Vitamin A deficiency as a preventable cause of maternal mortality in undernourished societies: plausibility and next steps
Maternal vitamin A deficiency is a public health problem in the developing world. Recent evidence from Nepal suggests that supplementing populations of rural, poor, and undernourished women with a recommended dietary amount of vitamin A—or its equivalent as beta-carotene—can lower mortality risk rel...
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| Published in | International journal of gynecology and obstetrics Vol. 85; no. S1; pp. S24 - S27 |
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| Main Author | |
| Format | Journal Article |
| Language | English |
| Published |
United States
Elsevier Ireland Ltd
01.06.2004
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| Abstract | Maternal vitamin A deficiency is a public health problem in the developing world. Recent evidence from Nepal suggests that supplementing populations of rural, poor, and undernourished women with a recommended dietary amount of vitamin A—or its equivalent as beta-carotene—can lower mortality risk related to pregnancy and childbirth, presumably by reducing the severity of conditions such as sepsis, tuberculosis, and diarrheal diseases. An adequate intake of beta-carotene may also reduce some maternal health risks related to oxidative stress. These findings reveal the potential for vitamin A and other micronutrient interventions to improve maternal and infant health and survival. They also present important implementation challenges for the developing world. |
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| AbstractList | Maternal vitamin A deficiency is a public health problem in the developing world. Recent evidence from Nepal suggests that supplementing populations of rural, poor, and undernourished women with a recommended dietary amount of vitamin A—or its equivalent as beta-carotene—can lower mortality risk related to pregnancy and childbirth, presumably by reducing the severity of conditions such as sepsis, tuberculosis, and diarrheal diseases. An adequate intake of beta-carotene may also reduce some maternal health risks related to oxidative stress. These findings reveal the potential for vitamin A and other micronutrient interventions to improve maternal and infant health and survival. They also present important implementation challenges for the developing world. Abstract Maternal vitamin A deficiency is a public health problem in the developing world. Recent evidence from Nepal suggests that supplementing populations of rural, poor, and undernourished women with a recommended dietary amount of vitamin A—or its equivalent as beta‐carotene—can lower mortality risk related to pregnancy and childbirth, presumably by reducing the severity of conditions such as sepsis, tuberculosis, and diarrheal diseases. An adequate intake of beta‐carotene may also reduce some maternal health risks related to oxidative stress. These findings reveal the potential for vitamin A and other micronutrient interventions to improve maternal and infant health and survival. They also present important implementation challenges for the developing world. |
| Author | West Jr, K.P. |
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| Keywords | Developing countries Micronutrient supplementation Diet Maternal vitamin A deficiency Food fortification |
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| References_xml | – year: 1996 ident: BIB17 publication-title: Vitamin A deficiency: health, survival and vision contributor: fullname: West – volume: 132 start-page: 790s year: 2002 end-page: 882s ident: BIB19 article-title: Forging effective strategies to combat iron deficiency publication-title: J Nutr April – volume: ii start-page: 595 year: 1931 end-page: 598 ident: BIB9 article-title: Diet as a prophylactic agent against puerperal sepsis publication-title: Br Med J contributor: fullname: Mellanby – volume: 61 start-page: 280 year: 2003 end-page: 284 ident: BIB11 article-title: Vitamin A, beta-carotene, and mother-to-child transmission of HIV publication-title: Nutr Rev contributor: fullname: Stephenson – volume: 68 start-page: 389 year: 1998 end-page: 398 ident: BIB15 article-title: Impact of a social marketing campaign promoting dark-green leafy vegetables and eggs in central Java, Indonesia publication-title: Int J Vitam Nutr Res contributor: fullname: Tjiong – volume: 92 start-page: 1105 year: 2002 end-page: 1107 ident: BIB20 article-title: Determinants of maternal