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Parul Christian - One of the best experts on this subject based on the ideXlab platform.

  • Recommendations for Indicators: Night Blindness during Pregnancy— A Simple Tool to Assess Vitamin A Deficiency in a Population
    The Journal of Nutrition, 2002
    Co-Authors: Parul Christian
    Abstract:

    Night Blindness during pregnancy caused by vitamin A deficiency is associated with an increased risk of morbidity and mortality among women. Because a history of maternal Night Blindness is simple and reliable to use it is recommended as a population-based indicator of vitamin A deficiency. Furthermore a maternal Night Blindness prevalence of >/=5% is recommended as a cut-off at which vitamin A deficiency may be considered to be a problem of public health significance within the community. This paper provides the justification for these recommendations. Night Blindness during pregnancy is strongly associated with low serum and breast milk vitamin A concentration abnormal conjunctival impression cytology and impaired dark adaptation which suggests that it is a valid indicator of vitamin A deficiency. The prevalence of Night Blindness during pregnancy tends to be high in countries where the prevalence of xerophthalmia in children is high and in countries where interventions are in place to reduce childhood vitamin A deficiency. Existing data suggest that misclassification of self-reported maternal Night Blindness may account for a prevalence of up to 3%. The suggested cut-off 5% is set higher than this potential level of false-positive prevalence (3%). Illustrative data from India and Cambodia on childhood xerophthalmia and maternal Night Blindness rates are used to demonstrate the validity of using a 5% prevalence of maternal Night Blindness as indicative of a community vitamin A deficiency problem. Finally it is recommended that Night Blindness history be elicited for a previous pregnancy that ended in a live birth in the past 3 y using the local term for Night Blindness whenever possible. (authors)

  • Maternal Night Blindness Increases Risk of Mortality in the First 6 Months of Life among Infants in Nepal
    The Journal of nutrition, 2001
    Co-Authors: Parul Christian, Keith P. West, Joanne Katz, Subarna K. Khatry, Steven C. Leclerq, Elizabeth Kimbrough-pradhan, Sharada Ram Shrestha
    Abstract:

    Night Blindness occurs commonly among women during pregnancy in rural Nepal. We examined the relationship between maternal Night Blindness and the risk of mortality occurring among infants in the first 6 mo of life. Stratified analysis by maternal Night Blindness status during pregnancy was done for 10000 women participating in a randomized placebo-controlled trial of vitamin A and s-carotene supplementation. Mortality of infants of nonNight blind women in all three supplementation groups was similar and when combined was 63/1000 live births. Relative to this mortality was higher by 63% [95% confidence interval (CI): 9–138%) and 50% (95% CI: 23 to 133%) among infants of Night blind women receiving placebo and s-carotene respectively but only by 14% (95% CI: -33 to 93%) among those receiving vitamin A. Thus 6-mo mortality was higher among infants of women who had Night Blindness during pregnancy. Maternal receipt of vitamin A reduced this risk. (authors)

  • Night Blindness during pregnancy and subsequent mortality among women in nepal effects of vitamin a and β carotene supplementation
    American Journal of Epidemiology, 2000
    Co-Authors: Parul Christian, Keith P. West, Joanne Katz, Subarna K. Khatry, Steven C. Leclerq, Sharada Ram Shrestha, Elizabeth Kimbroughpradhan, Sanu Maiya Dali, Alfred Sommer
    Abstract:

    Night Blindness due to vitamin A deficiency is common during pregnancy among women in Nepal. The authors assessed the risk of maternal death during and after a pregnancy with Night Blindness among women participating in a cluster-randomized placebo-controlled vitamin A and beta-carotene supplementation trial in Nepal from July 1994 to September 1997. Subjects were 877 women with Night Blindness and 9545 women without Night Blindness during pregnancy. Women were followed from the time they declared that they were pregnant through the end of the study representing a median follow-up of 90 weeks (interquartile range: 64-121 weeks). Mortality of Night-blind women in the placebo group was 3601 per 100000 pregnancies. In comparison the relative risk of dying among non-Night-blind women in the placebo group was 0.26 (95% confidence interval (CI): 0.13 0.55) and the relative risk among women with or without Night Blindness in the vitamin A/beta-carotene group was 0.32 (95% CI: 0.10 0.91) and 0.18 (95% CI: 0.09 0.36) respectively. Night-blind women were 5 times (95% CI: 2.20 10.58) more likely to die from infections than were women who were not Night blind. These findings show that Night Blindness during pregnancy is a risk of both short- and long-term mortality among women. Vitamin A/beta-carotene supplementation ameliorates this risk to a large extent. (authors)

