Roba Kedir Teji, Asefa Gemechu, Fite Meseret Belete, Oumer Abdu, Abdurahman Dureti, Motuma Aboma, Yilma Abebayehu N, Thompson Gretchen, Brewis Alexandra, Rosinger Asher Y
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, United States.
Front Nutr. 2025 Apr 3;12:1556074. doi: 10.3389/fnut.2025.1556074. eCollection 2025.
Vitamin A is essential for maternal and child health and plays a key role in reducing maternal and child mortality rates. A need exists for more evidence on the prevalence and associated factors of Vitamin A deficiency (VAD) among pregnant women in rural, underserved areas, such as eastern Ethiopia, where many risk factors for VAD may be concentrated.
A community-based cross-sectional study was conducted with 397 randomly selected pregnant women at the Haramaya University Demographic Health Surveillance sites. Data were collected through structured questionnaires, anthropometric measurements, blood serum samples, and other relevant household and individual-level information. Vitamin A deficiency (VAD) was defined as serum retinol levels <0.7 μmol/L, while marginal deficiency was defined as 0.70-1.05 μmol/L. Bivariable and multivariable logistic regression analyses were used to identify factors associated with VAD.
Approximately 48.1% (43.1-53.1%) of pregnant women in eastern Ethiopia had subclinical vitamin A deficiency (VAD), with a mean serum retinol concentration of 0.82 (±0.02) μmol/L. Only 122 (30.7%) and 159 (40.1%) of the participants reported having adequately diversified diets and adequate food variety scores, respectively. The use of khat (a stimulant) (adjusted odds ratio [AOR] = 1.67; 95% CI: 1.08-2.57) and a lack of awareness regarding vitamin A-rich foods (AOR = 1.67; 95% CI: 1.04-2.68) were found to be positively associated with VAD. Khat chewing was responsible for approximately 40.1% of VAD cases. Additionally, greater educational attainment of the husband (AOR = 0.47; 95% CI: 0.25-0.90) was significantly protective against subclinical VAD.
Almost half of the pregnant women in this eastern Ethiopian sample were found to have subclinical VAD, highlighting the need for nutritional education during antenatal care and community nutrition awareness campaigns by various stakeholders. Context-specific, targeted behavioral change communications are essential to improve dietary practices and healthcare utilization.
维生素A对母婴健康至关重要，在降低母婴死亡率方面发挥着关键作用。在农村地区、服务欠缺地区，如埃塞俄比亚东部，存在许多维生素A缺乏（VAD）的风险因素，因此需要更多关于这些地区孕妇维生素A缺乏患病率及其相关因素的证据。
在哈拉马亚大学人口健康监测点对397名随机选取的孕妇进行了一项基于社区的横断面研究。通过结构化问卷、人体测量、血清样本以及其他相关的家庭和个人层面信息收集数据。维生素A缺乏（VAD）定义为血清视黄醇水平<0.7μmol/L，边缘性缺乏定义为0.70 - 1.05μmol/L。采用双变量和多变量逻辑回归分析来确定与VAD相关的因素。
埃塞俄比亚东部约48.1%（43.1 - 53.1%）的孕妇存在亚临床维生素A缺乏（VAD），血清视黄醇平均浓度为0.82（±0.02）μmol/L。分别只有122名（30.7%）和159名（40.1%）参与者报告饮食充分多样化且食物种类得分充足。发现使用恰特草（一种兴奋剂）（调整后的优势比[AOR]=1.67；95%置信区间：1.08 - 2.57）和对富含维生素A食物缺乏认知（AOR = 1.67；95%置信区间：1.04 - 2.68）与VAD呈正相关。嚼恰特草约占VAD病例的40.1%。此外，丈夫受教育程度较高（AOR = 0.47；95%置信区间：0.25 - 0.90）对亚临床VAD有显著的保护作用。
在埃塞俄比亚东部的这个样本中，几乎一半的孕妇存在亚临床VAD，这凸显了在产前护理期间进行营养教育以及各利益相关方开展社区营养意识宣传活动的必要性。针对具体情况的、有针对性的行为改变宣传对于改善饮食习惯和医疗保健利用至关重要。
