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Articles

Vitamin A or ß-Carotene Supplementation Reduces Symptoms of Illness in Pregnant and Lactating Nepali Women¹

Parul Christian^*2, Keith P. West, Jr.^*, Subarna K. Khatry, Joanne Katz^*, Steven C. LeClerq^*, Elizabeth Kimbrough-Pradhan^*, Sanu Maiya Dali^** and Sharada Ram Shrestha

^* Johns Hopkins School of Public Health, Baltimore, Maryland; The National Society for Prevention of Blindness, Kathmandu, Nepal and ^** The National Maternity Hospital, Kathmandu, Nepal

²To whom correspondence should be addressed at Room 2041, 615 N. Wolfe St.

The contribution of nutritional interventions to the reduction in maternal morbidity rates in developing countries is not well known. We assessed the impact of weekly vitamin A and ß-carotene supplementation on the prevalence of pregnancy and postpartum illness symptoms among 15,832 Nepali women in a placebo-controlled, double-masked, cluster-randomized trial. There was no impact of either supplement on morbidity rates reported up to 28 wk of gestation, inclusive. However, in late pregnancy (>28 wk), symptoms of nausea, faintness and night blindness were reduced with vitamin A, but not ß-carotene, supplementation. Vitamin A supplementation shortened the length of labor by 1.5 h 50 min among nulliparous and multiparous women, respectively. Both interventions reduced the postpartum prevalence of at least four loose stools and night blindness. ß-Carotene supplementation also reduced symptoms of high fever postpartum. The mean number of days of any reported illness symptoms was 3–4 per wk throughout pregnancy. Among women receiving vitamin A, the total number of days of illness symptoms accrued over the last 12 wk of pregnancy was lower by 5 d compared with the placebo recipients. We found the burden of pregnancy-related illness symptoms to be high in this rural area of Nepal where antenatal care is poor and most deliveries occur at home. Maternal vitamin A or ß-carotene supplementation resulted in a reduction in the prevalence of selected illness symptoms during late pregnancy, at the time of birth and during 6 mo postpartum, suggesting that a diet adequate in vitamin A may be important for improving women’s reproductive health.

KEY WORDS: • illness symptoms • pregnancy and lactation • vitamin A • ß-carotene • humans

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