  • Vitamin A or β-Carotene Supplementation Reduces but Does Not Eliminate Maternal Night Blindness in Nepal
    The Journal of nutrition, 1998
    Co-Authors: Parul Christian, Keith P. West, Joanne Katz, Subarna K. Khatry, Steven C. Leclerq, Elizabeth K. Pradhan, Sharada Ram Shrestha
    Abstract:

    We investigated the effect of supplementing women weekly with 7000 microg retinol equivalents as preformed vitamin A or beta-carotene vs. a placebo, on the incidence of Night Blindness during pregnancy and the postpartum period in the rural plains of Nepal. Over a period of approximately 3 y, approximately 29,000 women of child-bearing age, living in 171 wards that were randomized to one of the three supplements, contributed 9932 first pregnancies. A prospective, weekly surveillance identified Night Blindness in pregnant women, verified further by detailed questioning about Nighttime vision. After delivery, women were also interviewed at approximately 3 and approximately 6 mo postpartum to elicit a Night Blindness history over the preceding 3 mo. Vitamin A supplementation reduced the incidence of Night Blindness during pregnancy from 10.7% among controls to 6.7% (relative risk 0.62, 95% confidence interval: 0.45-0.85). beta-Carotene supplementation had less of an effect (0. 83, 0.63-1.11). Among women who took >95% of their vitamin A supplements during pregnancy, incidence of verified Night Blindness was reduced by 67%. Incidence (per 100 person-years) of Night Blindness during the first 3 mo postpartum was 11.3 in the control, 4.3 in the vitamin A and 8.7 in the beta-carotene groups, yielding corresponding relative risks of 0.38 (0.26-0.55) and 0.77 (0.57-1. 04). In the second 3 mo postpartum, both vitamin A and beta-carotene reduced Night Blindness by approximately 50%. Vitamin A intakes approaching a recommended amount for pregnancy markedly reduced but did not eliminate Night Blindness in Nepali women. Greater intakes of vitamin A than provided and/or other nutrients may be needed to prevent maternal Night Blindness in rural South Asia.

  • Night Blindness of pregnancy in rural nepal nutritional and health risks
    International Journal of Epidemiology, 1998
    Co-Authors: Parul Christian, Keith P. West, Joanne Katz, Subarna K. Khatry, Steven C. Leclerq, Elizabeth K. Pradhan, Sharda Ram Shrestha, R P Pokhrel
    Abstract:

    Evidence from South East Asia suggests that Night Blindness may be widespread in pregnant women as well as children. The epidemiology of Night Blindness among pregnant women in Nepals Sarlahi District was investigated in a population-based case-control study. The 117 Night blind cases were identified through a weekly community surveillance system while 117 controls were selected from pregnant women without Night Blindness and matched to cases by gestational age. The mean serum retinol level was approximately 0.30 mcmol/l lower among cases than controls (p < 0.001). The mean hemoglobin level was 0.7 g/dl lower among cases and the risk of severe anemia was 3 times greater among cases than controls. The poor nutritional status of cases relative to controls was reflected in their lower mean weight (-2.6 kg difference) body mass index (-0.8) arm circumference (-0.9 cm) and triceps skinfold (-0.8 mm). Night Blindness was associated with less frequent consumption of preformed vitamin A and provitamin A foods especially during summer. Finally cases were 2-3 times more likely than controls to report symptoms of urinary/reproductive tract infection diarrhea/dysentery preeclampsia and eclampsia and nausea and vomiting during pregnancy than controls. A history of Night Blindness can be used to identify pregnant women who may require special nutritional support (including vitamin A supplementation) antenatal care and counseling.

Keith P. West - One of the best experts on this subject based on the ideXlab platform.

  • Maternal Night Blindness Increases Risk of Mortality in the First 6 Months of Life among Infants in Nepal
    The Journal of nutrition, 2001
    Co-Authors: Parul Christian, Keith P. West, Joanne Katz, Subarna K. Khatry, Steven C. Leclerq, Elizabeth Kimbrough-pradhan, Sharada Ram Shrestha
    Abstract:

    Night Blindness occurs commonly among women during pregnancy in rural Nepal. We examined the relationship between maternal Night Blindness and the risk of mortality occurring among infants in the first 6 mo of life. Stratified analysis by maternal Night Blindness status during pregnancy was done for 10000 women participating in a randomized placebo-controlled trial of vitamin A and s-carotene supplementation. Mortality of infants of nonNight blind women in all three supplementation groups was similar and when combined was 63/1000 live births. Relative to this mortality was higher by 63% [95% confidence interval (CI): 9–138%) and 50% (95% CI: 23 to 133%) among infants of Night blind women receiving placebo and s-carotene respectively but only by 14% (95% CI: -33 to 93%) among those receiving vitamin A. Thus 6-mo mortality was higher among infants of women who had Night Blindness during pregnancy. Maternal receipt of vitamin A reduced this risk. (authors)

