No abstract

A cross-sectional study of the prevalence of iron and vitamin A deficiency in normal pregnant women in West Java, Indonesia, was carried out. Of the 318 women studied, 49.4% were anemic and, according to multiple criteria, 43.5% had iron-deficiency anemia, 22.3% had iron-deficient erythropoiesis, and 6.6% had iron depletion. Serum retinol values revealed that 2.5% of the pregnant women were vitamin A deficient and 31% had marginal vitamin A status. The relative dose-response test carried out on 45 women showed that 4 (8.9%) had deficient vitamin A liver stores. After gestational stage, parity, and subdistrict were adjusted for, serum retinol concentrations were significantly positively associated (P < 0.01) with hemoglobin concentrations, hematocrit, and serum iron concentrations. The suboptimal vitamin A status associated with nutritional-deficiency anemia suggests that pregnant women in the area should be supplemented not only with iron but also with vitamin A. This proposal should be tested in an intervention study.

A cross-sectional study of the prevalence of iron and vitamin A deficiencies in 318 pregnant women revealed that 50.7% had iron deficiency and 21.3% had marginally deficient or deficient vitamin A status. Based on results, the influence of vitamin A and iron supplementation was studied in 305 anaemic pregnant women in west Java, in a randomized, doubleblind, placebo-controlled field trial. The women with a haemoglobin between 80 and 109 g/L were randomly allocated to four groups: vitamin A (2.4 mg retinol) and placebo iron tablets; iron (60 mg elemental iron as ferrous sulphate) and placebo vitamin A; vitamin A and iron; and both placebos, all daily for eight weeks. Maximum haemoglobin was achieved with both vitamin A and iron supplementation (12. 78 g/L, 95% Cl 10.86 to 14.70), with one-third of the response attributable to vitamin A (3.68 g/L, 2.03 to 5.33) and two-thirds to iron (771 g/L, 5.97 to 9.45). After supplementation, the proportion of women who became non-anaemic was 35 % in the vitamin Asupplemented group, 68% in the ironsupplemented group, 97% in the group supplemented with both, and 16% in the placebo group. We conclude that improvement in vitamin A status may contribute to the control of anaemia in pregnant women.