Determinants of gestational night blindness in pregnant women from Rio de Janeiro, Brazil

Abstract

Objective: To describe the prevalence and determinants of gestational night blindness in pregnant women receiving care in a hospital in Rio de Janeiro, Brazil. Design: Cross-sectional study of pregnant and postpartum women receiving care in a public hospital in Rio de Janeiro from 1999 to 2001 (group I; n 225) or from 2005 to 2008 (group II; n 381). Night blindness was identified through a standardized and validated interview (WHO, 1996). The determinants of gestational night blindness were identified through a hierarchical logistic regression model. Setting: Public maternity hospital in Rio de Janeiro, RJ, Brazil. Subjects: Adult pregnant and postpartum women (n 606), aged ≥20 years. Results: The prevalence of gestational night blindness was 9·9 %. The final model revealed that not living in the South Zone of Rio de Janeiro (distal level: adjusted OR = 1·846; 95 % CI 1·002, 3·401), belonging to group I (intermediate level: adjusted OR = 2·183; 95 % CI 1·066, 4·471) and for the proximal level, having a history of abortion (adjusted OR = 2·840; 95 % CI 1·134, 7·115) and having anaemia during the first and second trimesters of pregnancy (adjusted OR = 3·776; 95 % CI 1·579, 9·029) were determinants of gestational night blindness. Conclusion: Gestational night blindness should be assessed for during the prenatal care of all pregnant women, especially those living in deprived areas of the city and/or who have a history of abortion or anaemia. Nutritional monitoring is recommended during pregnancy to control gestational night blindness. Keywords Night blindness Vitamin A deficiencyPregnant women Cross-sectional study Vitamin A deficiency (VAD) remains an ongoing public health problem in many areas of the world. Children and women of childbearing age are most affected, with an estimated 190 million children of pre-school age and 19 million pregnant women having VAD (1) . Based on night blindness (XN; the ocular symptom of VAD) and xerophthalmia (the first stage of ocular manifestations due to VAD), it is estimated that 5·2 million pre-school children and 9·8 million pregnant women are impacted, corresponding to 0·9 % and 7·8 % of these populations worldwide (1,2) . A national survey conducted in Brazil examined VAD among children of pre-school age and women of reproductive age (3) . Analyses of serum retinol, which is the biochemical indicator of VAD, revealed that women from the Southeast region evinced the highest prevalence of VAD in the country (14·0 %), surpassing those in the Northeast region (12·1 %), which is considered at higher risk for this

Vitamin A and Pregnancy: A Narrative Review

“…Furthermore, a study conducted in Brazil in the upper Jequitinhonha valley of Minas Gerais reported night blindness in 8.7% of 92 pregnant women interviewed [79]. In another assessment, the prevalence of night blindness was 9.9% among 606 pregnant and postpartum women in Rio de Janeiro [80]. Another study found a prevalence of VAD of 34.8% in 89 pregnant adolescents in the state of Piauí, northeastern Brazil, suggesting the existence of a severe public health issue [53].…”

High prevalence of gestational night blindness and maternal anemia in a population-based survey of Brazilian Amazonian postpartum women

“…Prevalence rates less than 10% were registered in Indonesia (1.7%), Madagascar (7.5%), and Nigeria (7.7%), whereas high prevalence rates were observed in Bolivia (14.0%), Nepal (19.6%), and in the district of Medak, India (35.0%) [25]. There are no countrywide data for GXN in Brazil; most investigations have been concentrated in Rio de Janeiro, where a prevalence of GXN of 9.9% was found in a maternity hospital [8]. This result aligns with our findings in Brazilian Amazon.…”

“…In Brazil, the public health significance of GXN was considered mild (3.5%); however, the estimates for Brazil were retrieved through regression-based methods, owing to a lack of available data in the country [3]. Also, regional data suggest that prevalence of GXN in the country might be underestimated, as a prevalence of 9.9% was observed in a maternity hospital in Rio de Janeiro city [8].…”

“…Among the principal causes of VAD and anemia in pregnancy is the inadequate dietary intake of foods rich in vitamin A (VA) and iron, along with high rates of infection, and aspects related to the physiology of pregnancy, such as the hemodilution in the third trimester [3]. Other underlying causes for VAD and anemia include poor socioeconomic and environmental conditions, maternal illiteracy, history of abortion, and inadequate antenatal care [3,8,10].…”

The Prevalence of Vitamin A Deficiency and Associated Factors in Pregnant Women Receiving Prenatal Care at a Reference Maternity Hospital in Northeastern Brazil

“…Therefore, in population-based studies, its occurrence in ≥5% of the population would classify VAD as a severe public health problem [46]. Using this criterion, VAD was considered severe in Vale do Jetiquinhonha in the southeastern Brazilian state of Minas Gerais, where night blindness was found in 8.7% of the 92 pregnant women interviewed [16], and in Rio de Janeiro where the prevalence of night blindness was 9.9% in 606 pregnant or postpartum adult women [47]. …”