The purpose of this study was to ascertain whether there is an association between reduced vitamin E levels and an abnormal pregnancy. Levels were measured by HPLC in maternal and, where possible, in paired umbilical cord serum from normal and abnormal pregnancies at delivery and in serial serum samples from healthy women during gestation. Abnormal pregnancies were compared with normals. In normal pregnancies, mean vitamin E levels rose from 12.9 +/- 1.1 micrograms/ml in early pregnancy to 22.5 +/- 1.5 micrograms/ml at term (p < 0.05, n = 11). In pregnancies with fetal complications or maternal risks, levels were lower than in normals at corresponding gestational age (p < 0.005 in smokers, n = 20 at > or = 30 weeks & p < 0.01 in hypertensives, n = 4 at 16-23 weeks). Mean maternal and paired cord serum levels in normal pregnancies at delivery > or = 37 weeks were 21.3 +/- 0.6 and 3.8 +/- 0.1 micrograms/ml respectively (p < 0.001, n = 56). Maternal levels in women with a low birthweight infant and in smokers (> 10 cig/day) were significantly lower (p < 0.05, n = 13 & p < 0.0005, n = 12); levels in women with a malformed infant (n = 6) were also reduced, but just barely below the level of significance (p = 0.06). Cord serum levels in complicated pregnancies, however, were unchanged. The results show lower maternal levels of vitamin E in abnormal pregnancies, suggesting a changed vitamin E metabolism.