vitamin A or beta-carotene supplementation coverage: village-based female distributors in Nepal publication-title: Am J Pub Health contributor: fullname: Christian – volume: 318 start-page: 570 year: 1999 end-page: 575 ident: BIB6 article-title: Double blind, cluster randomised trial of low dose supplementation with vitamin A or B-carotene on mortality related to pregnancy in Nepal publication-title: Br Med J contributor: fullname: Shrestha – volume: 3 start-page: 321 year: 2000 end-page: 327 ident: BIB12 article-title: Vitamin A and causes of maternal mortality: association and biological plausibility publication-title: Public Health Nutr contributor: fullname: Pittrof – volume: 130 start-page: 2675 year: 2000 end-page: 2682 ident: BIB7 article-title: Vitamin A or B-carotene supplementation reduces symptoms of illness in pregnant and lactating Nepali women publication-title: J Nutr contributor: fullname: Kimbrough-Pradhan – volume: 56 start-page: 22 year: 1998 end-page: 32 ident: BIB8 article-title: The role of vitamin A and related retinoids in immune function publication-title: Nutr Rev contributor: fullname: Semba – volume: 79 start-page: 561 year: 2001 end-page: 568 ident: BIB3 article-title: Maternal mortality at the end of a decade: signs of progress? publication-title: Bull World Health Org contributor: fullname: Wardlaw – volume: 72 start-page: 280S year: 2000 end-page: 290S ident: BIB2 article-title: Nutrition in pregnancy: mineral and vitamin supplements publication-title: Am J Clin Nutr contributor: fullname: Ladipo – volume: 133 start-page: 1684S year: 2003 end-page: 1692S ident: BIB13 article-title: Nutrient involvement in preeclampsia publication-title: J Nutr contributor: fullname: Martinez – volume: 82 start-page: 321 year: 2002 end-page: 337 ident: BIB14 article-title: Micronutrient malnutrition and the pathogenesis of malarial anemia publication-title: Acta Trop contributor: fullname: Semba – year: 2000 ident: BIB16 publication-title: Strategies to fortify essential foods in Asia and the Pacific. Proceedings of a forum on food fortification policy for protecting populations in Asia and the Pacific from mineral and vitamin deficiencies, 21–24 February 2000 – volume: 132 start-page: 2857S year: 2002 end-page: 2866S ident: BIB4 article-title: Extent of vitamin A deficiency among preschool children and women of reproductive age publication-title: J Nutr contributor: fullname: West – volume: 152 start-page: 542 year: 2000 end-page: 547 ident: BIB5 article-title: Night blindness during pregnancy and subsequent mortality among women in Nepal: effects of vitamin A and B-carotene supplementation publication-title: Am J Epidemiol contributor: fullname: Katz – year: November, 1994 ident: BIB18 publication-title: Micronutrient fortification and enrichment of PL 480 Title II commodities: recommendation for improvement. Opportunities for Micronutrient Initiatives (OMNI) Project contributor: fullname: Buescher – year: 1999 ident: BIB10 publication-title: Impact of vitamin A & zinc supplements on maternal post partum infections, in rural central Java, Indonesia. XIX International Vitamin A Consultative Group Meeting, Durban South Africa contributor: fullname: Ismadi – volume: 318 start-page: 570 year: 1999 end-page: 575 article-title: Double blind, cluster randomised trial of low dose supplementation with vitamin A or B‐carotene on mortality related to pregnancy in Nepal publication-title: Br Med J – volume: 56 start-page: 22 year: 1998 end-page: 32 article-title: The role of vitamin A and related retinoids in immune function publication-title: Nutr Rev – volume: 61 start-page: 280 year: 2003 end-page: 284 article-title: Vitamin A, beta‐carotene, and mother‐to‐child transmission of HIV publication-title: Nutr Rev – volume: 3 start-page: 321 year: 2000 end-page: 327 article-title: Vitamin A and causes of maternal mortality: association and biological plausibility publication-title: Public Health Nutr – volume: 133 start-page: 1684S year: 2003 end-page: 1692S article-title: Nutrient involvement in preeclampsia publication-title: J Nutr – volume: 72 start-page: 280S year: 2000 end-page: 290S article-title: Nutrition in pregnancy: mineral and vitamin supplements publication-title: Am J Clin Nutr – volume: 82 start-page: 321 year: 2002 end-page: 337 article-title: Micronutrient malnutrition and the pathogenesis of malarial anemia publication-title: Acta Trop – volume: 130 start-page: 2675 year: 2000 end-page: 2682 article-title: Vitamin A or B‐carotene supplementation reduces