Vitamin A deficiency in poor, urban, lactating women in Bangladesh: factors influencing vitamin A status

Abstract

Aims: To investigate the prevalence of vitamin A deficiency among lactating women in a poor urban population of Bangladesh, and to examine the relationship between various factors and vitamin A status.Design: Cross-sectional study.Setting: Maternal and child health clinic in Dhaka City, Bangladesh.Subjects and methods: A total of 120 lactating women aged 17–37 years were randomly selected from women who attended a local maternal and child health clinic in Dhaka City for immunisation of their children. Various socio-economic, personal characteristics, dietary intakes of vitamin A and anthropometric data were collected. Serum retinol (vitamin A) concentration was determined as a measure of vitamin A status.Results: Of the subjects, 37% had low serum vitamin A levels (−1), with 13.3% having sub-clinical vitamin A deficiency (−1). Eighty-seven per cent had vitamin A intakes below the recommended dietary allowance. The lactating women who were either illiterate or received only informal education had significantly (P = 0.002) lower serum vitamin A levels compared with those who received formal education. The women whose husbands received formal education had significantly (P = 0.05) higher serum vitamin A levels than those whose husbands were either illiterate or received only informal education. The serum vitamin A levels of women in households with poor sanitation/latrine practice were significantly (P = 0.03) lower than those of women in households with good sanitation/latrine practice. The women with one child had significantly (P = 0.015) lower serum vitamin A levels than those with two or more children. Women with a lactation period of 6 months or more had significantly (P = 0.034) lower serum vitamin A levels than women with a lactation period of less than 6 months. The women who consumed less than the median vitamin A intake (274.8 μg day⁻¹) had significantly (P = 0.01) lower serum vitamin A levels than those who consumed more than the median vitamin A intake. By multiple regression analysis, education level of the women, number of living children, duration of lactation and dietary intake of vitamin A were found to have significant independent relationships with serum vitamin A. The overall F-ratio (6.8) was highly significant (P = 0.000), the adjusted R² was 0.16 (multiple R = 0.44).Conclusion: A significant proportion of poor, urban, lactating women in Bangladesh have vitamin A deficiency. Among the various factors, education level of the women, number of living children, duration of lactation and dietary intake of vitamin A appear to be important in influencing the vitamin A status of these women.