RESUMEN
Vitamin D deficiency is common in Arab women. In a pilot study we investigated the effect of sun exposure at recommended levels on the vitamin D status of Arab women. Eight healthy Arab women of childbearing age consented to expose their face, arms and hands for 15 minutes per day twice a week for 4 weeks within the privacy of their courtyard and to avoid changes in dietary vitamin D intake. Serum 25-hydroxyvitamin D [25(OH)] levels were measured pre- and post-intervention. Although vitamin D levels remained sub-optimal median serum 25(OH)D levels were significantly higher post-intervention (23.0 nmol/L) than pre-intervention (17.6 nmol/L). Extending sun exposure for more than 4 weeks should be investigated as part of strategies to improve vitamin D status in high-risk Arab women who lack outdoor sun exposure to the skin.
Asunto(s)
Luz Solar , Deficiencia de Vitamina D/epidemiología , Adulto , Árabes , Femenino , Humanos , Proyectos Piloto , Estadísticas no Paramétricas , Encuestas y Cuestionarios , Emiratos Árabes Unidos/epidemiología , Deficiencia de Vitamina D/etnologíaRESUMEN
UNLABELLED: Although hypovitaminosis D has been reported in the neonatal period and infancy, there is currently little information on the longitudinal changes in vitamin D status throughout early infancy. AIM: To estimate, in Al Ain, UAE, the prevalence of vitamin D deficiency and longitudinal changes and risk factors in infants between birth and 6 months of age. METHODS: Serum 25-OH-vitamin-D levels were measured after birth and 6 months later in 27 infants of mothers of Middle Eastern or Asian origin who were pregnant between the months of September and November 2007. RESULTS: At delivery, mean (SD) maternal serum 25-OH-vitamin-D level was 35.5 nmol/L (24.7); five mothers (22%, 95% CI 0.7-43) had adequate serum levels (>50 mmol/L), 11 (48%, 95% CI 27-70) insufficient levels (25-50 nmol/L) and seven (30%, 95% CI 13-53) deficient (<25 nmol/L) levels. Serum 25-OH-vitamin-D levels were adequate in eight infants (30%, CI 14-50%), insufficient in 13 (48%, CI 28-60%) and deficient in six (22%, CI 8.5-42%). Despite recommendations, none had received any vitamin D supplementation since birth. Despite the high prevalence of hypovitaminosis D at birth and the lack of pharmacological supplementation, the number of infants with adequate levels at 6 months of age rose to 20 (87%, CI 66-97%). No infant had deficiency (CI 0-21%) and three (13%, CI 27-33%) had insufficiency. Adequate levels were detected in four infants who were partially breastfed [mean (SD) 108.5 (20.7) nmol/L] and in only 84% of the 19 exclusively breastfed infants [mean (SD) 96.2 (44.5) nmol/L] but the difference was not statistically significant. Although serum levels improved at 6 months, it occurred more slowly in exclusively breastfed infants. CONCLUSION: In the absence of vitamin D supplementation, guidelines for vitamin D supplementation in infancy still need to be followed because the mechanisms for normalisation are not clearly understood.
Asunto(s)
Deficiencia de Vitamina D/diagnóstico , Deficiencia de Vitamina D/epidemiología , Vitamina D/sangre , Femenino , Humanos , Lactante , Recién Nacido , Estudios Longitudinales , Masculino , Prevalencia , Factores de RiesgoRESUMEN
Vitamin D deficiency is common in Arab women, In a pilot study we investigated the effect of sun exposure at recommended levels on the vitamin D status of Arab women. Eight healthy Arab women of child-bearing age consented to expose their face, arms and hands for 15 minutes per day twice a week for 4 weeks within the privacy of their courtyard and to avoid changes in dietary vitamin D intake. Serum 25-hydroxyvitamin D [25[OH]] levels were measured pre- and post-intervention. Although vitamin D levels remained sub-optimal, median serum 25[OH]D levels were significantly higher post-intervention [23.0 nmol/L] than pre-intervention [17.6 nmol/L]. Extending sun exposure for more than 4 weeks should be investigated as part of strategies to improve vitamin D status in high-risk Arab women who lack outdoor sun exposure to the skin
Asunto(s)
Vitamina D , Deficiencia de Vitamina D , Mujeres , Árabes , 25-Hidroxivitamina D 2 , Luz SolarRESUMEN
Prospective longitudinal study of vitamin D status and its risk factors in 75 pregnant women from early pregnancy until 6 months postpartum, by serial measurement of serum 25 (OH) vitamin D levels. The serum levels at booking were not significantly different between nationalities (p = 0.06), parity (p = 0.2), education levels (p = 0.4), dress code (p > 0.5), consumption of vitamin D fortified milk (p = 0.2) or, fatty fish (p = 0.5), sun-exposed body surface area (p = 0.3), weekly time exposed to the sun (p = 0.08) or the sun exposure index (p = 0.2). Vitamin D status progressively worsened as the proportion with adequate serum levels fell from 31% at the antenatal visit, to 23% after birth and 17%, 6 months later (p = 0.02). While 80% of mothers who were exclusively breast-feeding had low vitamin D levels 6 months after delivery, this occurred in only 67% of those partially breast-feeding (p = 0.6).
