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Vitamin A and iron supplementation of Indonesian pregnant women benefits vitamin A status of their infants

Published online by Cambridge University Press:  09 March 2007

Marjanka K. schmidt ,
Siti Muslimatun ,
Clive E. West ,
Werner Schultink  and
Joseph G. A. J. Hautvast
Marjanka K. schmidt
Affiliation:
Division of Human Nutrition and Epidemology, Wageningen University, The Netherlands
Siti Muslimatun
Affiliation:
Division of Human Nutrition and Epidemology, Wageningen University, The Netherlands SAMEO TROPMED Regional Center for Community Nutrition, University of Indonesia, Jakarta, Indonesia
Clive E. West*
Affiliation:
Division of Human Nutrition and Epidemology, Wageningen University, The Netherlands Department of Gastreology, University Medical Center Nijmeg en, The Netherlands
Werner Schultink
Affiliation:
SAMEO TROPMED Regional Center for Community Nutrition, University of Indonesia, Jakarta, Indonesia
Joseph G. A. J. Hautvast
Affiliation:
Department of Gastreology, University Medical Center Nijmeg en, The Netherlands
*
*Corresponding author: Dr. Clive E. West, fax +31 317 483342, email [email protected]
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Abstract

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Many Indonesian infants have an inadequate nutritional status, which may be due in part to inadequate maternal nutrition during pregnancy. This study was designed to investigate whether infant nutritional status could be improved by maternal vitamin A and Fe supplementation during gestation. Mothers of these infants from five villages had been randomly assigned on an individual basis, supervised and double-blind, to receive supplementation once weekly from approximately 18 weeks of pregnancy until delivery. Supplementation comprised 120 mg Fe and 500 μg folic acid with or without 4800 retinol equivalent vitamin A. Mothers of infants from four other villages who participated in the national Fe and folic acid supplementation programme were also recruited; intake of tablets was not supervised. Anthropometric and biochemical parameters of infants and their mothers were assessed approximately 4 months after delivery. Infants of mothers supplemented with vitamin A plus Fe had higher serum retinol concentrations than infants of mothers supplemented with Fe alone. However, the proportion of infants with serum retinol concentrations <0·70 μmol/l was >70 % in all groups. Maternal and infant serum retinol concentrations were correlated. Fe status, weight and length of infants were similar in all groups. Fe status of girls was better than that of boys, but boys were heavier and longer. We conclude that supplementation with vitamin A in conjunction with Fe supplementation of women during pregnancy benefits vitamin A status of their infants. However, considering the large proportion of infants with marginal serum retinol concentrations, it may still be necessary to increase their vitamin A intake.

Keywords

Infant nutritional statusVitamin AIronSupplementation during pregnancy
Type
Research Article
Information
British Journal of Nutrition , Volume 86 , Issue 5 , November 2001 , pp. 607 - 615
Copyright
Copyright © The Nutrition Society 2001

