Infant mortality and maternal vitamin A deficiency during human immunodeficiency virus infection

• Published in: Clinical infectious diseases Vol. 21; no. 4; p. 966
• Main Authors: Semba, R D, Miotti, P G, Chiphangwi, J D, Liomba, G, Yang, L P, Saah, A J, Dallabetta, G A, Hoover, D R
• Format: Journal Article
• Language: English
• Published: United States 01.10.1995
• Subjects: Adult; Birth Weight; CD4 Lymphocyte Count; Female; Follow-Up Studies; HIV Infections - complications; HIV Infections - mortality; HIV Infections - physiopathology; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases - mortality; Infant, Premature; Pregnancy; Pregnancy Complications, Infectious - mortality; Pregnancy Complications, Infectious - physiopathology; Vitamin A Deficiency - complications; Vitamin A Deficiency - mortality; Vitamin A Deficiency - physiopathology
• ISSN: 1058-4838
• DOI: 10.1093/clinids/21.4.966

The maternal factors that contribute to high mortality rates among infants born to women with human immunodeficiency virus (HIV) are unclear. We followed 474 HIV-infected mothers and their infants in Malawi from pregnancy through the infants' 12th month of life. Of the 474 HIV-infected pregnant women, 300 (63.3%) were deficient in vitamin A (serum level of vitamin A, <1.05 micromol/L). Mean serum vitamin A levels among mothers whose infants died were 0.78 +/- 0.03 micromol/L compared with 1.02 +/- 0.02 micromol/L among mothers whose infants had survived for the first 12 months of life (P <.0001). The overall infant mortality rate was 28.7%. We divided HIV-positive mothers into six groups according to serum vitamin A levels (micromol/L) as follows: group 1, <0.35; group 2, between 0.35 and 0.70; group 3, between 0.70 and 1.05; group 4, between 1.05 and 1.40; group 5, between 1.40 and 1.75; and group 6, >1.75. Infant mortality rates for each group were 93.3%, 41.6%, 23.4%, 18.5%, 17.7%, and 14.2%, respectively (P < .0001). Maternal vitamin A deficiency during HIV infection may contribute to increased infant mortality.