Associação entre deficiência de vitamina A e variáveis socioeconômicas, nutricionais e obstétricas de gestantes / Association between Vitamin A deficiency and socioeconomic, nutritional and obstetric variables

Este estudo investigou a prevalência de cegueira noturna e sua associação com as variáveis socioeconômicas, nutricionais e obstétricas de 92 gestantes atendidas em um posto municipal de saúde da cidade de Diamantina, Alto Vale do Jequitinhonha (MG). Para a coleta de dados, utilizou-se a entrevista preconizada pela OMS (1996) para o diagnóstico da cegueira noturna. Na análise estatística, utilizou-se o teste exato de Fisher e o de teste de Wilcoxon. Os resultados demonstraram uma prevalência maior de cegueira noturna nos distritos de Diamantina (15,38 por cento) e cidades vizinhas (13,04 por cento). Não foi encontrada associação significativa entre cegueira noturna e as variáveis socioeconômicas e obstétricas (p>0,05). No entanto, observou-se um menor consumo de vitamina A pelas gestantes com cegueira noturna (4,4 por cento). Tais achados apontam a necessidade de realizar novas investigações acerca da deficiência de vitamina A, a fim de subsidiar ações de prevenção e combate a esse agravo neste grupo em particular.

This study verified the night blindness prevalence, the first manifestation of this deficiency, and its association with socioeconomic, nutritionals and obstetric variables of 92 pregnant who were assisted on a health municipal center in Diamantina, Vale do Jequitinhonha. Data was collected through a model interview recommended by WHO (1996) to diagnose night blindness. The statistic analysis used Fisher exact test and Wilcoxon test. The results showed a higher prevalence of night blindness at Diamantina districts and neighbor cities (13.04 percent). No significant association was found between night blindness and socioeconomic and obstetric variables (p>0.05). It was observed a low vitamin A levels by pregnant with night blindness (4.4). This found shows the necessity of more investigations on vitamin A deficiency in order to help prevent, diagnose and combat this issue.

Gestational nightblindness among women attending a public maternity hospital in Rio de Janeiro, Brazil.

This study evaluated the prevalence of gestational nightblindness among postpartum women seen at the University Maternal Hospital of the Federal University in Rio de Janeiro, Brazil and the association of this symptom with a biochemical indicator (serum retinol levels) and sociodemographic, anthropometric and antenatal care variables. In total, 262 postpartum women, who did not receive vitamin A supplementation during pregnancy, were interviewed. Gestational nightblindness was diagnosed through the standardized interview as proposed by WHO. Serum retinol levels were evaluated by spectrophotometry. Gestational nightblindness relating to low levels of serum retinol (<1.05 micromol/L, p = 0.000) was diagnosed in 17.9% of subjects interviewed. Less than five antenatal care appointments (odds ratio [OR] = 2.179; confidence interval [CI] 95% = 1.078 - 4.402) and a history of one or more miscarriage(s) (OR = 2.306; CI 95% = 1.185 - 4.491) were predictors for gestational nightblindness. These findings justify the need for nutritional counselling, aimed at improving the vitamin A nutritional status, especially among pregnant women with a history of previous miscarriages and poor antenatal care.

Vitamin A deficiency disorders in 16 districts of India.

A multicentre study to assess vitamin A deficiency disorders (Bitot's spot and corneal scars) in 164,512 children (< 6 years) and night blindness among 113,202 children (24-71 months) from 16 districts of 11 states was carried out during 1997-2000. The prevalence of night blindness among 6,633 pregnant women from 15 districts was also assessed. The sampling methodology followed was a "30 cluster survey". The highest prevalence of Bitot's spot (4.71%), corneal scar (0.5%) and night blindness (5.17%) in children was found in Gaya district whereas the highest prevalence of night blindness (19.62%) among pregnant women was observed in Dibrugarh. No case of Bitot's spot was found in children screened from Mandi, Dehradun and Badaun districts. Similarly prevalance of night blindness was 'nil' among pregnant women of Badaun, Baramulla, Dehradun, Mainpuri, Srinagar, Bikaner and Raigarh.

Evaluation of vitamin A status during pregnancy.

Adequate maternal vitamin A nutrition is essential for successful pregnancy outcome and estimation of serum retinol among pregnant women enables a precise and objective assessment of vitamin A status, during pregnancy, even in subclinical state. In order to evaluate vitamin A status during pregnancy, and its relationship with personal and pregnancy related variables of the mother, 300 antenatal clinic attenders were interviewed at RG Kar Medical College and Hospital, Calcutta and tested for serum retinol, using Carr-Price test. Serum retinol values less than 30 microg/dl and 20 microg/dl, in this study, were considered as poor and severe vitamin A deficiency respectively. According to this 14.7% and 4% pregnant women were found to be suffering from poor and severe vitamin A deficiency respectively. Clinical signs of vitamin A deficiency (eg, nightblindness) were reported only among 60% cases of the deficient population. The problems of vitamin A deficiency were associated with low literacy and poor nutritional status of the mother, advanced gestational age of current pregnancy,increased number of pregnancies, shorter interval between births and poor dietary intake of vitamin A rich foods during pregnancy. The study thus raises the question of supplementation of vitamin A, during pregnancy, in Indian context where habitual diets are either inadequate or deficient in vitamin A.

Vitamin A deficiency in children with acute diarrhoea: a community-based study in Bangladesh.

The prevalences of nightblindness and xerophthalmia were assessed in 400 children, aged 6-59 months, with acute diarrhoea in a rural community in Bangladesh. The prevalences of nightblindness, conjunctival xerosis, and Bitot's spot were 7.8%, 9.5%, and 2.7% respectively. Fifty-two percent of the children who complained of nightblindness had ocular signs of vitamin A deficiency compared to 9% of those without nightblindness (p < 0.000). The nightblindness was significantly higher among the male children, aged 24-59 months, who were dysenteric and undernourished, did not consume vitamin A-containing foods daily, and were not breastfed. The coverage of periodic administration of vitamin A capsule was inversely related to the prevalence of nightblindness. This finding was determined by logistic regression analysis of data indicating that a combination of male sex, history of dysentery, absence of periodic administration of vitamin A treatment, and daily intake of vitamin A-containing foods gave the best-fitted model with an overall prediction of 92.5% of being nightblind. The findings of the study suggest that mothers should be educated to observe their diarrhoeal children about development of nightblindness and to seek treatment for it. The locally-relevant nutrition education should also be offered to them.