Asunto(s)
Complicaciones del Embarazo/etnología , Deficiencia de Vitamina D/etnología , Adolescente , Adulto , Femenino , Humanos , Estudios Longitudinales , Periodo Posparto , Embarazo , Prevalencia , Estudios Prospectivos , Factores de Riesgo , Emiratos Árabes Unidos/epidemiología , Adulto JovenRESUMEN
Micronutrient deficiencies exist among women of childbearing age in the United Arab Emirates but the effects of maternal micronutrient deficiency on fetal growth are not well documented. To investigate the association between micronutrients and birth weight, we measured maternal and cord blood micronutrients (vitamin A, C, D, and E) and ferritin in 84 term, singleton infants born to healthy Arab and South Asian women at Al-Ain hospital. Median serum ascorbic acid and 25-hydroxyvitamin D (25-OHD) concentrations were low in mothers and infants. In multivariate analysis, maternal serum 25-OHD correlated positively with birth weight while serum ferritin showed a negative correlation.
Asunto(s)
Peso al Nacer , Enfermedades Carenciales , Sangre Fetal/química , Trastornos de la Nutrición del Lactante , Micronutrientes , Complicaciones del Embarazo , Adulto , Ácido Ascórbico/sangre , Enfermedades Carenciales/sangre , Enfermedades Carenciales/epidemiología , Femenino , Ferritinas/sangre , Humanos , Lactante , Trastornos de la Nutrición del Lactante/sangre , Trastornos de la Nutrición del Lactante/epidemiología , Micronutrientes/sangre , Micronutrientes/deficiencia , Análisis Multivariante , Encuestas Nutricionales , Estado Nutricional , Proyectos Piloto , Embarazo , Complicaciones del Embarazo/sangre , Complicaciones del Embarazo/epidemiología , Estadísticas no Paramétricas , Emiratos Árabes Unidos/epidemiología , Vitamina A/sangre , Vitamina D/sangre , Vitamina E/sangreRESUMEN
Micronutrient deficiencies exist among women of childbearing age in the United Arab Emirates but the effects of maternal micronutrient deficiency on fetal growth are not well documented. To investigate the association between micronutrients and birth weight, we measured maternal and cord blood micronutrients [vitamin A, C, D, and E] and ferritin in 84 term, singleton infants born to healthy Arab and South Asian women at Al-Ain hospital. Median serum ascorbic acid and 25-hydroxyvitamin D [25-OHD] concentrations were low in mothers and infants. In multivariate analysis, maternal serum 25-OHD correlated positively with birth weight while serum ferritin showed a negative correlation
Asunto(s)
Estado Nutricional , Peso al Nacer , Lactante , Madres , Ferritinas , Ácido Ascórbico , 25-Hidroxivitamina D 2 , Deficiencia de Vitamina D , MicronutrientesRESUMEN
OBJECTIVES: (1) To study the prevalence of HEV infection in a cohort of pregnant women in the United Arab Emirates (UAE). (2) The rate of mother-to-infant transmission. METHOD: Sera of 469 pregnant women residing in the UAE was tested for anti-HEV with ELISA and for HEV-RNA by polymerase chain reaction (PCR). Neonatal cord-blood and infant blood was similarly tested for anti-HEV and HEV-RNA. Out of these 469 women, 33% were UAE nationals (Group A) and Egyptians (Group B), respectively, and 34% were from the Indian sub-continent (Group C). RESULTS: Out of 469 mothers 93 (20%) were anti-HEV positive and 28 (30%) of these 93 were HEV-RNA positive and symptomatic with on-going infection. The prevalence of anti-HEV was significantly increased amongst Groups B and C (Group A:B, P<0.001; Group A:C, P<0.001). Twelve of these 28 symptomatic women developed acute hepatic disease and two died undelivered, thus, were excluded from further study. Six of the remaining 10 women had non-fulminant acute viral hepatitis and four developed fulminant hepatic failure, of which one died in the early post-partum period. The remaining 16 women had mild symptomatic disease with complete recovery as did the remaining nine women with acute illness. Of the 10 babies born to mothers with acute disease, two were pre-term, three had anicteric hepatitis and two babies were born with hypothermia and hypoglycaemia and died within 48h. Noteworthy is the fact that, the 26 infants born to the 26 HEV-RNA positive mothers developed acute/on-going clinical infection and were HEV-RNA positive. Apart from the two early neonatal deaths, the remaining 24 infants had full recovery. No infant of the other mothers were symptomatic or had HEV-RNA. Thus, the mother-to-infant transmission was 100%. The remaining 65 sero-positive women remained asymptomatic with no evidence of clinical infection, continued to be HEV-RNA negative and delivered at term. Their infants had no evidence of infection and were sero-negative by 9 months of age, suggesting transplacental transmission of IgG antibodies. CONCLUSIONS: There is a high prevalence of anti-HEV among pregnant women residing in the UAE. Twelve of infected women developed fulminant/acute hepatitis resulting in three fatalities. Evidence suggests significant vertical transmission of HEV among HEV-RNA positive mothers with appreciable perinatal morbidity and mortality. Excluding mothers with acute hepatic disease, Breast-feeding appears to be safe in HEV sero-positive mothers.
