Vitamin A or β-carotene supplementation reduces but does not eliminate maternal night blindness in Nepal

被引:53
作者
Christian, P [1 ]
West, KP
Khatry, SK
Katz, J
LeClerq, S
Pradhan, EK
Shrestha, SR
机构
[1] Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Int Hlth, Ctr Human Nutr, Baltimore, MD 21205 USA
[2] Natl Soc Eye Hlth & Blindness Prevent, Nepal Intervent Project Sarlahi NNIPS, Kathmandu, Nepal
关键词
night blindness; pregnancy; postpartum; vitamin A; beta-carotene; Nepal;
D O I
10.1093/jn/128.9.1458
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
We investigated the effect of supplementing women weekly with 7000 mu g retinol equivalents as preformed vitamin A or beta-carotene vs. a placebo, on the incidence of night blindness during pregnancy and the postpartum period in the rural plains of Nepal. Over a period of similar to 3 y, similar to 29,000 women of child-bearing age, living in 171 wards that were randomized to one of the three supplements, contributed 9932 first pregnancies. A prospective, weekly surveillance identified night blindness in pregnant women, verified further by detailed questioning about nighttime vision. After delivery, women were also interviewed at similar to 3 and similar to 6 mo postpartum to elicit a night blindness history over the preceding 3 mo. Vitamin A supplementation reduced the incidence of night blindness during pregnancy from 10.7% among controls to 6.7% (relative risk 0.62, 95% confidence interval: 0.45-0.85). beta-Carotene supplementation had less of an effect (0.83, 0.63-1.11). Among women who took >95% of their vitamin A supplements during pregnancy, incidence of verified night blindness was reduced by 67%. Incidence (per 100 person-years) of night blindness during the first 3 mo postpartum was 11.3 in the control, 4.3 in the vitamin A and 8.7 in the beta-carotene groups, yielding corresponding relative risks of 0.38 (0.26-0.55) and 0.77 (0.57-1.04). In the second 3 mo postpartum, both vitamin A and beta-carotene reduced night blindness by similar to 50%. Vitamin A intakes approaching a recommended amount for pregnancy markedly reduced but did not eliminate night blindness in Nepali women. Greater intakes of vitamin A than provided and/or other nutrients may be needed to prevent maternal night blindness in rural South Asia.
引用
收藏
页码:1458 / 1463
页数:6
相关论文
共 35 条
[1]   EFFECTS OF BETA-CAROTENE SUPPLEMENTATION ON LIPID-PEROXIDATION IN HUMANS [J].
ALLARD, JP ;
ROYALL, D ;
KURIAN, R ;
MUGGLI, R ;
JEEJEEBHOY, KN .
AMERICAN JOURNAL OF CLINICAL NUTRITION, 1994, 59 (04) :884-890
[2]  
[Anonymous], NUTR NEEDS PRETERM I
[3]  
[Anonymous], 1996, Vitamin A deficiency
[4]  
BUTTE NF, 1982, BIOL NEONATE, V41, P273
[5]  
CAULFIELD LE, 1998, IN PRESS AM J CLIN N
[6]   An ethnographic study of night blindness "ratauni" among women in the Terai of Nepal [J].
Christian, P ;
Bentley, ME ;
Pradhan, R ;
West, KP .
SOCIAL SCIENCE & MEDICINE, 1998, 46 (07) :879-889
[7]   Hyporetinolemia, illness symptoms, and acute phase protein response in pregnant women with and without night blindness [J].
Christian, P ;
Schulze, K ;
Stoltzfus, RJ ;
West, KP .
AMERICAN JOURNAL OF CLINICAL NUTRITION, 1998, 67 (06) :1237-1243
[8]   Night blindness of pregnancy in rural Nepal - nutritional and health risks [J].
Christian, P ;
West, KP ;
Khatry, SK ;
Katz, J ;
Shrestha, SR ;
Pradhan, EK ;
LeClerq, SC ;
Pokhrel, RP .
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY, 1998, 27 (02) :231-237
[9]  
CHRISTIAN P, 1998, IN PRESS AM J CLIN N
[10]  
*DEM HLTH SURV, 1997, NEP FAM HLTH SURV 19