title: Vitamin A deficiency and maternal-infant transmissions of HIV in two metropolitan areas in the United States.
abstract: OBJECTIVE
  To determine whether vitamin A deficiency is associated with maternal-infant HIV transmission among HIV-infected pregnant women in two United States cities.
  
  
  METHODS
  Third trimester serum vitamin A levels were evaluated using high-performance liquid chromatography in 133 HIV-infected women who delivered livebirths during May 1986 to May 1994 and whose infants had known HIV infection status.
  
  
  RESULTS
  Sixteen per cent (seven out of 44) of the transmitting mothers and 6% (five out of 89) of the non-transmitting mothers had severe vitamin A deficiency (< 0.70 mumol/l; P = 0.05). Maternal-infant transmission was also associated with prematurity < 37 weeks gestation (P = 0.02), and Cesarean section delivery (P = 0.04), CD4 percentage (P = 0.03) and marginally associated with duration of membrane rupture of > or = 4 h (P = 0.06) by univariate analysis. In a multivariate logistic regression model, severe vitamin A deficiency [adjusted odds ratio (AOR), 5.05; 95% confidence interval (CI), 1.20-21.24], Cesarean section delivery (AOR, 3.75; 95% CI, 1.10-12.87), and prematurity (AOR, 2.25; 95% CI, 1.22-4.13) were associated with transmission after adjusting for CD4+ percentage, and duration of membrane rupture.
  
  
  CONCLUSIONS
  Increased risk of maternal-infant transmission was associated with severe vitamin A deficiency among non-breastfeeding women in these cohorts from the United States.
authors.affiliation: Department of Epidemiology and Social Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York 10467, USA.
authors.forename: B L
authors.initials: BL
authors.lastname: Greenberg
authors.forename: R D
authors.initials: RD
authors.lastname: Semba
authors.forename: P E
authors.initials: PE
authors.lastname: Vink
authors.forename: J J
authors.initials: JJ
authors.lastname: Farley
authors.forename: M
authors.initials: M
authors.lastname: Sivapalasingam
authors.forename: R W
authors.initials: RW
authors.lastname: Steketee
authors.forename: D M
authors.initials: DM
authors.lastname: Thea
authors.forename: E E
authors.initials: EE
authors.lastname: Schoenbaum
mesh_terms: D000328:Adult; D001942:Breast Feeding; D005260:Female; D005865:Gestational Age; D015658:HIV Infections / Q000635:transmission*; D015497:HIV-1; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D014801:Vitamin A / Q000097:blood; D014802:Vitamin A Deficiency / Q000150:complications*
chemical_list: D014801:Vitamin A