Prenatal nutrition: Are Vitamin A-rich foods safe during pregnancy?

Several pregnancy diets I have read recommend eating liver or substituting other foods that are high in Vitamin A. I know in the past, liver was considered to be beneficial due to it's high iron content, but I have heard that Vitamin A in large amounts can cause miscarriage and should be avoided during pregnancy. I have even read that it's important to avoid skin products containing Vitamin A at this time. Is this true? Is Vitamin A dangerous during pregnancy?

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Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

Most women do not have to worry about excess vitamin intake during pregnancy. Women who ingest Vitamin A (retinol or retinyl esters), up to 10,000 IUs per day, should have no concerns regarding increased teratogenic (causing birth defects) risk to their baby-to-be. In addition, beta-carotene as a source of vitamin A has not been shown to be teratogenic any dose.

There may be a population of women who should be alerted to the consequences of ingesting too much of the fat-soluble vitamins, A, D and E. Women are often given prenatal vitamins indiscriminately, without a full dietary assessment. Most prenatal supplements provide about 8,000 IUs. Vitamin A supplements should not exceed 10,000 IU (as retinol or retinyl esters, not beta-carotene) and when foods with a high concentration of vitamin A, for example liver, are ingested frequently, they can contribute to the overall total amount of retinol consumed daily.

The incidence of "Retinoid embryopathy," a syndrome of anomalies involving the face, ear, heart, central nervous system and thymus, is very rare, but has been associated with excessive intake of retinol. The 10,000 IU recommendation is well below any level in which birth defects have been observed.

In summary, if a woman is taking a multivitamin, prenatal vitamin or Vitamin A supplements containing less than 10,000 IU (as retinol or retinyl), or beta-carotene at any dose, there is no evidence of an increase in the risk of malformations in her baby. If she is ingesting any foods high in Vitamin A, she should investigate the amount of vitamin A contained in those food and limit her total daily intake to 10,000 IUs or less.

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