  • Night Blindness during pregnancy and subsequent mortality among women in nepal effects of vitamin a and β carotene supplementation
    American Journal of Epidemiology, 2000
    Co-Authors: Parul Christian, Keith P. West, Joanne Katz, Subarna K. Khatry, Steven C. Leclerq, Sharada Ram Shrestha, Elizabeth Kimbroughpradhan, Sanu Maiya Dali, Alfred Sommer
    Abstract:

    Night Blindness due to vitamin A deficiency is common during pregnancy among women in Nepal. The authors assessed the risk of maternal death during and after a pregnancy with Night Blindness among women participating in a cluster-randomized placebo-controlled vitamin A and beta-carotene supplementation trial in Nepal from July 1994 to September 1997. Subjects were 877 women with Night Blindness and 9545 women without Night Blindness during pregnancy. Women were followed from the time they declared that they were pregnant through the end of the study representing a median follow-up of 90 weeks (interquartile range: 64-121 weeks). Mortality of Night-blind women in the placebo group was 3601 per 100000 pregnancies. In comparison the relative risk of dying among non-Night-blind women in the placebo group was 0.26 (95% confidence interval (CI): 0.13 0.55) and the relative risk among women with or without Night Blindness in the vitamin A/beta-carotene group was 0.32 (95% CI: 0.10 0.91) and 0.18 (95% CI: 0.09 0.36) respectively. Night-blind women were 5 times (95% CI: 2.20 10.58) more likely to die from infections than were women who were not Night blind. These findings show that Night Blindness during pregnancy is a risk of both short- and long-term mortality among women. Vitamin A/beta-carotene supplementation ameliorates this risk to a large extent. (authors)

  • Night Blindness, diet and health in Nepalese children: An ethno‐epidemiological investigation of local beliefs
    Ecology of Food and Nutrition, 2000
    Co-Authors: Anita V. Shankar, Joel Gittelsohn, Rajendra Pradhan, Birendra Dahal, Keith P. West
    Abstract:

    This paper describes concepts of diet and health in Nepal related to Night Blindness in children. We compared beliefs of mothers with xerophthalmic children with those of mothers with children without xerophthalmia and those of selected community members participating in ethnographic interviews. Knowledge of Night Blindness terms, symptoms and local availability of vitamin A capsules were well understood. Night Blindness was classified as a “hot” illness, exacerbated by “heat” inducing environments, but balanced by cold conditions or foods. The link between diet and Night Blindness, however, was not evident from ethnographic or household interviews. Vitamin A‐rich foods were ascribed beneficial and harmful qualities during the ethnographic interviews. However, surveyed mothers tended not to report harmful food qualities. Food beliefs of mothers with xerophthalmic children did not differ significantly from those with non‐xerophthalmic children, although the former were slightly less likely to recommend giv...

  • Vitamin A or β-Carotene Supplementation Reduces but Does Not Eliminate Maternal Night Blindness in Nepal
    The Journal of nutrition, 1998
    Co-Authors: Parul Christian, Keith P. West, Joanne Katz, Subarna K. Khatry, Steven C. Leclerq, Elizabeth K. Pradhan, Sharada Ram Shrestha
    Abstract:

    We investigated the effect of supplementing women weekly with 7000 microg retinol equivalents as preformed vitamin A or beta-carotene vs. a placebo, on the incidence of Night Blindness during pregnancy and the postpartum period in the rural plains of Nepal. Over a period of approximately 3 y, approximately 29,000 women of child-bearing age, living in 171 wards that were randomized to one of the three supplements, contributed 9932 first pregnancies. A prospective, weekly surveillance identified Night Blindness in pregnant women, verified further by detailed questioning about Nighttime vision. After delivery, women were also interviewed at approximately 3 and approximately 6 mo postpartum to elicit a Night Blindness history over the preceding 3 mo. Vitamin A supplementation reduced the incidence of Night Blindness during pregnancy from 10.7% among controls to 6.7% (relative risk 0.62, 95% confidence interval: 0.45-0.85). beta-Carotene supplementation had less of an effect (0. 83, 0.63-1.11). Among women who took >95% of their vitamin A supplements during pregnancy, incidence of verified Night Blindness was reduced by 67%. Incidence (per 100 person-years) of Night Blindness during the first 3 mo postpartum was 11.3 in the control, 4.3 in the vitamin A and 8.7 in the beta-carotene groups, yielding corresponding relative risks of 0.38 (0.26-0.55) and 0.77 (0.57-1. 04). In the second 3 mo postpartum, both vitamin A and beta-carotene reduced Night Blindness by approximately 50%. Vitamin A intakes approaching a recommended amount for pregnancy markedly reduced but did not eliminate Night Blindness in Nepali women. Greater intakes of vitamin A than provided and/or other nutrients may be needed to prevent maternal Night Blindness in rural South Asia.

