Addo Emmanuel K, Gorka Joanna E, Allman Susan J, Harrison Deborah Y, Sharifzadeh Mohsen, Hoffman Robert O, Hartnett M Elizabeth, Varner Michael W, Bernstein Paul S
Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, 65 Mario Capecchi Drive, Salt Lake City, Utah, 84132.
Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah.
Ophthalmol Sci. 2024 Apr 24;4(5):100537. doi: 10.1016/j.xops.2024.100537. eCollection 2024 Sep-Oct.
Lutein (L) and zeaxanthin (Z) are xanthophyll carotenoids that have been promoted to enhance maternal health and infant visual and neurodevelopment. In this study, we determined the effects of prenatal L and Z supplementation on systemic and ocular carotenoid status in the mother and her newborn infant (NCT03750968). This report focuses on the ocular effects of prenatal carotenoid supplementation.
A prospective randomized clinical trial with 47 subjects randomly assigned by 1:1 allocation to receive standard-of-care prenatal vitamins along with 10 mg L and 2 mg Z softgel (Carotenoid Group) or standard-of-care prenatal vitamins with a placebo softgel (Control Group) starting in the first trimester.
We enrolled low-risk pregnancy subjects aged ≥18 years from the obstetrics and gynecology clinic of the University of Utah Hospital.
Maternal macular, skin, and serum carotenoid concentrations were measured using autofluorescence imaging, resonance Raman spectroscopy, and high-performance liquid chromatography, respectively. Infants' ocular carotenoids and retinal architecture were measured by blue light reflectance imaging and spectral-domain OCT, respectively.
Changes in maternal and infant macular pigment, skin, and serum carotenoid status over the study period. Differences in infants' retinal maturity indicators between the 2 study groups.
Following supplementation, there was a statistically significant increase in maternal macular pigment optical volume ( < 0.001) in the Carotenoid Group relative to the Control Group at all study time points, and there was no detectable maternal ocular carotenoid depletion. Infant skin and serum carotenoids increased significantly in the Carotenoid Group compared with the Control Group. As exploratory endpoints, infants in the Carotenoid Group had a 20% increase in macular pigment optical density ( = 0.242) and more mature foveal parameters compared with those in the Control Group.
Prenatal carotenoid supplementation significantly increased maternal and infant systemic carotenoids and caused a pattern of increased infant ocular carotenoid status, which may benefit both mothers and their infants' ocular development and function. This study provides important data to design and power a future multicenter study of prenatal carotenoid supplementation in higher-risk pregnancies.
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
叶黄素（L）和玉米黄质（Z）是叶黄素类胡萝卜素，已被推广用于促进孕产妇健康以及婴儿的视觉和神经发育。在本研究中，我们确定了产前补充L和Z对母亲及其新生儿全身和眼部类胡萝卜素状态的影响（NCT03750968）。本报告重点关注产前补充类胡萝卜素的眼部影响。
一项前瞻性随机临床试验，47名受试者按1:1分配随机分组，从孕早期开始接受标准护理产前维生素加10毫克L和2毫克Z软胶囊（类胡萝卜素组）或标准护理产前维生素加安慰剂软胶囊（对照组）。
我们从犹他大学医院妇产科诊所招募了年龄≥18岁的低风险妊娠受试者。
分别使用自发荧光成像、共振拉曼光谱和高效液相色谱法测量母亲黄斑、皮肤和血清中的类胡萝卜素浓度。分别通过蓝光反射成像和光谱域光学相干断层扫描测量婴儿的眼部类胡萝卜素和视网膜结构。
研究期间母亲和婴儿黄斑色素、皮肤和血清类胡萝卜素状态的变化。两个研究组婴儿视网膜成熟指标的差异。
补充后，在所有研究时间点，类胡萝卜素组母亲的黄斑色素光学体积相对于对照组有统计学显著增加（<0.001），且未检测到母亲眼部类胡萝卜素耗竭。与对照组相比，类胡萝卜素组婴儿的皮肤和血清类胡萝卜素显著增加。作为探索性终点，与对照组相比，类胡萝卜素组婴儿的黄斑色素光密度增加了20%（=0.242），且中央凹参数更成熟。
产前补充类胡萝卜素显著增加了母亲和婴儿的全身类胡萝卜素，并导致婴儿眼部类胡萝卜素状态增加，这可能对母亲及其婴儿的眼部发育和功能有益。本研究为设计和开展未来关于高危妊娠产前补充类胡萝卜素的多中心研究提供了重要数据。
作者对本文讨论的任何材料均无所有权或商业利益。
