Vitamin A Deficiency and Mother‐Infant Correlations in Bolivia

Abstract

Vitamin A deficiency (VAD) affects an estimated one‐third of preschool‐aged children in developing countries and is an important contributor to global child mortality. The goal of this analysis was to identify risk factors of VAD in a cohort of Bolivian infants. Healthy infants (n=163) were recruited from 2 hospitals in El Alto, Bolivia, and followed from 1 to 6 months of age. Blood specimens taken at 6 months were analyzed for retinol‐binding protein (RBP) levels (VAD defined as RBP < 0.7 µmol/L), C‐Reactive Protein (CRP), and alpha(1)‐acid glycoprotein (AGP). Potential covariates in logistic regression models of VAD included infant gender, stunting (length‐for‐age Z score < ‐2), iron deficiency (ferritin< 12 μg/L), acute respiratory or diarrheal illness, breastfeeding, maternal age, maternal vitamin A supplementation, maternal employment, and access to private toilets. Elevated CRP (>5 mg/L) and AGP (>1 g/L) were included in all models to account for inflammation. Prevalence of VAD was 25%. Backwards elimination indicated maternal age (OR: 4.6, 90% CI: [1.8‐11.4] for 25‐30 vs. 20‐25 years), maternal employment (0.4 [0.2‐0.9]) and elevated CRP (3.1 [1.2‐7.9]) were significantly associated with VAD using an alpha of 10%. These results suggest that sociodemographics may be an important risk factor for VAD, while inflammation also affects measures of VAD. A limitation of this study is the small sample size and subsequent lack of power, which will be improved as data collection continues.