  • Night Blindness of pregnancy in rural nepal nutritional and health risks
    International Journal of Epidemiology, 1998
    Co-Authors: Parul Christian, Keith P. West, Joanne Katz, Subarna K. Khatry, Steven C. Leclerq, Elizabeth K. Pradhan, Sharda Ram Shrestha, R P Pokhrel
    Abstract:

    Evidence from South East Asia suggests that Night Blindness may be widespread in pregnant women as well as children. The epidemiology of Night Blindness among pregnant women in Nepals Sarlahi District was investigated in a population-based case-control study. The 117 Night blind cases were identified through a weekly community surveillance system while 117 controls were selected from pregnant women without Night Blindness and matched to cases by gestational age. The mean serum retinol level was approximately 0.30 mcmol/l lower among cases than controls (p < 0.001). The mean hemoglobin level was 0.7 g/dl lower among cases and the risk of severe anemia was 3 times greater among cases than controls. The poor nutritional status of cases relative to controls was reflected in their lower mean weight (-2.6 kg difference) body mass index (-0.8) arm circumference (-0.9 cm) and triceps skinfold (-0.8 mm). Night Blindness was associated with less frequent consumption of preformed vitamin A and provitamin A foods especially during summer. Finally cases were 2-3 times more likely than controls to report symptoms of urinary/reproductive tract infection diarrhea/dysentery preeclampsia and eclampsia and nausea and vomiting during pregnancy than controls. A history of Night Blindness can be used to identify pregnant women who may require special nutritional support (including vitamin A supplementation) antenatal care and counseling.

Joanne Katz - One of the best experts on this subject based on the ideXlab platform.

  • Risk Factors for Maternal Night Blindness in Rural South India
    Ophthalmic epidemiology, 2009
    Co-Authors: Joanne Katz, James M. Tielsch, Ravilla D. Thulasiraj, Christian L. Coles, Sheela Sheeladevi, Elizabeth L. Yanik, Lakshmi Rahmathullah
    Abstract:

    Purpose: This study aimed to identify risk factors associated with maternal Night Blindness in rural South India. Methods: At delivery, women enrolled in a population-based trial of newborn vitamin A supplementation were asked whether they were Night blind at any time during the pregnancy. Multivariate logistic regression was used to identify socioeconomic, demographic, and pregnancy-related factors associated with maternal Night Blindness. Results: Women reported Night Blindness in 687 (5.2%) of 13,171 pregnancies. In a multivariate model, having a concrete roof (Odds Ratio (OR): 0.60, 95% Confidence Interval (CI): 0.47, 0.78), religion other than Hindu (OR: 0.46, 95% CI: 0.27, 0.76), maternal literacy (OR: 0.58, 95% CI: 0.49, 0.69), and maternal age from 25 to 29 years (OR: 0.68, 95% CI: 0.50, 0.93) were associated with a lower risk of Night Blindness in pregnancy. The odds of Night Blindness were higher for those leasing rather than owning land (OR: 1.78, 95%CI: 1.08, 2.93), parity 6 or more compared t...

  • Maternal Night Blindness During Pregnancy Is Associated With Low Birthweight, Morbidity, and Poor Growth in South India
    The Journal of nutrition, 2008
    Co-Authors: James M. Tielsch, Joanne Katz, Ravilla D. Thulasiraj, Christian L. Coles, Sheela Sheeladevi, Lakshmi Rahmathullah, Kartik Prakash
    Abstract:

    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:

  • maternal Night Blindness during pregnancy is associated with low birthweight morbidity and poor growth in south india
    Journal of Nutrition, 2008
    Co-Authors: James M. Tielsch, Joanne Katz, Ravilla D. Thulasiraj, Christian L. Coles, Sheela Sheeladevi, Lakshmi Rahmathullah, Kartik Prakash
    Abstract:

    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.

