Abstract
There are no established diagnostic criteria for neonatal vitamin A deficiency (VAD), and applying adult VAD criteria to neonates may overestimate the neonatal VAD rate. This study aimed to evaluate neonatal vitamin A (VA) status and redefine thresholds for neonatal VA adequacy and deficiency based on maternal VA nutrition. A cross-sectional study involving 1901 mother-neonate pairs was conducted in Chongqing, China. VA nutritional status was assessed by measuring serum VA levels and dietary VA intake from the third trimester to birth. The VAD rates of maternal dietary intake and serum were 27.091% and 23.356%, respectively, while 88.8% of neonates had serum VA levels < 0.70 μmol/L, the threshold for adult VAD. Neonatal VA levels were significantly lower than maternal levels. All neonates were healthy, with no clinical signs of VAD. Neonatal VA levels correlated positively with maternal VA levels. The threshold for neonatal VA adequacy was estimated to be ≥ 0.489 (95%CI: 0.464-0.512) μmol/L when maternal VA nutrition was adequate, and the 2.5th percentile of VA levels among all neonates was 0.192 μmol/L, predicting neonatal VAD. The study concluded that neonatal VAD rates might be overestimated, as most neonates received adequate VA from their mothers. Maternal VA status is a reliable predictor of neonatal VA status due to their close relationship. This study offers a new perspective on prenatal nutrition for determining neonatal VA adequacy and deficiency thresholds and developing neonatal VA supplementation programs. Further research is needed.