Hypervitaminosis a in early human pregnancy and malformations of the central nervous system

Abstract

A case of malformations of the fetal CNS following hypervitaminosis A in early pregnancy is reported. The mother was treated with 150,000 IU vitamin A daily during gestation days 19-40. Determination of urinary estriol carried out in the 42nd wk of pregnancy revealed a very low excretion (4.2-6.6 .mu.mol/24 h). Induced delivery resulted in a microcephalic child who died after 18 min. The child had multiple malformations of the CNS and very small adrenal glands (1.5 g; normal 11 .+-. 4 g). The very low urinary estriol excretion was well explained by the hypoplastic adrenals, which in turn can be related to insufficient ACTH stimulation, a condition similar to anencephaly. The malformations shown in the present case are considered to be related to the high doses of vitamin A given to the mother.