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Previous issue date: 2015-05-05 / O termo vitamina E refere-se a um grupo de oito compostos moleculares que
diferem em estrutura e biodisponibilidade, sendo o RRR-alfa-tocoferol a forma mais
ativa biologicamente. A composi??o de vitamina E no leite materno sofre varia??es
ao longo da lacta??o, sendo o leite colostro mais rico neste micronutriente quando
comparado ao leite de transi??o e maduro. Os rec?m-nascidos, especialmente os
prematuros s?o mais suscept?veis a defici?ncia de vitamina E e para prevenir os
danos causados por esta defici?ncia tem sido proposta a suplementa??o do neonato
com este micronutriente, por?m, n?o existe consenso para realiza??o desta
interven??o. Assim, a suplementa??o materna com RRR-alfa-tocoferol no p?s-parto
pode ser uma boa alternativa para tentar elevar os n?veis de alfa-tocoferol no leite
materno e, consequentemente, fornecer ao rec?m-nascido prematuro quantidades
adequadas de vitamina E. Este estudo objetivou avaliar o efeito da suplementa??o
com 400 UI de acetato de RRR-alfa-tocoferol em mulheres com partos prematuros,
sobre a concentra??o de alfa-tocoferol no leite materno colostro, transi??o e maduro.
Participaram do estudo 89 pu?rperas adultas saud?veis, que foram distribu?das no
grupo controle (n = 51) e grupo suplementado (n = 38). Foram coletadas amostras
de sangue e leite colostro logo ap?s o parto (leite 0h), vinte e quatro horas ap?s,
nova al?quota de leite colostro foi coletado (leite 24h). O leite de transi??o e maduro
foram coletados em sete dias (leite 7d) e trinta dias (leite 30d) ap?s o parto,
respectivamente. A suplementa??o no grupo suplementado foi realizada ap?s a
coleta de sangue e leite 0h. As an?lises de alfa-tocoferol foram realizadas por
cromatografia l?quida de alta efici?ncia. Valores s?ricos de alfa-tocoferol menores
que 516 ?g/dL foram considerados indicativos de defici?ncia nutricional. A
concentra??o m?dia de alfa-tocoferol no soro das parturientes do grupo controle foi
1159,8 ? 292,4 ?g/dL e do grupo suplementado foi 1128,3 ? 407,2 ?g/dL (p = 0,281).
Todas as pu?rperas apresentaram estado nutricional em vitamina E adequado. Em
ambos os grupos, foi poss?vel observar que a concentra??o de vitamina E no leite
colostro foi maior em rela??o ao leite de transi??o e maduro. No grupo
suplementado, a concentra??o de alfa-tocoferol no leite 24h aumentou em 60% ap?s
a suplementa??o, passando de 1339,3 ? 414,2 ?g/dL (leite 0h) para 2234,7 ? 997,3
?g/dL (leite 24h). Enquanto que o grupo controle os valores no colostro 0h e colostro
24h foram semelhantes (p = 0,681). No leite de transi??o do grupo controle o valor
de alfa-tocoferol foi 875,3 ? 292,4 ?g/dL e no grupo suplementado 1352,8 ? 542,3
?g/dL, com aumento de 35% no grupo suplementado em rela??o ao controle (p <
0,001). No leite maduro as concentra??es de alfa-tocoferol entre o grupo controle
(426,6 ? 187,5 ?g/dL) e suplementado (416,4 ? 214,2 ?g/dL) foram semelhantes (p =
0,853). Apenas o leite 24h do grupo suplementado atendeu o requerimento
nutricional de alfa-tocoferol (4 mg/dia) do rec?m-nascido. Tais resultados evidenciam
que o transporte deste micronutriente para o leite ocorre de maneira controlada e
limitada. Dessa forma, a suplementa??o materna com vitamina E eleva a
concentra??o de alfa-tocoferol no leite colostro e de transi??o e n?o influencia a
concentra??o no leite maduro. Apenas o aumento no leite colostro foi suficiente para
atingir o requerimento nutricional do rec?m-nascido prematuro. / The term vitamin E refers to a group of eight molecular compounds which
differ in structure and bioavailability, and the RRR-alpha-tocopherol more biologically
active form. The composition of vitamin E in breast milk undergoes variations during
lactation, colostrum and milk richer in this micronutrient compared to transitional and
mature milk. Newborns, especially premature infants are more susceptible to vitamin
E deficiency and to prevent the damage caused by this deficiency has been
proposed supplementation of neonates with this micronutrient, however, there is no
consensus to carry out this intervention. Thus, maternal supplementation with RRRalpha-tocopherol
in the postpartum period can be a good alternative to try to raise the
alpha-tocopherol levels in breast milk and therefore provide the premature newborn
adequate amounts of vitamin E. This study to evaluate the effect of supplementation
with 400 UI acetate RRR-alpha-tocopherol in women with premature births, on the
concentration of alpha-tocopherol in breast milk colostrum, transitional and mature.