  • Maternal Night Blindness Increases Risk of Mortality in the First 6 Months of Life among Infants in Nepal
    The Journal of nutrition, 2001
    Co-Authors: Parul Christian, Keith P. West, Joanne Katz, Subarna K. Khatry, Steven C. Leclerq, Elizabeth Kimbrough-pradhan, Sharada Ram Shrestha
    Abstract:

    Night Blindness occurs commonly among women during pregnancy in rural Nepal. We examined the relationship between maternal Night Blindness and the risk of mortality occurring among infants in the first 6 mo of life. Stratified analysis by maternal Night Blindness status during pregnancy was done for 10000 women participating in a randomized placebo-controlled trial of vitamin A and s-carotene supplementation. Mortality of infants of nonNight blind women in all three supplementation groups was similar and when combined was 63/1000 live births. Relative to this mortality was higher by 63% [95% confidence interval (CI): 9–138%) and 50% (95% CI: 23 to 133%) among infants of Night blind women receiving placebo and s-carotene respectively but only by 14% (95% CI: -33 to 93%) among those receiving vitamin A. Thus 6-mo mortality was higher among infants of women who had Night Blindness during pregnancy. Maternal receipt of vitamin A reduced this risk. (authors)

  • Night Blindness during pregnancy and subsequent mortality among women in nepal effects of vitamin a and β carotene supplementation
    American Journal of Epidemiology, 2000
    Co-Authors: Parul Christian, Keith P. West, Joanne Katz, Subarna K. Khatry, Steven C. Leclerq, Sharada Ram Shrestha, Elizabeth Kimbroughpradhan, Sanu Maiya Dali, Alfred Sommer
    Abstract:

    Night Blindness due to vitamin A deficiency is common during pregnancy among women in Nepal. The authors assessed the risk of maternal death during and after a pregnancy with Night Blindness among women participating in a cluster-randomized placebo-controlled vitamin A and beta-carotene supplementation trial in Nepal from July 1994 to September 1997. Subjects were 877 women with Night Blindness and 9545 women without Night Blindness during pregnancy. Women were followed from the time they declared that they were pregnant through the end of the study representing a median follow-up of 90 weeks (interquartile range: 64-121 weeks). Mortality of Night-blind women in the placebo group was 3601 per 100000 pregnancies. In comparison the relative risk of dying among non-Night-blind women in the placebo group was 0.26 (95% confidence interval (CI): 0.13 0.55) and the relative risk among women with or without Night Blindness in the vitamin A/beta-carotene group was 0.32 (95% CI: 0.10 0.91) and 0.18 (95% CI: 0.09 0.36) respectively. Night-blind women were 5 times (95% CI: 2.20 10.58) more likely to die from infections than were women who were not Night blind. These findings show that Night Blindness during pregnancy is a risk of both short- and long-term mortality among women. Vitamin A/beta-carotene supplementation ameliorates this risk to a large extent. (authors)

Subarna K. Khatry - One of the best experts on this subject based on the ideXlab platform.

  • Maternal Night Blindness Increases Risk of Mortality in the First 6 Months of Life among Infants in Nepal
    The Journal of nutrition, 2001
    Co-Authors: Parul Christian, Keith P. West, Joanne Katz, Subarna K. Khatry, Steven C. Leclerq, Elizabeth Kimbrough-pradhan, Sharada Ram Shrestha
    Abstract:

    Night Blindness occurs commonly among women during pregnancy in rural Nepal. We examined the relationship between maternal Night Blindness and the risk of mortality occurring among infants in the first 6 mo of life. Stratified analysis by maternal Night Blindness status during pregnancy was done for 10000 women participating in a randomized placebo-controlled trial of vitamin A and s-carotene supplementation. Mortality of infants of nonNight blind women in all three supplementation groups was similar and when combined was 63/1000 live births. Relative to this mortality was higher by 63% [95% confidence interval (CI): 9–138%) and 50% (95% CI: 23 to 133%) among infants of Night blind women receiving placebo and s-carotene respectively but only by 14% (95% CI: -33 to 93%) among those receiving vitamin A. Thus 6-mo mortality was higher among infants of women who had Night Blindness during pregnancy. Maternal receipt of vitamin A reduced this risk. (authors)

  • Night Blindness during pregnancy and subsequent mortality among women in nepal effects of vitamin a and β carotene supplementation
    American Journal of Epidemiology, 2000
    Co-Authors: Parul Christian, Keith P. West, Joanne Katz, Subarna K. Khatry, Steven C. Leclerq, Sharada Ram Shrestha, Elizabeth Kimbroughpradhan, Sanu Maiya Dali, Alfred Sommer
    Abstract:

