JAMA logoThere have been studies suggesting vitamin A or beta carotene supplements to pregnant women with their deficiency, and are believed to reduce maternal, infant or fetal death. However a study involving pregnant rural women from Bangladesh showed that maternal, infant or fetal death did not reduce even after vitamin A or beta carotene supplementation in comparison with those who received placebo.

Maternal Vitamin A deficiency is not as rare as it seems and is known to be common in developing nations. This deficiency is often related to gestational night blindness, which could result in maternal anaemia and other health problems or even death. According to this background information if vitamin A deficiency is properly controlled during pregnancy then it would in turn improve maternal survival.

In a process of examining the effect of vitamin A and beta carotene supplements on pregnant women, Keith P. West Jr., Dr.P.H. of Johns Hopkins University, Baltimore, and his colleagues conducted a study. The investigation was carried out between 2001 and 2007, examining 125 to 257 pregnant women in a randomized trial between 13 to 45 years of age, and their live-born infants of up to 12 weeks (84 days) postpartum in rural northern Bangladesh. These women were given beta carotene supplements, 7,000 micrograms of retinol equivalents as Retinyl Palmitate, 42 mg of all-trans beta carotene, or placebo weekly, from the first trimester through 12 weeks postpartum. The women were then observed for 5 weeks by the scientists after their pregnancy was ascertained. Biochemical studies had to be performed and blood samples were collected for the same.

Comparisons were drawn between first trimester maternal characteristics across supplement groups as attached with supplementation. According to the investigators there were 138 maternal deaths due to varied reasons, with 41 for placebo, 47 for vitamin A, and 50 for beta carotene groups. Thus with this it could be concluded that the death toll was approximately 206, 237 and 250 per 100,000 pregnancies. The stillbirth percentage was also high with around 703 in placebo, 665 on the vitamin A group and 776 in the beta carotene group. This eventually resulted in 7.9, 5.6, 51.8 death rates per 1,000 births, respectively. The total number of infant deaths was found to be 2,834 out of which the death toll with placebo was the highest with 951 followed by, 904 in the vitamin A group, and 979 in the beta carotene group, resulting in mortality rates of 68.1, 65.0, and 69.8 deaths per 1,000 live births, respectively. There were no significantly different rates.

Gestational night blindness was not thoroughly treated by vitamin A but it helped to a certain extent to reduce its effect compared to either placebo or beta carotene supplements. This effect was possibly due to the increased plasma retinol concentrations by Vitamin A

Thus scientists believe that vitamin A deficiency should not be taken lightly. It results in many health problems and maternal survival is hugely dependent on essential vitamins. This study basically shows that these supplements are ineffective in maternal survival however irrespective of its effect on maternal survival; vitamin deficiency during pregnancy has to be taken care of.

This study is published in the May 18 issue of JAMA.