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J Obstet Gynecol India Vol. 56, No. 6 : November/December 2006 Pg 489-494
Title : A study of maternal vitamin A status and its relationship with intrauterine growth restriction

Author : Dabi DR, Parakh Manish, Bothra Anuradha
Department of Pediatrics, Umaid Hospital for Women and Children, Regional Institute for Maternal and Child Health, Dr. SN Medical college, Jodhpur

OBJECTIVE(S) : To determine the prevalence of vitamin A deficiency in mothers of intrauterine growth restriction (IUGR) neonates and to evaluate the relationship of vitamin A levels with birth weight.

METHOD(S) : In a case control-cross sectional study, 50 mothers at term with small for gestional age neonates and 50 mothers at term with appropriate for gestational age neonates were studied to determine the prevalence of clinical and biochemical status of vitamin A deficiency. Serum vitamin A level was then correlated with birth weight in each of the two groups separatelty, and also jointly only in all the mothers in the two groups who had body mass index (BMI) of more than 18 kg/m2 and hemoglobin level of more than 10g/dL. Student t test and chi square test were used as applicable to find out the significance between two observed values, and regression analysis was used to determine the correlation between two continuous variables.

RESULTS: Clinical signs and symptoms of vitamin A deficiency (night blindness, conjunctival xerosis, Bitot’s spots, corneal xerosis) and low levels of serum vitamin A were commonly seen almost twice often in mothers who delivered IUGR newborns. At least 24% mothers delivering IUGR babies and 10% mothers delivering appropriate for gestational age babies had one or the other clinical sign of hypovitaminosis A. Clinical signs of vitamin A deficiency correlated well with serum vitamin A levels. Severe deficiency of vitamin A (serum vitamin A < 10 mg/dL) was observed in 4% mothers who delivered IUGR babies, while it was not observed in mothers of appropriate for gestational age babies. There was no correlation between serum vitamin A levels and birth weight when other factors such as malnutrition and anemia were associated, but increasing serum vitamin A levels were associated with higher birth weight when mothers had BMI of more than 18 kg/m2 and hemoglobin level of more than 10 g/dL.

CONCLUSION(S): Vitamin A deficiency during pregnancy may be a very important factor for growth hindrance of the fetus. In malnourished mothers, besides vitamin A many other factors also have an influence on intrauterine growth restriction but vitamin A deficiency appears to be a key factor in mothers who are otherwise not severely malnourished.