Between fear and anticipation, women’s pregnancy journey begins laden with warnings and recommendations, a large part of which comes from the legacy of mothers and grandmothers, and because the pregnant woman’s body’s need for foods rich in vitamins increases during the period of fetus growth in her womb, nutritional advice has received the largest share of attention in various societies, especially in the Arab countries and the rest of the developing countries around the world.
However, with scientific progress, most of the inherited advice began to be subjected to research and verification to reveal the validity of the information that had its roots in the minds of generation after generation, in an attempt to prevent women from being led by advice that might prevent them from obtaining the nutritional elements that are essential for the health of themselves and their children.
Prohibitions vary geographically
Recommendations for women during pregnancy vary depending on the countries they live in. In South Africa, meat, fish, potatoes, fruits, eggs, and squash are classified as prohibited during pregnancy, while in Ethiopia, pregnant women are prohibited from consuming dairy products, vegetables, honey, and fruits.
As for Asian countries, there are recommendations to avoid foods rich in iron, carbohydrates, or animal proteins during pregnancy, despite the pregnant woman’s increasing need for iron. Many women abstain from eating liver – a source of iron – for example, and may experience a wave of anxiety if they eat it before they learn that they are pregnant.
Do the studies agree with societal norms prohibiting pregnant women from eating liver? And why? What are the alternatives that meet her needs during pregnancy regarding prohibited foods such as liver and others?
Why are women advised to avoid liver during pregnancy?
Between acceptance and skepticism, most women are wary of eating liver during pregnancy to avoid a potential risk that could harm the fetus or themselves, even if it is small. So what raised doubts about liver during pregnancy?
Liver, whether from chicken, cow, or goat, contains vitamin A in its active form that the body can easily absorb, which is known as “preformed vitamin A.” It is joined by other animal sources such as cheese, milk, butter, egg yolks, fish oil, and cod liver oil.
If its level in a pregnant mother increases, vitamin A is associated with the possibility of fetal deformities, or perhaps miscarriage, as it is transformed in various body tissues into one of its active, unstable forms known as retinoic acid, which is necessary during the formation of the fetus, but the level of retinoic acid must remain very low in the blood serum to maintain normal fetal growth, especially in the first trimester of pregnancy.
However, if the level of retinoic acid increases greatly in the pregnant mother, it may penetrate to the fetus through the placenta, triggering genetic activity during a very sensitive stage in the construction and formation of the fetus’s organs and tissues, which may lead to structural or functional deformities and disorders of the fetus, such as hydrocephalus, incomplete development of the skull and brain, myelomeningocele, eye deformities, small ears, small jaws, cleft palate, etc., according to experiments. Laboratory studies on animals that attempted to explore the effect of vitamin A deficiency in the fetus were previously published in the 1980s.
Because liver is rich in vitamin A, it is one of the taboos that women try to avoid in order to protect their children from deformities that may haunt them for the rest of their lives. Therefore, it is recommended to avoid eating it continuously, repeatedly, and in large quantities during pregnancy.
The effect of vitamin A deficiency on the mother and fetus
Vitamin A is one of the vitamins necessary for the body to perform many vital functions, but how is its importance justified when the pregnant woman avoids all sources of it during the formation of her fetus, coinciding with her body’s urgent need for food? How does the body compensate for this deficiency, which may sometimes be severe?
One of the ironies worth mentioning, after recommendations to avoid it and enumerate its harms, is the important role of vitamin A for the mother and her fetus. It is necessary in the formation and growth of the eye and the differentiation of its cells in the fetus. It also participates in the growth of its bones, plays protective roles in the skin and its mucous lining, strengthens its immune system, and also contributes to raising the efficiency of the functional capabilities of the reproductive organs.
As for the benefits of vitamin A for the pregnant mother, it is necessary to maintain the level of her night vision and to continue providing her fetus with what it needs for the growth of its organs that need it. Low levels of vitamin A are widespread among pregnant women, especially in the last quarter of pregnancy during accelerated fetal growth and increased blood volume. Nearly 20 million pregnant women around the world suffer from the risk of low levels of vitamin A, according to World Health Organization statistics published in 2009 that were previously conducted by Professor West Keith and whose results were published in 2009. 2002, of whom 7 million pregnant women actually suffer from a significant decrease in vitamin A levels.
Low levels of vitamin A are concentrated among pregnant women in developing countries of the world, specifically in Africa and Southeast and South Asia. The danger of its deficiency lies in the high incidence of a condition known as night blindness (difficulty seeing at night or in dim light). According to the same report published by the World Health Organization, night blindness affects 9.8 million pregnant women out of a total of those at risk of low levels of vitamin A.
Compensating for vitamin A deficiency in pregnant women
If one of the factors in the spread of low levels of vitamin A during pregnancy is the poor educational level of mothers, then the concerned authorities should be careful to educate women about the importance of vitamin A for them and their fetuses, and direct them to obtain it from safe sources and in quantities within the recommendations adopted by specialists, so that they should not abstain from it at all and do not take it excessively without medical supervision.
Specialists and experts recommend that pregnant women cover their needs for vitamin A through food sources and refrain from taking vitamin A supplements, except in certain cases, in order to avoid its risks that may lead to fetal deformities.
The recommended amount of vitamin A during pregnancy in cases of severe deficiency is the equivalent of 800 micrograms of retinol equivalent per day, which is difficult to obtain from food alone.
While the recommended daily amount of vitamin A for pregnant women between the ages of 19 and 50 is estimated at 770 micrograms, the pregnant woman’s body’s need for vitamin A during the last three months of pregnancy increases by approximately 50 micrograms per day.
Are vitamin A supplements prohibited during pregnancy?
Specialists often recommend avoiding vitamin A supplements during pregnancy in order to protect the mother and her fetus, but in some cases it may be recommended to use specific doses of certain formulations of vitamin A to compensate for the severe deficiency in its levels and prevent night blindness, on the condition of completely abstaining from eating liver with vitamin A supplements or taking one of its products a maximum of once, according to what was published by researchers Van den Bergh and Hulshoff Desliberre from the Netherlands in 1996 after they conducted a study. Their study was on 58 pregnant women.
The daily dose of vitamin A should not exceed 10,000 international units or 25,000 international units per week. It is also preferable for a pregnant woman to take vitamin A in the form of beta-carotene, as it is necessary for the formation of vitamin A in the body and is classified as safe during pregnancy and does not cause fetal deformities.
Green leafy vegetables (spinach, etc.), yellow (squash, carrots) and orange non-citrus fruits (mango, apricot, papaya) are rich in pro-vitamin A carotenoids.
However, it is always recommended to consult a specialist to monitor the health condition of the pregnant woman and her fetus, and to make the most appropriate decision to take vitamin A supplements or not. Regular consumption of liver rich in vitamin A should be avoided during pregnancy, especially in cases of taking vitamin A supplements, and the doctor should be informed of this to avoid poisoning or deformity of the fetus.