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Effects of vitamin A deficiency during pregnancy on maternal and child health
Author(s) -
Radhika M.S.,
Bhaskaram P.,
Balakrish.,
Ramalakshmi B.A.,
Devi Savitha,
Kumar B. Siva
Publication year - 2002
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2002.01010.x
Subject(s) - medicine , pregnancy , obstetrics , vitamin a deficiency , population , gestational age , retinol , pediatrics , anthropometry , vitamin d deficiency , vitamin , vitamin d and neurology , environmental health , genetics , biology
Objective To examine the association between biochemical vitamin A deficiency in pregnancy and maternal and fetal health. Design A cross sectional clinical study. Setting 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. Population 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. Main outcome measures 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 μg/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 μg/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 μg/dL and preterm delivery ( P = 0.02 ) and anaemia ( P = 0.003 ) persisted, while that for pregnancy‐induced hypertension disappeared ( P = 0.71 ). Conclusion The study suggests that subclinical vitamin A deficiency is a problem during the third trimester of pregnancy. Serum concentration of retinol <20 μg/dL appears to indicate a deficient status, and is associated with an increased risk of preterm delivery and maternal anaemia.