictory scientific data, respectively. In this review, we attempted to answer some frequently asked questions by the patients in the backdrop of contraindicatory perceptions of physicians observed in our survey. Additionally, we tried to put a perspective on dietary factors related to thyroid disorders through the available scientific evidence to help make an informed decision-making.

Pre-pregnancy body mass index, gestational diabetes mellitus, and gestational weight gain: individual and combined effects on fetal growth

Background

Pre-pregnancy body mass index (BMI), gestational diabetes mellitus (GDM), and gestational weight gain (GWG) are interlinked and may play a complex role in fetal growth. We aimed to examine the relationship between pre-pregnancy BMI, GDM, GWG, and fetal growth outcomes and explore the contribution of GDM and GWG to the relationship between Pre-pregnancy obesity/overweight and large-for-gestational-age (LGA) in a prospective cohort.

Methods

We prospectively recruited women in the first trimester and having one-step GDM screened with a 75-g oral glucose tolerance test between 24 and 28 weeks of gestation (n = 802). Outcomes included LGA, small-for-gestational-age (SGA), and preterm birth. To assess the individual and cumulative associations between pre-pregnancy BMI, GDM, GWG, and these outcomes, we used multivariate logistic regression analysis. Furthermore, we employed structural equation modeling (SEM) to investigate the mediating role of GDM and excessive GWG in the correlation between pre-pregnancy overweight/obesity and LGA.

Results

Pre-pregnancy obesity, GDM, and excessive GWG were all independently associated with increased odds of LGA. Inadequate GWG was associated with higher odds of preterm birth. Compared with women unexposed to pre-pregnancy overweight/obesity, GDM, or excessive GWG, women exposed any two conditions had higher odds for LGA (AOR 3.18, 95% CI 1.25-8.11) and women with coexistence of all had the highest odds for LGA (AOR 8.09, 95% CI 2.18-29.97). The mediation analysis showed that GDM explained 18.60% (p < 0.05) of the total effect of pre-pregnancy overweight/obesity on LGA, and GWG explained 17.44% (p < 0.05) of the total effect.

Conclusion

Pre-pregnancy obesity/overweight, GDM, and excessive GWG are associated with higher odds of fetal growth disturbances as individual factors and when they co-exist. The effect of pre-pregnancy overweight/obesity on LGA is partially achieved through GDM and excessive GWG.

Association of vitamin A with gestational diabetes and thyroid disorders in pregnancy and their influence on maternal, fetal, and neonatal outcomes

Gestational diabetes mellitus (GDM) and thyroid disorders during pregnancy pose significant health concerns, impacting a substantial number of mothers globally. Globally, about 14% of pregnant women develop GDM, while thyroid disorders impact approximately 2%-3%. Both conditions contribute to adverse outcomes, including gestational hypertension, excessive fetal growth, and heightened perinatal morbidity. The central focus of this literature review is to examine the relationship between vitamin A, a crucial fat-soluble micronutrient in fetal development, and the occurrence of GDM and thyroid disorders during pregnancy. The primary research question investigates the association between vitamin A, GDM, and thyroid disorders, analyzing their combined impact on maternal, fetal, and neonatal outcomes. The review underscores the potential of vitamin A to modulate the risk and outcomes of GDM and thyroid disorders during gestation, emphasizing its role in GDM development and resolution and its influence on thyroid function in pregnancy.