Delayed visual maturation in Karen refugee infants

Abstract

Thirty-eight babies born to Karen mothers living in camps for displaced persons in north-western Thailand have delayed visual maturation (DVM type 1) that recovers within 6 months. Vitamin A concentrations were deficient in 16% of breast-milk samples from lactating mothers and vitamin B(1) concentrations were deficient in 60% of plasma samples. Infantile beriberi was common in this population. The levels of fatty acids in plasma and milk in Karen women were excellent at birth and in the postpartum period. The degree of deficiencies in these vitamins and the concentration of essential fatty acids in cord blood and maternal breast-milk did not correlate significantly with visual impairment in the infants. DVM might be caused by nutritional deficiency or toxic effects during critical periods of gestation that lead to delayed cortical myelination or structural defects which impinge on parietal cortex function.

Clinically Unapparent Infantile Thiamin Deficiency in Vientiane, Laos

“…Among the infants on the Thailand/Burma border, McGready et al [50] demonstrated delayed visual maturation type 1 and suggested thiamin deficiency as a possible cause. Follow up of Israeli infants who survived beriberi, due to substandard infant formula devoid of thiamin, suggests that thiamin deficiency was associated with subsequent delayed language development and epilepsy [51].…”

The Dubowitz neurological examination of the full‐term newborn

“…However, in those with various degrees of maternal illness and/or malnutrition, differences are much more marked. The extent to which these are the reflection of the ethnic background and are the main contributing factors remains unsolved [McGready et al, 2000[McGready et al, , 2003. However, in these circumstances the neurological examination is often used to compare groups of infants and thus it remains a useful tool.…”

The connection between maternal thiamine shortcoming and offspring cognitive damage and poverty perpetuation in underprivileged communities across the world

“…Therefore, CNS development in an environment that lacks thiamine will probably be negatively affected [47,33]. Although cerebral plasticity enables the compensation of the vitamin shortcoming, the molecular mechanism and its limit of action are still unknown.…”