Asunto(s)
Anticuerpos Antivirales/sangre , Virus de la Hepatitis E/inmunología , Hepatitis E/epidemiología , Hepatitis E/transmisión , Transmisión Vertical de Enfermedad Infecciosa , Complicaciones Infecciosas del Embarazo/epidemiología , Adulto , Ensayo de Inmunoadsorción Enzimática , Femenino , Hepatitis E/diagnóstico , Virus de la Hepatitis E/genética , Humanos , Recién Nacido , Reacción en Cadena de la Polimerasa , Embarazo , Complicaciones Infecciosas del Embarazo/virología , ARN Viral/sangre , Emiratos Árabes Unidos/epidemiologíaRESUMEN
Vitamin C and D levels in Arab women and their newborn infants have been shown to be low. We investigated the prevalence of and risk factors for possible hypovitaminosis C and D in a convenience sample of 51 hospitalized children without clinical features of vitamin C or D deficiency. The mean age was 15.4 months. The serum vitamin C concentration was low in the mothers but normal in the children. Both mothers and children had low serum 25-hydroxyvitamin D (25-OHD) concentrations. Fifty per cent of the mothers and 22% of the infants and children had hypovitaminosis D (serum 25-OHD level < 25 nmol/l). Infants who received dietary vitamin D supplementation had a higher mean (SD) serum 25-OHD concentration than the unsupplemented group (62.5 (29.8) vs 38.5 (27.3), p = 001). Cutaneous light exposure in these children was poor. The children's serum 25-OHD concentration correlated with dietary vitamin D supplementation and maternal serum 25-OHD levels. The results suggest normal vitamin C status but a possible high prevalence of hypovitaminosis D in Arab children and their mothers in UAE. Health education to encourage greater sunshine exposure and improvement in maternal vitamin D stores and the availability of adequate vitamin D supplements would improve children's vitamin D status. The study indicates that hypovitaminosis D continues to be an important maternal and child health problem, despite the abundant sunshine.
Asunto(s)
Ácido Ascórbico/sangre , Vestuario , Países en Desarrollo , Dieta , Luz Solar , Vitamina D/sangre , Calcifediol/sangre , Suplementos Dietéticos , Femenino , Humanos , Lactante , Masculino , Estado Nutricional , Prevalencia , Factores de Riesgo , Emiratos Árabes UnidosAsunto(s)
Infecciones por Parvoviridae/epidemiología , Parvovirus B19 Humano , Complicaciones Infecciosas del Embarazo/epidemiología , Adolescente , Adulto , Anticuerpos Antivirales/sangre , Femenino , Humanos , Inmunoglobulina M/sangre , Persona de Mediana Edad , Parvovirus B19 Humano/inmunología , Embarazo , Emiratos Árabes Unidos/epidemiologíaRESUMEN
To establish the frequency and clinical pattern of Respiratory Syncytial virus (RSV) infection in the region, children under 3 years of age admitted for acute lower respiratory illness during two winter seasons of the years 1993-94 and 1994-95 were studied prospectively. Seventy two cases were diagnosed to have RSV infection among the 252 studied, representing 28.57% of these patients. The overall infection rate was 32.1% and 36.5% respectively for the two studied winter seasons. Among these children, 90% were under 12 months of age. A clinical diagnosis of sepsis and respiratory distress was entertained in five RSV positive cases and they were < 1 month of age. The clinical pattern of RSV infection included bronchiolitis in 58.3% of cases, bronchopneumonia (19.4%) and pneumonia (11.1%). RSV activity was detected throughout the year with predominance during cooler months with an associated relative humidity (RH) between 50-60%. These results indicate that RSV plays a significant etiologic role among ALRI in hospitalized infants and young children in the Oasis region of the UAE. Factors such as RH, environmental temperature and lifestyle probably play an additional role in our region for the maintenance and dissemination of infection around the year.