Christian P, West K P, Khatry S K, Kimbrough-Pradhan E, LeClerq S C, Katz J, Shrestha S R, Dali S M, Sommer A
Johns Hopkins School of Public Health, Baltimore, MD 21205, USA.
Am J Epidemiol. 2000 Sep 15;152(6):542-7. doi: 10.1093/aje/152.6.542.
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 9,545 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 3,601 per 100,000 pregnancies. In comparison, the relative risk of dying among nonnight-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 five 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 factor of both short- and long-term mortality among women. Vitamin A/beta-carotene supplementation ameliorates this risk to a large extent.
在尼泊尔，孕期因维生素A缺乏导致的夜盲症很常见。作者评估了参与1994年7月至1997年9月在尼泊尔进行的一项整群随机、安慰剂对照的维生素A和β-胡萝卜素补充试验的女性在孕期及产后出现夜盲症时的孕产妇死亡风险。研究对象为877名孕期患有夜盲症的女性和9545名未患夜盲症的女性。从女性宣称怀孕开始直至研究结束对她们进行随访，中位随访时间为90周（四分位间距：64 - 121周）。安慰剂组中患夜盲症女性的死亡率为每100,000次妊娠3601例。相比之下，安慰剂组中未患夜盲症女性的死亡相对风险为0.26（95%置信区间（CI）：0.13, 0.55），维生素A/β-胡萝卜素组中患或未患夜盲症女性的死亡相对风险分别为0.32（95% CI：0.10, 0.91）和0.18（95% CI：0.09, 0.36）。患夜盲症的女性死于感染的可能性是未患夜盲症女性的五倍（95% CI：2.20, 10.58）。这些发现表明，孕期夜盲症是女性短期和长期死亡的一个风险因素。补充维生素A/β-胡萝卜素在很大程度上降低了这种风险。
