title: Vitamin A status in pregnant women in Iran in 2001 and its relationship with province and gestational age.
abstract: BACKGROUND
  Vitamin A deficiency is considered as one of the public health problems among pregnant women worldwide. Population representative data on vitamin A status in pregnancy have not previously been published from Iran.
  
  
  OBJECTIVE
  The aim of this study was to publish data on vitamin A status in pregnant women in all the provinces of Iran in 2001, including urban and rural areas, and to describe the association of vitamin A status with maternal age, gestational age, and parity.
  
  
  METHODS
  This descriptive cross-sectional study was conducted on 3,270 healthy pregnant women from the entire country, 2,631 with gestational age ≤36 weeks, and 639 with gestational age >36 weeks. Vitamin A status was determined in serum using high-performance liquid chromatography.
  
  
  RESULTS
  Retinol levels corresponding to deficiency were detected in 6.6% (<0.36 µmol/L) and 18% had insufficient vitamin A levels (≥0.36-<0.7 µmol/L). Suboptimal level of serum retinol was observed in 55.3% of the pregnant women (0.7-1.4 µmol/L). Only about 20% of the women had optimal values (>1.4 µmol/L). The level of serum retinol was lower in older pregnant women (p=0.008), and at higher gestational age (p=0.009). High vitamin A levels were observed in pregnant women in the central areas of Iran and the lowest values in those in the southern areas of Iran.
  
  
  CONCLUSIONS
  The vitamin A status was good in 2001 but should be closely monitored also in the future. About 25% of pregnant women had a vitamin A status diagnosed as insufficient or deficient (<0.7 µmol/L). The mean serum retinol decreased as the gestational age increased. The clinical significance of this finding should be further investigated, followed by a careful risk group approach to supplementation during pregnancy.
authors.affiliation: Department of Nutrition and Food Health, Faculty of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran ; Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Beheshteh
authors.initials: B
authors.lastname: Olang
authors.affiliation: Nutrition Department, Ministry of Health and Medical Education, Tehran, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Abdollahi
authors.affiliation: Unit for Public Health Nutrition, Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Roshanak
authors.initials: R
authors.lastname: Neshati
authors.affiliation: Unit for Public Health Nutrition, Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Mohamed Atiya
authors.initials: MA
authors.lastname: Ali
authors.affiliation: Global Health Department, Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Naghavi
authors.affiliation: Unit for Public Health Nutrition, Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden ; School of Hospitality, Culinary Arts and Meal Sciences, Örebro University, Örebro, Sweden.
authors.forename: Agneta
authors.initials: A
authors.lastname: Yngve
keywords: deficiency; gestational age; insufficiency; maternal age; retinol