Vitamin A status in pregnant women in Iran in 2001 and its relationship with province and gestational age

BACKGROUND Vitamin A deficiency is considered as one of the public health problems among pregnant women worldwide. Population representative data on vitamin A status in pregnancy have not previously been published from Iran. OBJECTIVES The aim of this study was to publish data on vitamin A status in pregnant women in all the provinces of Iran in 2001, including urban and rural areas, and to describe the association of vitamin A status with maternal age, gestational age, and parity. DESIGN This descriptive cross-sectional study was conducted on 3,270 healthy pregnant women from the entire country, 2,631 with gestational age ≤36 weeks, and 639 with gestational age >36 weeks. Vitamin A status was determined in serum using high-performance liquid chromatography. RESULT Retinol levels corresponding to deficiency were detected in 6.6% (<0.36 µmol/L) and 18% had insufficient vitamin A levels (≥0.36-<0.7 µmol/L). Suboptimal level of serum retinol was observed in 55.3% of the pregnant women (0.7-1.4 µmol/L). Only about 20% of the women had optimal values (>1.4 µmol/L). The level of serum retinol was lower in older pregnant women (p=0.008), and at higher gestational age (p=0.009). High vitamin A levels were observed in pregnant women in the central areas of Iran and the lowest values in those in the southern areas of Iran. CONCLUSIONS The vitamin A status was good in 2001 but should be closely monitored also in the future. About 25% of pregnant women had a vitamin A status diagnosed as insufficient or deficient (<0.7 µmol/L). The mean serum retinol decreased as the gestational age increased. The clinical significance of this finding should be further investigated, followed by a careful risk group approach to supplementation during pregnancy.