The study included 89 healthy adult women were enrolled in the control group (n =
51) and supplemented group (n = 38). Blood samples were collected and milk
colostrum soon after birth (0h milk) twenty-four hours, new rate of colostrum milk was
collected (24h milk). The transitional and mature milk were collected in seven days
(7d milk) and thirty days (30d milk) after delivery, respectively. Supplementation in
the supplemented group was held after the collection of blood and 0h milk. The
alpha-tocopherol analyzes were performed by high-performance liquid
chromatography. Serum levels of alpha-tocopherol less than 516 ?g/dL were
considered indicative of nutritional deficiency. The average concentration of alphatocopherol
in the serum of the control group mothers was 1159.8 ? 292.4 ?g/dL and
the supplemented group was 1128.3 ? 407.2 ?g/dL (p = 0.281). All women had
nutritional status in vitamin E suitable. In both groups, it was observed that the
concentration of vitamin E in colostrum milk was higher compared to transitional and
mature milk. In the supplemented group, the concentration of alpha-tocopherol in the
milk increased 60 % after supplementation, from 1339.3 ? 414.2 ?g/dL (0h milk) to
2234.7 ? 997.3 ?g/dL (24h milk). While the control group values in colostrum 0h and
colostrum 24h were similar (p = 0.681). In the control group the follow-on milk alphatocopherol
value was 875.3 ? 292.4 ?g/dL and in the group supplemented 1352.8 ?
542.3 ?g/dL, an increase of 35% in the supplemented group compared to control (p
<0.001). In mature milk alpha-tocopherol concentrations between the control group
(426.6 ? 187.5 ?g/dL) and supplemented (416.4 ? 214.2 ?g/dL) were similar (p =
0.853). Only 24h milk supplemented group answered the nutritional requirement of
alpha-tocopherol (4 mg/day) of the newborn. These results show that the transport of
this micronutrient for milk occurs in a controlled and limited way. Thus, the native
vitamin E supplementation increases the concentration of alpha-tocopherol in
colostrum and milk and transition does not influence the concentration in mature milk.
Only the increase in colostrum milk was sufficient to meet the nutritional requirement
of premature newborns.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/20053 |
| Date | 05 May 2015 |
| Creators | Pires, Jeane Franco |
| Contributors | 18095640425, http://lattes.cnpq.br/8520928220989866, Bezerra, Danielle Soares, 03378988479, http://lattes.cnpq.br/4545867903131219, Ramalho, Heryka Myrna Maia, 03277964485, http://lattes.cnpq.br/7004568465714771, Neves, Renata Alexandra Moreira das, Dimenstein, Roberto |
| Publisher | Universidade Federal do Rio Grande do Norte, PROGRAMA DE P?S-GRADUA??O EM BIOQU?MICA, UFRN, Brasil |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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