title: Infant mortality and maternal vitamin A deficiency during human immunodeficiency virus infection.
abstract: The maternal factors that contribute to high mortality rates among infants born to women with human immunodeficiency virus (HIV) are unclear. We followed 474 HIV-infected mothers and their infants in Malawi from pregnancy through the infants' 12th month of life. Of the 474 HIV-infected pregnant women, 300 (63.3%) were deficient in vitamin A (serum level of vitamin A, <1.05 micromol/L). Mean serum vitamin A levels among mothers whose infants died were 0.78 +/- 0.03 micromol/L compared with 1.02 +/- 0.02 micromol/L among mothers whose infants had survived for the first 12 months of life (P <.0001). The overall infant mortality rate was 28.7%. We divided HIV-positive mothers into six groups according to serum vitamin A levels (micromol/L) as follows: group 1, <0.35; group 2, between 0.35 and 0.70; group 3, between 0.70 and 1.05; group 4, between 1.05 and 1.40; group 5, between 1.40 and 1.75; and group 6, >1.75. Infant mortality rates for each group were 93.3%, 41.6%, 23.4%, 18.5%, 17.7%, and 14.2%, respectively (P < .0001). Maternal vitamin A deficiency during HIV infection may contribute to increased infant mortality.
authors.affiliation: Department of Ophthalmology, Johns Hopkins Schools of Medicine and Hygiene and Public Health, Baltimore, Maryland, USA.
authors.forename: R D
authors.initials: RD
authors.lastname: Semba
authors.forename: P G
authors.initials: PG
authors.lastname: Miotti
authors.forename: J D
authors.initials: JD
authors.lastname: Chiphangwi
authors.forename: G
authors.initials: G
authors.lastname: Liomba
authors.forename: L P
authors.initials: LP
authors.lastname: Yang
authors.forename: A J
authors.initials: AJ
authors.lastname: Saah
authors.forename: G A
authors.initials: GA
authors.lastname: Dallabetta
authors.forename: D R
authors.initials: DR
authors.lastname: Hoover
mesh_terms: D000328:Adult; D001724:Birth Weight; D018791:CD4 Lymphocyte Count; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000401:mortality; D007234:Infant, Premature; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000401:mortality / Q000503:physiopathology*; D014802:Vitamin A Deficiency / Q000150:complications / Q000401:mortality* / Q000503:physiopathology