symptoms of illness in pregnant and lactating Nepali women publication-title: J Nutr – volume: 68 start-page: 389 year: 1998 end-page: 398 article-title: Impact of a social marketing campaign promoting dark‐green leafy vegetables and eggs in central Java, Indonesia publication-title: Int J Vitam Nutr Res – volume: ii start-page: 595 year: 1931 end-page: 598 article-title: Diet as a prophylactic agent against puerperal sepsis publication-title: Br Med J – year: 2000 – year: 1996 – volume: 152 start-page: 542 year: 2000 end-page: 547 article-title: Night blindness during pregnancy and subsequent mortality among women in Nepal: effects of vitamin A and B‐carotene supplementation publication-title: Am J Epidemiol – volume: 79 start-page: 561 year: 2001 end-page: 568 article-title: Maternal mortality at the end of a decade: signs of progress? publication-title: Bull World Health Org – volume: 132 start-page: 2857S year: 2002 end-page: 2866S article-title: Extent of vitamin A deficiency among preschool children and women of reproductive age publication-title: J Nutr – year: 1994 – volume: 132 start-page: 790s issue: (4 Suppl) year: 2002 end-page: 882s article-title: Forging effective strategies to combat iron deficiency publication-title: J Nutr April – volume: 92 start-page: 1105 year: 2002 end-page: 1107 article-title: Determinants of maternal vitamin A or beta‐carotene supplementation coverage: village‐based female distributors in Nepal publication-title: Am J Pub Health – year: 1999 – ident: e_1_2_3_10_2 doi: 10.1136/bmj.2.3691.595 – volume: 132 start-page: 790s issue: 4 year: 2002 ident: e_1_2_3_20_2 article-title: Forging effective strategies to combat iron deficiency publication-title: J Nutr April – ident: e_1_2_3_3_2 doi: 10.1093/ajcn/72.1.280S – ident: e_1_2_3_5_2 doi: 10.1093/jn/132.9.2857S – ident: e_1_2_3_7_2 doi: 10.1136/bmj.318.7183.570 – ident: e_1_2_3_8_2 doi: 10.1093/jn/130.11.2675 – volume-title: Micronutrient fortification and enrichment of PL 480 Title II commodities: recommendation for improvement. Opportunities for Micronutrient Initiatives (OMNI) Project year: 1994 ident: e_1_2_3_19_2 contributor: fullname: Combs G.F. – volume: 56 start-page: 22 year: 1998 ident: e_1_2_3_9_2 article-title: The role of vitamin A and related retinoids in immune function publication-title: Nutr Rev contributor: fullname: Semba R.D. – ident: e_1_2_3_13_2 doi: 10.1017/S1368980000000367 – ident: e_1_2_3_21_2 doi: 10.2105/AJPH.92.7.1105 – volume: 68 start-page: 389 year: 1998 ident: e_1_2_3_16_2 article-title: Impact of a social marketing campaign promoting dark‐green leafy vegetables and eggs in central Java, Indonesia publication-title: Int J Vitam Nutr Res contributor: fullname: de Pee S. – volume: 79 start-page: 561 year: 2001 ident: e_1_2_3_4_2 article-title: Maternal mortality at the end of a decade: signs of progress? publication-title: Bull World Health Org contributor: fullname: AbouZahr C. – ident: e_1_2_3_14_2 doi: 10.1093/jn/133.5.1684S – ident: e_1_2_3_15_2 doi: 10.1016/S0001-706X(02)00049-9 – ident: e_1_2_3_12_2 doi: 10.1301/nr.2003.aug.280-284 – ident: e_1_2_3_2_2 – volume-title: Impact of vitamin A & zinc supplements on maternal post partum infections, in rural central Java, Indonesia. XIX International Vitamin A Consultative Group Meeting, Durban South Africa year: 1999 ident: e_1_2_3_11_2 contributor: fullname: Hakimi M. – volume-title: Strategies to fortify essential foods in Asia and the Pacific. Proceedings of a forum on food fortification policy for protecting populations in Asia and the Pacific from mineral and vitamin deficiencies, 21–24 February 2000 year: 2000 ident: e_1_2_3_17_2 contributor: fullname: Manila Forum 2000 – volume-title: Vitamin A deficiency: health, survival and vision year: 1996 ident: e_1_2_3_18_2 doi: 10.1093/oso/9780195088243.001.0001 contributor: fullname: Sommer A. – ident: e_1_2_3_6_2 doi: 10.1093/aje/152.6.542 |
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| SubjectTerms | Developing Countries Diet Female Food fortification Health Services Accessibility Humans Malnutrition Maternal Health Services - organization & administration Maternal Mortality Maternal vitamin A deficiency Medically Underserved Area Micronutrient supplementation Pregnancy Pregnancy Complications - prevention & control Vitamin A Deficiency - prevention & control |
| Title | Vitamin A deficiency as a preventable cause of maternal mortality in undernourished societies: plausibility and next steps |
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