全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Maternal Vitamin A Deficiency during Pregnancy and Its Relation with Maternal and Neonatal Hemoglobin Concentrations among Poor Egyptian Families

DOI: 10.1155/2013/652148

Full-Text   Cite this paper   Add to My Lib

Abstract:

Background. Vitamin A deficiency (VAD) during pregnancy represents a major public health problem in developing countries. Anemia is a common consequence of VAD. We aimed to measure serum retinol concentrations of a sample of poor Egyptian mothers and correlate it with their Hb% and cord Hb%. Methods. This cross-sectional study included 200 healthy mothers and their healthy full term newborns. Maternal and cord blood samples were collected for CBC and measurement of serum retinol concentrations. Results. Forty-seven mothers (23.5%) had VAD and 50% were anemic. Mothers with VAD had a significantly lower mean Hb% and a significantly higher frequency of anemia (95.7%) compared to mothers without VAD (35.9%). The relative risk for anemia among mothers with VAD was 2.7 (CI = 2.12–3.3). Newborns of mothers with VAD had a significantly lower mean cord Hb% compared to newborns of mothers without VAD. Maternal serum retinol concentrations were positively correlated with maternal Hb% and cord Hb%. Conclusion. Maternal VAD during pregnancy among poor mothers is associated with maternal anemia and lower Hb% of newborns at birth. Vitamin A supplementation is highly recommended for this vulnerable group. 1. Introduction The requirements of vitamin A are increased during pregnancy. A daily intake of 800?μg retinol equivalents was recommended as a safe level of vitamin A for pregnant women [1]. According to WHO, 7.8% of pregnant women in Africa have night blindness and 15.3% have low serum retinol concentrations [2]. Vitamin A deficiency (VAD) during pregnancy is associated with increased maternal mortality [3] and increased infant mortality rates during the first year of life [4]. According to WHO, anemia globally affects 41.8% of pregnant women all over the world and 57.1% of pregnant women in Africa [5]. Maternal anemia during pregnancy increases the maternal mortality [6] and has many adverse effects on fetal outcome including small for gestational age, premature rupture of membranes, preterm delivery. Severe maternal anemia may be associated with stillbirth and neonatal deaths [7]. Vitamin A is known to play a role in hematopoiesis, and anemia is a common consequence of VAD [8]. Vitamin A supplementation during pregnancy was found to improve maternal Hb% [9]. The aim of the present study was to measure serum retinol concentrations of a cohort of poor Egyptian mothers and correlate it with their hemoglobin concentrations (Hb%) and cord Hb% of their respective newborns. 2. Subjects and Methods This cross-sectional study included 200 full term newborns and their

