Medicinal Plants Classification Biosynthesis and ... - Index of

Biological Effects of -Carotene
A (~50 000 IU) within several hours to several days after birth. In Indonesia, Humphrey et al
(1996) reported a 64% reduction in mortality in a trial among 2067 hospital-born infants, and
in south India, Rahmathullah et al (2003) observed a 22% reduction in mortality through 6
months of age in a community-based trial among 11,619 infants.
Vitamin A deficiency is common among women in developing countries. Mean serum
retinol concentrations of about 1.05 µmol/l (300 µg/l) have been reported during pregnancy
among diverse groups of south Asian women (Sivakumar et al., 1997) in comparison with
values of 1.57­1.75 µmol/l (450­500 µg/l) in better nourished populations (Morse et al.,
1975).
Concern about maternal vitamin A deficiency has focused on its effects on fetal and
infant vitamin A status, health, and survival, with little attention being paid to its effects on
the health consequences for the woman (Dimenstein et al., 1996). An early trial in England
reported that maternal vitamin A supplementation in late pregnancy through the first week
post partum could reduce the incidence of puerperal sepsis (Green et al., 1931), but this lead
was ignored.
In Nepal maternal night blindness, an indicator of vitamin A deficiency, has been
associated with increased risks of urinary or reproductive tract infections and diarrhoea or
dysentery and raised acute phase protein concentrations during infection (Christian et al.,
1998) That vitamin A deficiency could predispose women to increased infectious morbidity
and mortality is supported by evidence in children and animals. Mechanisms underlying such
an effect could include impaired barrier defences of epithelial tissues and compromised
innate and acquired immunity (Semba, 1994). Conducted a study in rural southeast central
plains of Nepal to assess the impact on mortality related to pregnancy of supplementing
women of reproductive age each week with a recommended dietary allowance of vitamin A,
either preformed or as β-carotene. The treatment of the 44,646 married women, of whom
20,119 became pregnant 22,189 times to receive weekly a single oral supplement of placebo,
vitamin A (7000 µg retinol equivalents) or β-carotene (42 mg, or 7000 µg retinol
equivalents) for over 31⁄2 years. Supplementation of women with either vitamin A or βcarotene
at recommended dietary amounts during childbearing years can lower mortality
related to pregnancy in rural, undernourished populations of south Asia (West et al., 1999).
In other trail conducted in 19 unions in rural northwest Bangladesh was evenly
randomized for newborns of participating mothers to receive a single, oral supplement of
vitamin A (50 000 IU) or placebo as droplets of oil squeezed from a gelatinous capsule.
Mothers provided informed consent for newborn participation at ~28 weeks gestation. After
birth, typically at home, 17,116 infants were supplemented and their vital status was followed
through 24 weeks of age. The main outcome measure was mortality through 24 weeks of age.
Newborn vitamin A dosing improved infant survival through the first 6 months of life in
Bangladesh. These results corroborate previous findings from studies in Indonesia and India
and provide additional evidence that vitamin A supplementation shortly after birth can reduce
infant mortality in South Asia (Klemm et al., 2008).
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