Vitamin A

Although poor maternal vitamin A status is associated with preterm birth, intrauterine growth retardation, low birth weight, and increased maternal infection in developing regions of the world, vitamin A deficiency is quite rare in industrialized countries due the higher intake of the preformed vitamin (reti-nol). An increase of 50 mg/day for the entire pregnancy period is added to the EAR for nonpregnant adolescent girls and women, based on accumulation of vitamin A in the liver of the fetus. Excessive preformed vitamin A (>3000 mgRAE) should be avoided shortly before or during pregnancy, especially in the early months, because of its potential teratogenicity, so the upper limit for vitamin A intake in pregnancy is set at 3000 mg RAE/day for all women of childbearing age. An alternative dose schedule is up to 8500 RAE weekly during pregnancy. Fetal vitamin A toxicity and birth defects have also occurred from ingestion of isotretinoin and etrenti-nate, drugs used for treatment of severe cystic acne. High intakes of ^carotene (a precursor of vitamin A) do not have the same teratogenic effects.

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