Plasma and breast milk vitamin A as indicators of vitamin A status in pregnant women

Breast milk vitamin A is not well characterized as an indicator of vitamin A status in women with infections. A controlled trial of vitamin A, 3 mg re tinol equivalent/day, was conducted among 697 pregnant women with human imm unodeficiency virus (HIV) infection in Malawi which allowed comparison of p lasma versus breast milk vitamin A as indicators of vitamin A status. Retin ol concentrations were measured in plasma at baseline (18-28 weeks) and 38 weeks gestation and breast milk at 6 weeks post-partum. Plasam alpha (1)-ac id glycoprotein (ACP) and C-reactive protein (CRP) were measured at baselin e. Plasma retinol (geometric mean, SD) at 38 weeks was 0.72(0.44, 1.18) and 0.61 (0.38, 0.98) mu mol/L (P < 0.0002) and breast milk retinol was 1.32 ( 0.71, 2.43) and 0.95 (0.49, 1.82) mu mol/L ( P < 0.0001) in vitamin A and p lacebo groups, respectively. Women with elevated acute phase protein (AGP > 1 gm/L and/or CRP > 5 mg/L) at baseline who received vitamin A had signifi cantly higher plasma and breast milk vitamin A at follow-up compared with p lacebo. Elevated acute phase proteins did not distinguish women with low bo dy stores of vitamin A. Breast milk retinol appears to be a better indicato r of vitamin A status than plasma retinol in women with infections.