Effects of vitamin A deficiency during pregnancy on maternal and child health.
OBJECTIVE
To examine the association between biochemical vitamin A deficiency in pregnancy and maternal and fetal health.


METHODS
A cross sectional clinical study.


METHODS
Antenatal clinic of nutrition unit of Niloufer Hospital catering for a low socio-economic population, and a private nursing home (Swapna nursing home) catering for a high socio-economic population.


METHODS
736 pregnant women in their third trimester of pregnancy belonging to low (n = 522) and high socio-economic groups (n = 214).


METHODS
All the women were subjected to a detailed clinical, anthropometric and obstetric examination. Night blindness was assessed by administering the standard WHO questionnaire. Birthweight and gestational age of the infants, maternal anaemia and development of pregnancy-induced hypertension in the mother were recorded. Haemoglobin and serum retinol were estimated at the time of recruitment to the study.


METHODS
Serum retinol levels, anaemia, pregnancy-induced hypertension, birthweight and gestational age of the infant.


RESULTS
Night blindness was observed in 2.9% of the women and subclincal vitamin A deficiency (serum retinol <20 microg/dL with no clinical signs) in 27% of the women. Moderate to severe anaemia was observed in 41.2% of the women, and 15.8% of the women developed pregnancy-induced hypertension. Sixty-one (9.4%) women delivered preterm. Univariate analysis identified a significant association between serum retinol <20 microg/dL and preterm delivery (OR = 1.74, 95% CI 1.03-2.96), maternal anaemia (OR = 1.82, 95% CI 1.28-2.60) and pregnancy-induced hypertension (OR = 1.56, 95% CI 1.02-2.83). After adjusting for the confounding variables (body mass index, parity, age and socio-economic status) in a multivariate analysis, the significant associations between serum retinol <20 microg/dL and preterm delivery (P = 0.02) and anaemia (P = 0.003) persisted, while that for pregnancy-induced hypertension disappeared (P = 0.71).


CONCLUSIONS
The study suggests that subclinical vitamin A deficiency is a problem during the third trimester of pregnancy. Serum concentration of retinol <20 microg/dL appears to indicate a deficient status, and is associated with an increased risk of preterm delivery and maternal anaemia.
Radhika
M S
MS
National Institute of Nutrition, Jamai Osmania, Hyderabad, India.
Bhaskaram
P
P
Balakrishna
N
N
Ramalakshmi
B A
BA
Devi
Savitha
S
Kumar
B Siva
BS
D000328:Adult; D001724:Birth Weight; D002648:Child; D002669:Child Welfare; D003430:Cross-Sectional Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D008429:Maternal Welfare; D007752:Obstetric Labor, Premature / Q000209:etiology; D016017:Odds Ratio; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000209:etiology*; D011250:Pregnancy Complications, Hematologic / Q000209:etiology*; D011263:Pregnancy Trimester, Third; D012307:Risk Factors; D014801:Vitamin A / Q000097:blood; D014802:Vitamin A Deficiency / Q000097:blood / Q000150:complications*
D014801:Vitamin A