References

Referenses

Administrative Committee on Coordination/Sub-Committee on Nutrition (2000) Fourth Report on the World Nutrition Situation. Nutrition Throughout the Life Cycle, Geneva: Administrative Committee on Coordination/Sub-Committee on Nutrition in collaboration with International Food Policy Research Institute.Google Scholar
Allen, LH (1994) Nutritional influences on linear growth: a general review. European Journal of Clinical Nutrition 48, 75S–89S.Google ScholarPubMed
Allen, LH (2000) Anemia and iron deficiency: effects on pregnancy outcome. American Journal of Clinical Nutrition 71, 1280S–1284S.CrossRefGoogle ScholarPubMed
Azaïs-Braesco, V and Pascal, G (2000) Vitamin A in pregnancy: requirements and safety limits. American Journal of Clinical Nutrition 71, 1325S–1333S.CrossRefGoogle ScholarPubMed
Frongillo, EA (1999) Symposium: Causes and etiology of stunting. Introduction. Journal of Nutrition 129, 529S–530S.CrossRefGoogle ScholarPubMed
Hadi, H, Stoltzfus, RJ, Dibley, MJ, Moulton, LH, West, KPJ, Kjolhede, CL & Sadjimin, T (2000) Vitamin A supplementation selectively improves the linear growth of Indonesian preschool children: results from a randomized controlled trial. American Journal of Clinical Nutrition 71, 507–513.CrossRefGoogle ScholarPubMed
Hautvast, JL, Tolboom, JJ, West, CE, Kafwembe, EM, Sauerwein, RW & van Staveren, WA (1998) Malaria is associated with reduced serum retinol levels in rural Zambian children. International Journal for Vitamin and Nutrition Research 68, 384–388.Google ScholarPubMed
Katz, J, West, KPJ, Khatry, SK, Pradhan, EK, LeClerq, SC, Christian, P, Wu, LS-F, Adhikari, RK, Shrestha, SR & Sommer, A (2000) Maternal low-dose vitamin A or β-carotene supplementation has no effect on fetal loss and early infant mortality: a randomized cluster trial in Nepal. American Journal of Clinical Nutrition 71, 1570–1576.CrossRefGoogle ScholarPubMed
Kosen, S, Herman, S & Schultink, W (1998) An overview of studies on iron deficiency in Indonesia. Nutrition Research 18, 1935–1941.CrossRefGoogle Scholar
Lindblad, BS, Patel, M, Hamadeh, M, Helmy, N, Ahmad, I, Dawodu, A & Zaman, S (1998) Age and sex are important factors in determining normal retinol levels. Journal of Tropical Pediatrics 44, 96–99.CrossRefGoogle ScholarPubMed
Mejia, LA & Chew, F (1988) Hematological effect of supplementing anemic children with vitamin A alone and in combination with iron. American Journal of Clinical Nutrition 48, 595–600.CrossRefGoogle ScholarPubMed
Muhilal, , Permeisih, D, Idjradinata, YR, Muherdiyantiningsih and Karyadi, D (1988) Vitamin A-fortified monosodium glutamate and health, growth, and survival of children: a controlled field trial. American Journal of Clinical Nutrition 48, 1271–1276.CrossRefGoogle ScholarPubMed
Muslimatun, S, Schmidt, MK, Schultink, W, West, CE, Hautvast, JGAJ, Gross, R & Muhilal, (2001) Weekly supplementation with iron and vitamin A during pregnancy increases hemoglobin concentration but decreases serum ferritin concentration in Indonesian pregnant women. Journal of Nutrition 131, 85–90.CrossRefGoogle ScholarPubMed
Nokes, C, Van den Bosch, C & Bundy, DAP (1998) The effects of iron deficiency and anemia on mental and motor performance, educational achievement, and behavior in children. A Report of the International Nutritional Anemia Consultative Group. Washington, DC: International Life Science Institute.Google Scholar
Olson, JA, Gunning, DB & Tilton, RA (1984) Liver concentrations of vitamin A and carotenoids, as a function of age and other parameters, of American children who died of various causes. American Journal of Clinical Nutrition 39, 903–910.CrossRefGoogle ScholarPubMed
Ortega, RM, Andres, P, Martinez, RM & Lopez-Sobaler, AM (1997) Vitamin A status during the third trimester of pregnancy in Spanish women: influence on concentrations of vitamin A in breast milk. American Journal of Clinical Nutrition 66, 564–568.CrossRefGoogle ScholarPubMed
Panth, M, Shatrugna, V, Yasodhara, P & Sivakumar, B (1990) Effect of vitamin A supplementation on haemoglobin and vitamin A levels during pregnancy. British Journal of Nutrition 64, 351–358.CrossRefGoogle ScholarPubMed
Preziosi, P, Prual, A, Galan, P, Daouda, H, Boureima, H & Hercberg, S (1997) Effect of iron supplementation on the iron status of pregnant women: consequences for newborns. American Journal of Clinical Nutrition 66, 1178–1182.CrossRefGoogle ScholarPubMed
Rahman, MM, Mahalanabis, D, Alvarez, JO, Wahed, MA, Islam, MA, Habte, D & Khaled, MA (1996) Acute respiratory infections prevent improvement of vitamin A status in young infants supplemented with vitamin A. Journal of Nutrition 126, 628–633.CrossRefGoogle ScholarPubMed
