Along with meso-zeaxanthin, lutein (L) and zeaxanthin (Z) are concentrated at the fovea of the human eye, and they protect the macula against various types of damage, from blue light and age-related macular degeneration to free radicals and visual performance. They must be obtained through food or supplementation.
Previous research suggests that retinal and neural tissues may also benefit from xanthophyll carotenoids during gestational development, while their depletion could negatively impact pregnant mothers. However, like many other micronutrient supplementation suggestions, there are gaps in clinical research and knowledge regarding L and Z supplementation for prenatal care. Therefore, researchers conducted the Lutein and Zeaxanthin in Pregnancy (L-ZIP) trial, a phase 2, randomized clinical trial with results published in Ophthalmology Science. The study examined the impact of prenatal carotenoid supplementation on ocular and systemic biomarkers of carotenoid status in both mothers and their infants.
The L-ZIP trial found mothers in the carotenoid group had a statistically significant increase in macular pigment optical volume (MPOV) compared to the control group, without any depletion of ocular carotenoids during pregnancy. Infants born to mothers in the carotenoid group demonstrated a 20% increase in macular pigment optical density (MPOD) and more mature foveal architecture, although these results were not statistically significant. Both maternal and infant systemic carotenoid levels in skin and serum significantly increased in the carotenoid group compared to the control group.
The study examined 47 low-risk pregnant women and their infants to evaluate the impact of L and Z supplementation on MPOV and other visual markers. Patients were pregnant women 18 years or older with uncomplicated obstetric histories. They were randomly assigned 1:1 to either the carotenoid or control group. Along with a standard-of-care prenatal multivitamin, the carotenoid group received softgels with L and Z dosages equal to the AREDS2 formula: 10 mg L and 2 mg Z. Patients were then followed for four visits with phone communication between visits to ensure proper compliance.
The investigators measured best-corrected visual acuity, contrast sensitivity, and macular pigment using methods including optical coherence tomography. They also assessed infant foveal anatomy after birth, and carotenoids in participants’ serum and skin.
The researchers noted that the improved carotenoid outcomes could provide long-term benefits for eye health and visual performance. The results showing improved foveal maturity in the infants born to the carotenoid group could help shape future research, they added.
A full list of author disclosures can be found in the published research.