Responsiveness of dark-adaptation threshold to vitamin A and beta-carotene supplementation in pregnant and lactating women in Nepal.
BACKGROUND
Impaired dark adaptation occurs commonly in vitamin A deficiency.


OBJECTIVE
We sought to examine the responsiveness of dark-adaptation threshold to vitamin A and beta-carotene supplementation in Nepali women.


METHODS
The dark-adapted pupillary response was tested in 298 pregnant women aged 15-45 y in a placebo-controlled trial of vitamin A and beta-carotene; 131 of these women were also tested at 3 mo postpartum. Results were compared with those for 100 nonpregnant US women of similar age. The amount of light required for pupillary constriction was recorded after bleaching and dark adaptation.


RESULTS
Pregnant women receiving vitamin A had better dark-adaptation thresholds (-1.24 log cd/m(2)) than did those receiving placebo (-1.11 log cd/m(2); P: = 0. 03) or beta-carotene (-1.13 log cd/m(2); P: = 0.05) (t tests with Bonferroni correction). Dark-adaptation threshold was associated with serum retinol concentration in pregnant women receiving placebo (P: = 0.001) and in those receiving beta-carotene (P: = 0.003) but not in those receiving vitamin A. Among women receiving placebo, mean dark-adaptation thresholds were better during the first trimester (-1.23 log cd/m(2)) than during the second and third trimesters (-1.03 log cd/m(2); P: = 0.02, t test). The mean threshold of nonpregnant US women (-1.35 log cd/m(2)) was better than that of all 3 Nepali groups (P: < 0.001, t test, for all 3 groups).


CONCLUSIONS
During pregnancy, pupillary dark adaptation was strongly associated with serum retinol concentration and improved significantly in response to vitamin A supplementation. This noninvasive testing technique is a valid indicator of population vitamin A status in women of reproductive age.
Congdon
N G
NG
Center for Human Nutrition, Department of International Health, The Johns Hopkins School of Hygiene and Public Health, Baltimore, MD, USA.
Dreyfuss
M L
ML
Christian
P
P
Navitsky
R C
RC
Sanchez
A M
AM
Wu
L S
LS
Khatry
S K
SK
Thapa
M D
MD
Humphrey
J
J
Hazelwood
D
D
West
K P
KP
D000293:Adolescent; D000328:Adult; D000886:Anthropometry; D002851:Chromatography, High Pressure Liquid; D003623:Dark Adaptation / Q000187:drug effects*; D019587:Dietary Supplements; D005260:Female; D005865:Gestational Age; D006801:Humans; D007407:Interviews as Topic; D007774:Lactation / Q000502:physiology; D016014:Linear Models; D008875:Middle Aged; D009390:Nepal; D009755:Night Blindness / Q000517:prevention & control*; D009752:Nutritional Status; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000503:physiopathology; D012044:Regression Analysis; D012424:Rural Population; D014801:Vitamin A / Q000008:administration & dosage* / Q000097:blood; D014802:Vitamin A Deficiency / Q000188:drug therapy* / Q000503:physiopathology; D019207:beta Carotene / Q000008:administration & dosage*
D019207:beta Carotene; D014801:Vitamin A