Maternal fat-soluble vitamin trajectories and infant birth weight in individuals with overweight or obesity
By
Astrid Kamilla Stunes
Unni Syversen
Anna Hundere Øvreseth
Ingvild Tapio Kinge
Siv Mørkved
Kjell Åsmund Salvesen
Kirsti Krohn Garnæs
Trine Moholdt
April 15, 2026
Clinical Scorecard: Maternal Trajectories of Fat-Soluble Vitamins and Their Impact on Birth Weight in Overweight or Obese Pregnant Individuals
At a Glance
Category Detail
Condition Maternal fat-soluble vitamin status during pregnancy Key Mechanisms Vitamins A, D, and E modulate fetal growth pathways via cellular differentiation, hormone signaling, and oxidative balance Target Population Pregnant individuals with pre-pregnancy overweight or obesity Care Setting Antenatal care in high-income settings
Key Highlights
Maternal vitamin A and D concentrations decline from second to third trimester, while vitamin E increases. Vitamin A insufficiency and vitamin D deficiency/insufficiency are common in this population during late pregnancy. No independent association was found between maternal fat-soluble vitamin levels and birth weight, including macrosomia risk. Guideline-Based Recommendations
Diagnosis
Measure plasma retinol and α-tocopherol by high performance liquid chromatography. Measure serum 25(OH)D by liquid chromatography-tandem mass spectrometry. Classify birth weight as normal (2500 – <4000 g) or macrosomic (≥4000 g). Management
Monitor maternal vitamin A, D, and E status during pregnancy, especially in overweight or obese individuals. Address vitamin D deficiency and insufficiency as they are prevalent in this population. Monitoring & Follow-up
Track changes in maternal fat-soluble vitamin concentrations between the second and third trimesters. Monitor fetal growth and birth weight outcomes in relation to maternal nutritional status. Risks
Vitamin A insufficiency and vitamin D deficiency/insufficiency may be common but were not independently linked to birth weight in this study. Macrosomia occurred in 43.9% of infants born to overweight or obese mothers. Patient & Prescribing Data
Pregnant individuals with pre-pregnancy overweight or obesity in a high-income country
Maternal fat-soluble vitamin levels during mid- to late pregnancy may not be major determinants of fetal growth or macrosomia risk in this population.
Clinical Best Practices
Consider routine assessment of fat-soluble vitamin status in pregnant individuals with overweight or obesity. Recognize that declining vitamin A and D levels during pregnancy are common and may require nutritional attention. Focus on comprehensive metabolic and nutritional management rather than relying solely on fat-soluble vitamin levels to predict birth weight outcomes. References
