A new study published in the American Journal of Clinical Nutrition has found that maternal vitamin E status in the first trimester may influence risk of early pregnancy loss. This is believed to be the first population study of early pregnancy vitamin E nutritional status and risk of miscarriage.

In rural Bangladesh, which is a typically undernourished population, alpha-tocopherol and gamma-tocopherol plasma status was measured in 1,605 women. According to the Institute of Medicine (IOM), alpha-tocopherol accounts for vitamin E activity. A total of 1,161 of the women (72.3 percent) had low-to-deficient vitamin E status defined by a plasma alpha-tocopherol concentration of <12.0 µmol/L. The most important finding was that women with low alpha-tocopherol concentrations were almost twice more likely to miscarry than women with normal status. Women with low gamma-tocopherol status were also significantly more likely to miscarry than those with higher concentrations.

Vitamin E status is rarely assessed in pregnant women in undernourished populations. The cutoff of plasma alpha-tocopherol concentration 12.0 µmol/L was proposed to define vitamin E deficiency in normal, healthy adults. However, to date, there is no consensus on the definition of vitamin E deficiency in pregnant women because α-tocopherol concentrations increase with blood lipids over the course of pregnancy.

Dr Keith West, lead scientist from the Johns Hopkins Bloomberg School of Public Health and one of the authors of the new research paper, commented: “Micronutrient deficiencies are a public health concern as diets undergo change across diverse cultures.

“Vitamin E deficiency, widely thought not to exist, does—very much so in rural South Asia—and may place mothers at risk of miscarriage. This finding resonates with observed placental failure noted in deficient animals by Evans and Bishop in 1922, which led to the vitamin being named ‘tocopherol’. The term was drawn from the Greek language meaning ‘to bear offspring’.”      

The findings show an association between adequate alpha-tocopherol status and reduced risk of miscarriage in human populations, inviting future study of potential beneficial effects of achieving adequate vitamin E status during pregnancy.