References

[1]  FAO/WHO, Vitamin and Mineral Requirements in Human Nutrition, Vitamin A and mineral requirements in human nutrition. Report of a joint FAO/WHO Expert Consultation on human vitamin and mineral requirements, World Health Organization and Food and Agriculture Organization of the United Nations, 2nd edition, 2004, http://www.who.int/nutrition/publications/micronutrients/9241546123/en/index.html.
[2]  World Health Organization, Global Prevalence of Vitamin A Deficiency in Population at Risk: 1995–2005, Summary of the global prevalence of vitamin A deficiency in populations at risk, WHO, Geneva, Switzerland, 2009, http://www.who.int/vmnis/database/vitamina/x/en/.
[3]  P. Christian, K. P. West Jr., S. K. Khatry et al., “Night blindness during pregnancy and subsequent mortality among women in Nepal: effects of vitamin A and β-carotene supplementation,” The American Journal of Epidemiology, vol. 152, no. 6, pp. 542–547, 2000.
[4]  P. Christian, K. P. West Jr., S. K. Khatry et al., “Maternal night blindness increases risk of mortality in the first 6 months of life among infants in Nepal,” Journal of Nutrition, vol. 131, no. 5, pp. 1510–1512, 2001.
[5]  B. Benoist, E. McLean, M. Cogswell, I. Egli, and D. Wojdyla, Worldwide Prevalence of Anemia 1993–2005, WHO Global Database on Anemia, World Health Organization, Geneva, Switzerland, 2008, http://www.who.int/vmnis/publications/anaemia_prevalence/en/.
[6]  K. Kalaivani, “Prevalence & consequences of anaemia in pregnancy,” Indian Journal of Medical Research, vol. 130, no. 5, pp. 627–633, 2009.
[7]  M. Rohilla, A. Raveendran, L. K. Dhaliwal, and S. Chopra, “Severe anaemia in pregnancy: a tertiary hospital experience from northern India,” Journal of Obstetrics and Gynaecology, vol. 30, no. 7, pp. 694–696, 2010.
[8]  R. D. Semba and M. W. Bloem, “The anemia of vitamin A deficiency: epidemiology and pathogenesis,” European Journal of Clinical Nutrition, vol. 56, no. 4, pp. 271–281, 2002.
[9]  S. Muslimatun, M. K. Schmidt, W. Schultink et al., “Weekly supplementation with iron and vitamin A during pregnancy increases hemoglobin concentration but decreases serum ferritin concentration in Indonesian pregnant women,” Journal of Nutrition, vol. 131, no. 1, pp. 85–90, 2001.
[10]  M. Ravallion, S. Chen, and P. Sangruala, “Dollar a day revisited,” World Bank Policy Working Paper 4620, World Bak, Washington, DC, USA, Development Reseach Group, 2008, http://econ.worldbank.org/external/default/main?pagePK=64165259&theSitePK=469372&piPK=64165421&menuPK=64166093&entityID=000158349_20080902095754.
[11]  C. Vitali, H. M. Moutsopoulos, and S. Bombardieri, “The European community study group on diagnostic criteria for Sjogren's syndrome. Sensitivity and specificity of tests for ocular and oral involvement in Sjogren's syndrome,” Annals of the Rheumatic Diseases, vol. 53, no. 10, pp. 637–647, 1994.
[12]  V. Apgar, “A proposal for a new method of evaluation of the newborn infant,” Current Researches in Anesthesia & Analgesia, vol. 32, no. 4, pp. 260–267, 1953.
[13]  J. L. Ballard, J. C. Khoury, K. Wedig, L. Wang, B. L. Eilers-Walsman, and R. Lipp, “New Ballard Score, expanded to include extremely premature infants,” Journal of Pediatrics, vol. 119, no. 3, pp. 417–423, 1991.
[14]  A. L. Sowell, D. L. Huff, P. R. Yeager, S. P. Caudill, and E. W. Gunter, “Retinol, α-tocopherol, lutein/zeaxanthin, β-cryptoxanthin, lycopene, α- carotene, trans-β-carotene, and four retinyl esters in serum determined simultaneously by reversed-phase HPLC with multiwavelength detection,” Clinical Chemistry, vol. 40, no. 3, pp. 411–416, 1994.
[15]  E. K. El-Khashab, A. M. Hamdy, K. M. Maher, M. A. Fouad, and G. Z. Abbas, “Effect of maternal vitamin A deficiency during pregnancy on neonatal kidney size,” Journal of Perinatal Medicine, vol. 41, no. 2, pp. 199–203, 2013.