    Night Blindness due to vitamin A deficiency is common during pregnancy among women in Nepal. The authors assessed the risk of maternal death during and after a pregnancy with Night Blindness among women participating in a cluster-randomized placebo-controlled vitamin A and beta-carotene supplementation trial in Nepal from July 1994 to September 1997. Subjects were 877 women with Night Blindness and 9545 women without Night Blindness during pregnancy. Women were followed from the time they declared that they were pregnant through the end of the study representing a median follow-up of 90 weeks (interquartile range: 64-121 weeks). Mortality of Night-blind women in the placebo group was 3601 per 100000 pregnancies. In comparison the relative risk of dying among non-Night-blind women in the placebo group was 0.26 (95% confidence interval (CI): 0.13 0.55) and the relative risk among women with or without Night Blindness in the vitamin A/beta-carotene group was 0.32 (95% CI: 0.10 0.91) and 0.18 (95% CI: 0.09 0.36) respectively. Night-blind women were 5 times (95% CI: 2.20 10.58) more likely to die from infections than were women who were not Night blind. These findings show that Night Blindness during pregnancy is a risk of both short- and long-term mortality among women. Vitamin A/beta-carotene supplementation ameliorates this risk to a large extent. (authors)

  • Vitamin A or β-Carotene Supplementation Reduces but Does Not Eliminate Maternal Night Blindness in Nepal
    The Journal of nutrition, 1998
    Co-Authors: Parul Christian, Keith P. West, Joanne Katz, Subarna K. Khatry, Steven C. Leclerq, Elizabeth K. Pradhan, Sharada Ram Shrestha
    Abstract:

    We investigated the effect of supplementing women weekly with 7000 microg retinol equivalents as preformed vitamin A or beta-carotene vs. a placebo, on the incidence of Night Blindness during pregnancy and the postpartum period in the rural plains of Nepal. Over a period of approximately 3 y, approximately 29,000 women of child-bearing age, living in 171 wards that were randomized to one of the three supplements, contributed 9932 first pregnancies. A prospective, weekly surveillance identified Night Blindness in pregnant women, verified further by detailed questioning about Nighttime vision. After delivery, women were also interviewed at approximately 3 and approximately 6 mo postpartum to elicit a Night Blindness history over the preceding 3 mo. Vitamin A supplementation reduced the incidence of Night Blindness during pregnancy from 10.7% among controls to 6.7% (relative risk 0.62, 95% confidence interval: 0.45-0.85). beta-Carotene supplementation had less of an effect (0. 83, 0.63-1.11). Among women who took >95% of their vitamin A supplements during pregnancy, incidence of verified Night Blindness was reduced by 67%. Incidence (per 100 person-years) of Night Blindness during the first 3 mo postpartum was 11.3 in the control, 4.3 in the vitamin A and 8.7 in the beta-carotene groups, yielding corresponding relative risks of 0.38 (0.26-0.55) and 0.77 (0.57-1. 04). In the second 3 mo postpartum, both vitamin A and beta-carotene reduced Night Blindness by approximately 50%. Vitamin A intakes approaching a recommended amount for pregnancy markedly reduced but did not eliminate Night Blindness in Nepali women. Greater intakes of vitamin A than provided and/or other nutrients may be needed to prevent maternal Night Blindness in rural South Asia.

  • Night Blindness of pregnancy in rural nepal nutritional and health risks
    International Journal of Epidemiology, 1998
    Co-Authors: Parul Christian, Keith P. West, Joanne Katz, Subarna K. Khatry, Steven C. Leclerq, Elizabeth K. Pradhan, Sharda Ram Shrestha, R P Pokhrel
    Abstract:

    Evidence from South East Asia suggests that Night Blindness may be widespread in pregnant women as well as children. The epidemiology of Night Blindness among pregnant women in Nepals Sarlahi District was investigated in a population-based case-control study. The 117 Night blind cases were identified through a weekly community surveillance system while 117 controls were selected from pregnant women without Night Blindness and matched to cases by gestational age. The mean serum retinol level was approximately 0.30 mcmol/l lower among cases than controls (p < 0.001). The mean hemoglobin level was 0.7 g/dl lower among cases and the risk of severe anemia was 3 times greater among cases than controls. The poor nutritional status of cases relative to controls was reflected in their lower mean weight (-2.6 kg difference) body mass index (-0.8) arm circumference (-0.9 cm) and triceps skinfold (-0.8 mm). Night Blindness was associated with less frequent consumption of preformed vitamin A and provitamin A foods especially during summer. Finally cases were 2-3 times more likely than controls to report symptoms of urinary/reproductive tract infection diarrhea/dysentery preeclampsia and eclampsia and nausea and vomiting during pregnancy than controls. A history of Night Blindness can be used to identify pregnant women who may require special nutritional support (including vitamin A supplementation) antenatal care and counseling.

