Night blindness of pregnancy in rural Nepal - nutritional and health risks
Night blindness of pregnancy in rural Nepal - nutritional and health risks
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DOI：
10.1093/ije/27.2.231
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发表时间：
1998-04-01
影响因子：
7.7
通讯作者：
Pokhrel, RP
中科院分区：
文献类型：
--
作者：
Christian, P;West, KP;Pokhrel, RP
背景夜盲是发展中国家儿童维生素A缺乏症最常见的临床症状。然而，人们对母体XN的病因或相关风险知之甚少。来自东南亚的新证据表明，XN在育龄妇女中的发病率可能比以前认为的更高，特别是在怀孕期间。方法采用以人群为基础的病例对照研究，揭示尼泊尔孕妇中XN的流行病学。通过每周一次的社区监测系统，历史上确认了夜间盲人病例。对照组是从没有XN的孕妇池中随机选择的，并与病例的孕周配对。在选择的一周内进行家庭评估，收集7天的食物频率和病史，测量人体尺寸，并抽取毛细血管血进行血清视黄醇、β-胡萝卜素和血红蛋白(Hb)的评估。结果病例和对照组没有年龄或既往怀孕次数的差异。然而，病例更有可能来自较低的种姓，是文盲，生活在质量较差的家庭，并且没有土地。病例组平均血清视黄醇水平约为0.30uMol/L，低于对照组(P<；0.001)，提示夜盲组孕妇维生素A水平偏低。平均Hb水平显著降低(降低0.7g/dl，P<；0.004)，严重贫血(Hb)的风险
Background Night blindness (XN) is the most common clinical symptom of vitamin A deficiency among children in developing countries. Yet little is known about the aetiology or associated risks of maternal XN. Emerging evidence from South East Asia suggests that it may be more frequent than previously thought in women of reproductive age, especially during pregnancy.Methods A population-based, case-control study was conducted to reveal the epidemiology of XN among pregnant Nepali women. Night blind cases were identified by history through a weekly community surveillance system. Controls were randomly selected from a pool of pregnant women without XN and pair-matched for gestational age of the cases. A home-based assessment was done within a week of selection, at which 7-day food frequency and morbidity histories were collected, anthropometry measured, and capillary blood drawn for serum retinol, beta-carotene and haemoglobin (Hb) estimation.Results Cases and controls did not differ by age or number of previous pregnancies. How ever, cases were more likely to be from the lower castes, be illiterate, live in poorer quality homes, and own no land. The mean serum retinol level of cases was similar to 0.30 mu mol/l lower than controls (P < 0.001), indicating a low vitamin A status of night blind pregnant women. Mean Hb level was significantly lower (by 0.7 g/dl, P < 0.004), and the risk of severe anaemia (Hb