[16]  I. O. Williams, E. U. Essien, and O. U. Eka, “Socioeconomic factors and vitamin a status of pregnant women in calabar urban, southeastern Nigeria,” Maternal and Child Health Journal, vol. 15, no. 7, pp. 943–948, 2011.
[17]  V. Lee, F. Ahmed, S. Wada et al., “Extent of vitamin a deficiency among rural pregnant women in Bangladesh,” Public Health Nutrition, vol. 11, no. 12, pp. 1326–1331, 2008.
[18]  I. O. Williams, O. U. Eka, and E. U. Essien, “Vitamin A status of pregnant women in Calabar metropolis, Nigeria,” Pakistan Journal of Biological Sciences, vol. 11, no. 13, pp. 1702–1707, 2008.
[19]  M. A. Ayoya, M. A. Bendech, N. M. Zagré, and F. Tchibindat, “Maternal anaemia in West and Central Africa: time for urgent action,” Public Health Nutrition, vol. 15, no. 5, pp. 916–927, 2012.
[20]  P. Christian, K. P. West Jr., S. K. Khatry et al., “Night blindness of pregnancy in rural Nepal: nutritional and health risks,” International Journal of Epidemiology, vol. 27, no. 2, pp. 231–237, 1998.
[21]  D. Suharno, C. E. West, M. Muhilal et al., “Cross-sectional study on the iron and vitamin A status of pregnant women in West Java, Indonesia,” The American Journal of Clinical Nutrition, vol. 56, no. 6, pp. 988–993, 1992.
[22]  M. S. Radhika, P. Bhaskaram, N. Balakrishna, B. A. Ramalakshmi, S. Devi, and B. Siva Kumar, “Effects of vitamin A deficiency during pregnancy on maternal and child health,” BJOG, vol. 109, no. 6, pp. 689–693, 2002.
[23]  F. Ahmed, I. Mahmuda, A. Sattar, and M. Akhtaruzzaman, “Anaemia and vitamin A deficiency in poor urban pregnant women of Bangladesh,” Asia Pacific Journal of Clinical Nutrition, vol. 12, no. 4, pp. 460–466, 2003.
[24]  N. van den Broek, L. Dou, M. Othman, J. P. Neilson, S. Gates, and A. M. Gülmezoglu, “Vitamin A supplementation during pregnancy for maternal and newborn outcomes,” Cochrane Database of Systematic Reviews, vol. 11, Article ID CD008666, 2010.
[25]  T. I. Kambe, J. Tada-Kambe, Y. Kuge, Y. Yamaguchi-Iwai, M. Nagao, and R. Sasaki, “Retinoic acid stimulates erythropoietin gene transcription in embryonal carcinoma cells through the direct repeat of a steroid/thyroid hormone receptor response element half-site in the hypoxia-response enhancer,” Blood, vol. 96, no. 9, pp. 3265–3271, 2000.
[26]  M. B. Zimmermann, R. Biebinger, F. Rohner et al., “Vitamin A supplementation in children with poor vitamin A and iron status increases erythropoietin and hemoglobin concentrations without changing total body iron,” The American Journal of Clinical Nutrition, vol. 84, no. 3, pp. 580–586, 2006.
[27]  E. Villamor and W. W. Fawzi, “Vitamin A supplementation: implications for morbidity and mortality in children,” Journal of Infectious Diseases, vol. 182, supplement 1, no. 3, pp. S122–S133, 2000.
[28]  R. T. Means Jr., “The anemia of infection,” Best Practice and Research Clinical Haematology, vol. 13, no. 2, pp. 151–162, 2000.
[29]  S. F. Arruda, E. M. Siqueira, and F. F. de Valência, “Vitamin A deficiency increases hepcidin expression and oxidative stress in rat,” Nutrition, vol. 25, no. 4, pp. 472–478, 2009.
[30]  S. Jiang, C.-X. Wang, L. Lan, and D. Zhao, “Vitamin A deficiency aggravates iron deficiency by upregulating the expression of iron regulatory protein-2,” Nutrition, vol. 28, no. 3, pp. 281–287, 2012.
[31]  A. I. Lee and M. M. Okam, “Anemia in pregnancy,” Hematology/Oncology Clinics of North America, vol. 25, no. 2, pp. 241–259, 2011.
[32]  A.-G. Ma, E. G. Schouten, Y. Wang et al., “Micronutrient status in anemic and non-anemic Chinese women in the third trimester of pregnancy,” Asia Pacific Journal of Clinical Nutrition, vol. 18, no. 1, pp. 41–47, 2009.

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133