  • Night Blindness of pregnancy in rural Nepal—nutritional and health risks
    International journal of epidemiology, 1998
    Co-Authors: Parul Christian, Keith P. West, Joanne Katz, Subarna K. Khatry, Steven C. Leclerq, Elizabeth K. Pradhan, Sharda Ram Shrestha, R P Pokhrel
    Abstract:

    Evidence from South East Asia suggests that Night Blindness may be widespread in pregnant women as well as children. The epidemiology of Night Blindness among pregnant women in Nepals Sarlahi District was investigated in a population-based case-control study. The 117 Night blind cases were identified through a weekly community surveillance system while 117 controls were selected from pregnant women without Night Blindness and matched to cases by gestational age. The mean serum retinol level was approximately 0.30 mcmol/l lower among cases than controls (p < 0.001). The mean hemoglobin level was 0.7 g/dl lower among cases and the risk of severe anemia was 3 times greater among cases than controls. The poor nutritional status of cases relative to controls was reflected in their lower mean weight (-2.6 kg difference) body mass index (-0.8) arm circumference (-0.9 cm) and triceps skinfold (-0.8 mm). Night Blindness was associated with less frequent consumption of preformed vitamin A and provitamin A foods especially during summer. Finally cases were 2-3 times more likely than controls to report symptoms of urinary/reproductive tract infection diarrhea/dysentery preeclampsia and eclampsia and nausea and vomiting during pregnancy than controls. A history of Night Blindness can be used to identify pregnant women who may require special nutritional support (including vitamin A supplementation) antenatal care and counseling.

Steven C. Leclerq - One of the best experts on this subject based on the ideXlab platform.

  • Maternal Night Blindness Increases Risk of Mortality in the First 6 Months of Life among Infants in Nepal
    The Journal of nutrition, 2001
    Co-Authors: Parul Christian, Keith P. West, Joanne Katz, Subarna K. Khatry, Steven C. Leclerq, Elizabeth Kimbrough-pradhan, Sharada Ram Shrestha
    Abstract:

    Night Blindness occurs commonly among women during pregnancy in rural Nepal. We examined the relationship between maternal Night Blindness and the risk of mortality occurring among infants in the first 6 mo of life. Stratified analysis by maternal Night Blindness status during pregnancy was done for 10000 women participating in a randomized placebo-controlled trial of vitamin A and s-carotene supplementation. Mortality of infants of nonNight blind women in all three supplementation groups was similar and when combined was 63/1000 live births. Relative to this mortality was higher by 63% [95% confidence interval (CI): 9–138%) and 50% (95% CI: 23 to 133%) among infants of Night blind women receiving placebo and s-carotene respectively but only by 14% (95% CI: -33 to 93%) among those receiving vitamin A. Thus 6-mo mortality was higher among infants of women who had Night Blindness during pregnancy. Maternal receipt of vitamin A reduced this risk. (authors)

  • Night Blindness during pregnancy and subsequent mortality among women in nepal effects of vitamin a and β carotene supplementation
    American Journal of Epidemiology, 2000
    Co-Authors: Parul Christian, Keith P. West, Joanne Katz, Subarna K. Khatry, Steven C. Leclerq, Sharada Ram Shrestha, Elizabeth Kimbroughpradhan, Sanu Maiya Dali, Alfred Sommer
    Abstract:

    Night Blindness due to vitamin A deficiency is common during pregnancy among women in Nepal. The authors assessed the risk of maternal death during and after a pregnancy with Night Blindness among women participating in a cluster-randomized placebo-controlled vitamin A and beta-carotene supplementation trial in Nepal from July 1994 to September 1997. Subjects were 877 women with Night Blindness and 9545 women without Night Blindness during pregnancy. Women were followed from the time they declared that they were pregnant through the end of the study representing a median follow-up of 90 weeks (interquartile range: 64-121 weeks). Mortality of Night-blind women in the placebo group was 3601 per 100000 pregnancies. In comparison the relative risk of dying among non-Night-blind women in the placebo group was 0.26 (95% confidence interval (CI): 0.13 0.55) and the relative risk among women with or without Night Blindness in the vitamin A/beta-carotene group was 0.32 (95% CI: 0.10 0.91) and 0.18 (95% CI: 0.09 0.36) respectively. Night-blind women were 5 times (95% CI: 2.20 10.58) more likely to die from infections than were women who were not Night blind. These findings show that Night Blindness during pregnancy is a risk of both short- and long-term mortality among women. Vitamin A/beta-carotene supplementation ameliorates this risk to a large extent. (authors)

  • Vitamin A or β-Carotene Supplementation Reduces but Does Not Eliminate Maternal Night Blindness in Nepal
    The Journal of nutrition, 1998
    Co-Authors: Parul Christian, Keith P. West, Joanne Katz, Subarna K. Khatry, Steven C. Leclerq, Elizabeth K. Pradhan, Sharada Ram Shrestha
    Abstract:

