Emmanuel K. Addo OD , Joanna E. Gorka BS , Susan J. Allman CCRC , Deborah Y. Harrison MSc , Mohsen Sharifzadeh PhD , Robert O. Hoffman MD , M. Elizabeth Hartnett MD , Michael W. Varner MD , Paul S. Bernstein MD, PhD
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This report focuses on the ocular effects of prenatal carotenoid supplementation.</p></div><div><h3>Design</h3><p>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.</p></div><div><h3>Subjects</h3><p>We enrolled low-risk pregnancy subjects aged ≥18 years from the obstetrics and gynecology clinic of the University of Utah Hospital.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Main Outcome Measures</h3><p>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.</p></div><div><h3>Results</h3><p>Following supplementation, there was a statistically significant increase in maternal macular pigment optical volume (<em>P</em> < 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 (<em>P</em> = 0.242) and more mature foveal parameters compared with those in the Control Group.</p></div><div><h3>Conclusion</h3><p>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. 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引用次数: 0
摘要
目的 叶黄素（L）和玉米黄质（Z）是黄绿素类胡萝卜素，被认为可促进孕产妇健康以及婴儿的视觉和神经发育。在这项研究中，我们确定了产前补充叶黄素和玉米黄质对母亲及其新生儿全身和眼部类胡萝卜素状态的影响（NCT03750968）。设计一项前瞻性随机临床试验，47 名受试者按 1:1 随机分配，从怀孕头三个月开始接受标准护理产前维生素以及 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以及安慰剂软胶囊（对照组）。我们从犹他大学医院的妇产科诊所招募了年龄≥18岁的低风险妊娠受试者。方法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体黄斑、皮肤和血清中类胡萝卜素的浓度。主要结果测量研究期间母婴黄斑色素、皮肤和血清类胡萝卜素状况的变化。结果补充类胡萝卜素后，在所有研究时间点，类胡萝卜素组的母体黄斑色素光学体积相对于对照组都有统计学意义上的显著增加（P< 0.001），而且没有发现母体眼部类胡萝卜素消耗。与对照组相比，类胡萝卜素组的婴儿皮肤和血清类胡萝卜素显著增加。作为探索性终点，类胡萝卜素组婴儿的黄斑色素光学密度比对照组增加了20%（P = 0.242），眼窝参数也更加成熟。这项研究为今后在高危妊娠中进行产前补充类胡萝卜素的多中心研究的设计和实施提供了重要数据。
Ocular Effects of Prenatal Carotenoid Supplementation in the Mother and Her Child: The Lutein and Zeaxanthin in Pregnancy (L-ZIP) Randomized Trial - Report Number 2
Purpose
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.
Design
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.
Subjects
We enrolled low-risk pregnancy subjects aged ≥18 years from the obstetrics and gynecology clinic of the University of Utah Hospital.
Methods
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.
Main Outcome Measures
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.
Results
Following supplementation, there was a statistically significant increase in maternal macular pigment optical volume (P < 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 (P = 0.242) and more mature foveal parameters compared with those in the Control Group.
Conclusion
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.
Financial Disclosure(s)
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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