Maternal night blindness during pregnancy is associated with low birthweight, morbidity, and poor growth in South India.

Maternal night blindness is common during pregnancy in many developing countries. Previous studies have demonstrated important consequences of maternal night blindness during pregnancy on the health of the mother and newborn infant. We compared birthweight, 6-mo infant mortality, morbidity, and growth among infants of women who did and did not report a history of night blindness from a community-based, randomized trial of newborn vitamin A supplementation in south India. Birthweight was measured within 72 h of delivery. Infants were followed until 6 mo of age for mortality and morbidity was assessed at household visits every 2 wk. Anthropometry was assessed at 6 mo of age. A total of 12,829 live-born infants were included, 680 of whom were infants of mothers with night blindness during the index pregnancy. Maternal night blindness was associated with an increased risk of low birthweight in a dose-dependent fashion based on birthweight cut-offs: <2500 g, adjusted relative risk (RR) = 1.13 (95% CI = 1.01, 1.26); <2000 g, adjusted RR = 1.70 (95% CI = 1.27, 2.26); <1500 g, adjusted RR = 3.38 (95% CI = 1.18, 6.33); with an increased risk of diarrhea (adjusted RR = 1.16, 95% CI = 1.03, 1.30), dysentery (adjusted RR = 1.25, 95% CI = 1.03, 1.53), acute respiratory illness (adjusted RR = 1.32, 95% CI = 1.21, 1.44), and poor growth at 6 mo; underweight (adjusted RR = 1.14, 95% CI = 1.02, 1.26), stunting (adjusted RR = 1.19, 95% CI = 1.05, 1.34). Maternal night blindness was not associated with 6-mo infant mortality or wasting at 6 mo. This study demonstrates that there are important consequences to the infant of maternal vitamin A deficiency during pregnancy.

[1]  H. Seneviratne,et al.  Vitamin A status of pregnant women in five districts of Sri Lanka. , 2010, Asia-Oceania journal of obstetrics and gynaecology.

[2]  M. Onis,et al.  WHO child growth standards , 2008, The Lancet.

[3]  J. Katz,et al.  Newborn vitamin A dosing reduces the case fatality but not incidence of common childhood morbidities in South India. , 2007, The Journal of nutrition.

[4]  C. Saunders,et al.  Association between gestational night blindness and serum retinol in mother/newborn pairs in the city of Rio de Janeiro, Brazil. , 2005, Nutrition.

[5]  Martin W. Bloem,et al.  Risk factors for nightblindness among women of childbearing age in Cambodia , 2003, European Journal of Clinical Nutrition.

[6]  K. West Public Health Impact of Preventing Vitamin A Deficiency in the First Six Months of Life , 2003 .

[7]  J. Katz,et al.  Impact of supplementing newborn infants with vitamin A on early infant mortality: community based randomised trial in southern India , 2003, BMJ : British Medical Journal.

[8]  R. Biggar,et al.  Antenatal vitamin A supplementation increases birth weight and decreases anemia among infants born to human immunodeficiency virus-infected women in Malawi. , 2002, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[9]  W. Schultink,et al.  Randomised double-blind trial of the effect of vitamin A supplementation of Indonesian pregnant women on morbidity and growth of their infants during the first year of life , 2002, European Journal of Clinical Nutrition.

[10]  P. Rondó,et al.  Vitamin A and neonatal anthropometry. , 2001, Journal of tropical pediatrics.

[11]  J. Katz,et al.  Maternal night blindness increases risk of mortality in the first 6 months of life among infants in Nepal. , 2001, The Journal of nutrition.

[12]  A. Sommer,et al.  Night blindness during pregnancy and subsequent mortality among women in Nepal: effects of vitamin A and beta-carotene supplementation. , 2000, American journal of epidemiology.

[13]  I. Chakraborty,et al.  Evaluation of vitamin A status during pregnancy. , 2000, Journal of the Indian Medical Association.

[14]  A. Al-Othman,et al.  Neonates' vitamin A status in relation to birth weight, gestational age, and sex. , 1998, Journal of tropical pediatrics.

[15]  Donna Spiegelman,et al.  Randomised trial of effects of vitamin supplements on pregnancy outcomes and T cell counts in HIV-1-infected women in Tanzania , 1998, The Lancet.

[16]  J. Katz,et al.  Night blindness of pregnancy in rural Nepal--nutritional and health risks. , 1998, International journal of epidemiology.

[17]  D. Hoover,et al.  Maternal vitamin A deficiency and child growth failure during human immunodeficiency virus infection. , 1997, Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association.

[18]  K. West,et al.  Vitamin A Deficiency: Health, Survival and Vision , 1997, The American Journal of Clinical Nutrition.

[19]  A. Sommer,et al.  Night blindness is prevalent during pregnancy and lactation in rural Nepal. , 1995, The Journal of nutrition.

[20]  D. Karyadi,et al.  Lack of improvement in vitamin A status with increased consumption of dark-green leafy vegetables , 1995, The Lancet.

[21]  R. Shah,et al.  Vitamin A status of the newborn in relation to gestational age, body weight, and maternal nutritional status. , 1984, The American journal of clinical nutrition.

[22]  J. Manshande CHILD GROWTH STANDARDS , 1980, The Lancet.

[23]  J. Waterlow CHILD GROWTH STANDARDS , 1980, The Lancet.

[24]  P. Suryohudoyo,et al.  Anemia and hypovitaminosis A among rural women in East Java, Indonesia. , 1980, Tropical and geographical medicine.

[25]  D. Dixit NIGHT-BLINDNESS IN THIRD TRIMESTER OF PREGNANCY , 1967 .

[26]  M. Schmidt,et al.  ORIGINAL COMMUNICATION Randomised double-blind trial of the effect of vitamin A supplementation of Indonesian pregnant women on morbidity and growth of their infants during the first year of life , 2002 .