    We investigated the effect of supplementing women weekly with 7000 microg retinol equivalents as preformed vitamin A or beta-carotene vs. a placebo, on the incidence of Night Blindness during pregnancy and the postpartum period in the rural plains of Nepal. Over a period of approximately 3 y, approximately 29,000 women of child-bearing age, living in 171 wards that were randomized to one of the three supplements, contributed 9932 first pregnancies. A prospective, weekly surveillance identified Night Blindness in pregnant women, verified further by detailed questioning about Nighttime vision. After delivery, women were also interviewed at approximately 3 and approximately 6 mo postpartum to elicit a Night Blindness history over the preceding 3 mo. Vitamin A supplementation reduced the incidence of Night Blindness during pregnancy from 10.7% among controls to 6.7% (relative risk 0.62, 95% confidence interval: 0.45-0.85). beta-Carotene supplementation had less of an effect (0. 83, 0.63-1.11). Among women who took >95% of their vitamin A supplements during pregnancy, incidence of verified Night Blindness was reduced by 67%. Incidence (per 100 person-years) of Night Blindness during the first 3 mo postpartum was 11.3 in the control, 4.3 in the vitamin A and 8.7 in the beta-carotene groups, yielding corresponding relative risks of 0.38 (0.26-0.55) and 0.77 (0.57-1. 04). In the second 3 mo postpartum, both vitamin A and beta-carotene reduced Night Blindness by approximately 50%. Vitamin A intakes approaching a recommended amount for pregnancy markedly reduced but did not eliminate Night Blindness in Nepali women. Greater intakes of vitamin A than provided and/or other nutrients may be needed to prevent maternal Night Blindness in rural South Asia.

  • Night Blindness of pregnancy in rural nepal nutritional and health risks
    International Journal of Epidemiology, 1998
    Co-Authors: Parul Christian, Keith P. West, Joanne Katz, Subarna K. Khatry, Steven C. Leclerq, Elizabeth K. Pradhan, Sharda Ram Shrestha, R P Pokhrel
    Abstract:

    Evidence from South East Asia suggests that Night Blindness may be widespread in pregnant women as well as children. The epidemiology of Night Blindness among pregnant women in Nepals Sarlahi District was investigated in a population-based case-control study. The 117 Night blind cases were identified through a weekly community surveillance system while 117 controls were selected from pregnant women without Night Blindness and matched to cases by gestational age. The mean serum retinol level was approximately 0.30 mcmol/l lower among cases than controls (p < 0.001). The mean hemoglobin level was 0.7 g/dl lower among cases and the risk of severe anemia was 3 times greater among cases than controls. The poor nutritional status of cases relative to controls was reflected in their lower mean weight (-2.6 kg difference) body mass index (-0.8) arm circumference (-0.9 cm) and triceps skinfold (-0.8 mm). Night Blindness was associated with less frequent consumption of preformed vitamin A and provitamin A foods especially during summer. Finally cases were 2-3 times more likely than controls to report symptoms of urinary/reproductive tract infection diarrhea/dysentery preeclampsia and eclampsia and nausea and vomiting during pregnancy than controls. A history of Night Blindness can be used to identify pregnant women who may require special nutritional support (including vitamin A supplementation) antenatal care and counseling.

  • Night Blindness of pregnancy in rural Nepal—nutritional and health risks
    International journal of epidemiology, 1998
    Co-Authors: Parul Christian, Keith P. West, Joanne Katz, Subarna K. Khatry, Steven C. Leclerq, Elizabeth K. Pradhan, Sharda Ram Shrestha, R P Pokhrel
    Abstract:

    Evidence from South East Asia suggests that Night Blindness may be widespread in pregnant women as well as children. The epidemiology of Night Blindness among pregnant women in Nepals Sarlahi District was investigated in a population-based case-control study. The 117 Night blind cases were identified through a weekly community surveillance system while 117 controls were selected from pregnant women without Night Blindness and matched to cases by gestational age. The mean serum retinol level was approximately 0.30 mcmol/l lower among cases than controls (p < 0.001). The mean hemoglobin level was 0.7 g/dl lower among cases and the risk of severe anemia was 3 times greater among cases than controls. The poor nutritional status of cases relative to controls was reflected in their lower mean weight (-2.6 kg difference) body mass index (-0.8) arm circumference (-0.9 cm) and triceps skinfold (-0.8 mm). Night Blindness was associated with less frequent consumption of preformed vitamin A and provitamin A foods especially during summer. Finally cases were 2-3 times more likely than controls to report symptoms of urinary/reproductive tract infection diarrhea/dysentery preeclampsia and eclampsia and nausea and vomiting during pregnancy than controls. A history of Night Blindness can be used to identify pregnant women who may require special nutritional support (including vitamin A supplementation) antenatal care and counseling.