Rice, AL, Stoltzfus, RJ, de-Francisco, A, Chakraborty, J, Kjolhede, CL & Wahed, MA (1999) Maternal vitamin A or beta-carotene supplementation in lactating Bangladeshi women benefits mothers and infants but does not prevent subclinical deficiency. Journal of Nutrition 129, 356–365.CrossRefGoogle Scholar
Roodenburg, AJ, West, CE, Hovenier, R & Beynen, AC (1996) Supplemental vitamin A enhances the recovery from iron deficiency in rats with chronic vitamin A deficiency. British Journal of Nutrition 75, 623–636.CrossRefGoogle ScholarPubMed
Scholl, TO & Hediger, ML (1994) Anemia and iron-deficiency anemia: compilation of data on pregnancy outcome. American Journal of Clinical Nutrition 59, 492S–500S.CrossRefGoogle ScholarPubMed
Shah, RS & Rajalakshmi, R (1984) Vitamin A status of the newborn in relation to gestational age, body weight, and maternal nutritional status. American Journal of Clinical Nutrition 40, 794–800.CrossRefGoogle ScholarPubMed
Shah, RS, Rajalakshmi, R, Bhatt, RV, Hazra, MN, Patel, BC, Swamy, NB & Patel, TV (1987) Liver stores of vitamin A in human fetuses in relation to gestational age, fetal size and maternal nutritional status. British Journal of Nutrition 58, 181–189.CrossRefGoogle ScholarPubMed
Siimes, MA, Saarinen, UM & Dallman, PR (1979) Relationship between hemoglobin concentration and transferrin saturation in iron-sufficient infants. American Journal of Clinical Nutrition 32, 2295–2300.CrossRefGoogle ScholarPubMed
Stephensen, CB & Gildengorin, G (2000) Serum retinol, the acute phase response, and the apparent misclassification of vitamin A status in the third National Health and Nutrition Examination Survey. American Journal of Clinical Nutrition 72, 1170–1178.CrossRefGoogle ScholarPubMed
Stoltzfus, RJ, Hakimi, M, Miller, KW, Rasmussen, KM, Dawiesah, S, Habicht, JP & Dibley, MJ (1993) High dose vitamin A supplementation of breast-feeding Indonesian mothers: effects on the vitamin A status of mother and infant. Journal of Nutrition 123, 666–675.CrossRefGoogle ScholarPubMed
Suharno, D, West, CE, Muhilal, Karyadi, D & Hautvast, JGAJ (1993) Supplementation with vitamin A and iron for nutritional anaemia in pregnant women in West Java, Indonesia. Lancet 342, 1325–1328.CrossRefGoogle ScholarPubMed
Suharno, D, West, CE, Muhilal, Logman, MH, de-Waart, FG, Karyadi, D & Hautvast, JGAJ (1992) Cross-sectional study on the iron and vitamin A status of pregnant women in West Java, Indonesia. American Journal of Clinical Nutrition 56, 988–993.CrossRefGoogle ScholarPubMed
Suominen, P, Punnonen, K, Rajamaki, A, Majuri, R, Hanninen, V & Irjala, K (1999) Automated immunoturbidimetric method for measuring serum transferrin receptor. Clinical Chemistry 45, 1302–1305.CrossRefGoogle ScholarPubMed
Underwood, BA (1994) Maternal vitamin A status and its importance in infancy and early childhood. American Journal of Clinical Nutrition 59, 517S–522S.CrossRefGoogle ScholarPubMed
Virtanen, MA, Viinikka, LU, Virtanen, MK, Svahn, JC, Anttila, RM, Krusius, T, Cook, JD, Axelsson, IE, Raiha, NC & Siimes, MA (1999) Higher concentrations of serum transferrin receptor in children than in adults. American Journal of Clinical Nutrition 69, 256–260.Google ScholarPubMed
Waterlow, JC & Schürch, B (1994) Causes and mechanisms of linear growth retardation. Proceedings of an I/D/E/C/G workshop held in London January 15–18, 1993. European Journal of Clinical Nutrition 48, S1–S216.Google Scholar
West, KP, LeClerq, SC, Shrestha, SR, Wu, LS, Pradhan, EK, Khatry, SK, Katz, J, Adhikari, R & Sommer, A (1997) Effects of vitamin A on growth of vitamin A-deficient children: field studies in Nepal. Journal of Nutrition 127, 1957–1965.CrossRefGoogle ScholarPubMed
Wharf, SG, Fox, TE, Fairweather, TS & Cook, JD (1997) Factors affecting iron stores in infants 4–18 months of age. European Journal of Clinical Nutrition 51, 504–509.CrossRefGoogle ScholarPubMed
World Health Organization (1996) Indicators for Assessing Vitamin A Deficiency and their Application in Monitoring and Evaluating Intervention Programmes WHO/NUT/96.10. Geneva: WHO.Google Scholar
World Health Organization (1998) Safe Vitamin A Dosage during Pregnancy and Lactation. Recommendations and Report of a Consultation.. Geneva: WHO, Micronutrient Initiative.Google Scholar
Yip, R (2000) Significance of an abnormally low or high hemoglobin concentration during pregnancy: special consideration of iron nutrition. American Journal of Clinical Nutrition 72, 272S–278S.CrossRefGoogle ScholarPubMed