Effect of maternal vitamin A deficiency during pregnancy on neonatal kidney size.

BACKGROUND AND AIMS: In animal studies, vitamin A deficiency (VAD) during pregnancy has been shown to be associated with a decrease in nephron number and kidney weight of the offspring. At present, it is unclear whether these observations are pertinent to humans. Thus, this study was performed to assess the vitamin A status of a cohort of Egyptian pregnant women and their newborns and to determine the potential effect of maternal VAD during pregnancy on the neonatal kidney size. METHODS: The maternal and cord blood samples were collected for the measurement of serum retinol concentration.Within the first 3 days after delivery, an abdominal ultrasound was performed in all newborns to determine the renal dimensions and volume. RESULTS: Sixteen (20%) mothers had VAD. The newborns delivered to VAD mothers had significantly lower mean values of cord retinol concentrations and dimensions of both kidneys than the newborns delivered to mothers with vitamin A sufficiency. The maternal serum retinol concentrations were positively correlated with the cord retinol concentrations, the dimensions of both kidneys, and the combined renal volume of their respective newborns. CONCLUSION: Maternal VAD during pregnancy may decrease renal size in the infant at birth. The functional implications of this effect warrant further study.

Pattern of milk feeding and family size as risk factors for iron deficiency anemia among poor Egyptian infants 6 to 24 months old.

Infants between 6 and 24 months of age are at the highest risk of development of iron deficiency anemia (IDA) in developing countries. Consuming unmodified cow's milk, delayed introduction of solid foods after 6 months, and high birth order could be predictors of the presence of IDA. Three hundred infants between the ages of 6 and 24 months (mean, 13.94 ± 6.17 months) from Ain Shams University Children's Hospital were enrolled in the study. Data collected included demographic information and dietary assessment including the type of milk feeding, introduction of solid foods, and daily iron intake. The infants were examined, and anthropometric measurements were recorded. Anemic infants (hemoglobin level <11 g/dL) were further evaluated by complete blood count, hemoglobin electrophoresis, and iron profile. Anemia was diagnosed among 198 infants (66%), of whom 129 (43%) had IDA. Red cell distribution width at a cutoff value of 15.8% was 86% sensitive and 74% specific in predicting IDA. The main risk factors for IDA included being between 6 and 18 months of age, of the male sex, birth order above the second order, consuming cow's milk, predominant breast-feeding beyond 6 months of age, and low daily iron intake. We conclude that IDA is the most common cause of anemia among Egyptian infants 6 to 24 months old of low socioeconomic standard. Independent clinical predictors were consuming cow's milk during the first 6 months, delayed introduction of solid foods after 6 months, and birth order beyond the second order.