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First-trimester plasma tocopherols are associated with risk of miscarriage in rural Bangladesh.

The American journal of clinical nutrition (2015-02-04)
Abu Ahmed Shamim, Kerry Schulze, Rebecca D Merrill, Alamgir Kabir, Parul Christian, Saijuddin Shaikh, Lee Wu, Hasmot Ali, Alain B Labrique, Sucheta Mehra, Rolf D W Klemm, Mahbubur Rashid, Pongtorn Sungpuag, Emorn Udomkesmalee, Keith P West

Tocopherols were discovered for their role in animal reproduction, but little is known about the contribution of deficiencies of vitamin E to human pregnancy loss. We sought to determine whether higher first-trimester concentrations of α-tocopherol and γ-tocopherol were associated with reduced odds of miscarriage (pregnancy losses <24 wk of gestation) in women in rural Bangladesh. A case-cohort study in 1605 pregnant Bangladeshi women [median (IQR) gestational age: 10 wk (8-13 wk)] who participated in a placebo-controlled vitamin A- or β-carotene-supplementation trial was done to assess ORs of miscarriage in women with low α-tocopherol (<12.0 μmol/L) and γ-tocopherol (<0.81 μmol/L; upper tertile cutoff of the γ-tocopherol distribution in women who did not miscarry). In all women, plasma α- and γ-tocopherol concentrations were low [median (IQR): 10.04 μmol/L (8.07-12.35 μmol/L) and 0.66 μmol/L (0.50-0.95 μmol/L), respectively]. In a logistic regression analysis that was adjusted for cholesterol and the other tocopherol, low α-tocopherol was associated with an OR of 1.83 (95% CI: 1.04, 3.20), whereas a low γ-tocopherol concentration was associated with an OR of 0.62 (95% CI: 0.41, 0.93) for miscarriage. Subgroup analyses revealed that opposing ORs were evident only in women with BMI (in kg/m(2)) ≥18.5 and serum ferritin concentration ≤150 μg/L, although low BMI and elevated ferritin conferred stronger risk of miscarriage. In pregnant women in rural Bangladesh, low plasma α-tocopherol was associated with increased risk of miscarriage, and low γ-tocopherol was associated with decreased risk of miscarriage. Maternal vitamin E status in the first trimester may influence risk of early pregnancy loss. The JiVitA-1 study, from which data for this report were derived, was registered at as NCT00198822.

Product Number
Product Description

(+)-α-Tocopherol, from vegetable oil, Type V, ~1000 IU/g
Ferritin from human liver, Type IV, 10 μg/mL
(+)-α-Tocopherol, Type VI, from vegetable oil, liquid (≥0.88M based on potency, density and molecular wt.), BioReagent, suitable for insect cell culture, ≥1000 IU/g
Cholesterol, Plant-Derived, SyntheChol®, NF, Ph. Eur., JP
Cholesterol, Sigma Grade, ≥99%
Cholesterol, powder, BioReagent, suitable for cell culture, ≥99%
Cholesterol, from sheep wool, ≥92.5% (GC), powder
Cholesterol, tested according to Ph. Eur.
Ferritin from equine spleen, Type I, saline solution
Ferritin from human spleen, Type V, 10 μg/mL in 0.15 M NaCl, 10 mM Tris, pH 8.0, containing 0.1% sodium azide
SyntheChol® NS0 Supplement, 500 ×, synthetic cholesterol, animal component-free, aqueous solution, sterile-filtered, suitable for cell culture
Cholesterol solution, certified reference material, 10 mg/mL in chloroform
Tocopherols, mixed, FCC, Low-α type, FG