Evidence from South East Asia suggests that night blindness may be widespread in pregnant women as well as children. The epidemiology of night blindness among pregnant women in Nepals Sarlahi District was investigated in a population-based case-control study. The 117 night blind cases were identified through a weekly community surveillance system while 117 controls were selected from pregnant women without night blindness and matched to cases by gestational age. The mean serum retinol level was approximately 0.30 mcmol/l lower among cases than controls (p < 0.001). The mean hemoglobin level was 0.7 g/dl lower among cases and the risk of severe anemia was 3 times greater among cases than controls. The poor nutritional status of cases relative to controls was reflected in their lower mean weight (-2.6 kg difference) body mass index (-0.8) arm circumference (-0.9 cm) and triceps skinfold (-0.8 mm). Night blindness was associated with less frequent consumption of preformed vitamin A and provitamin A foods especially during summer. Finally cases were 2-3 times more likely than controls to report symptoms of urinary/reproductive tract infection diarrhea/dysentery preeclampsia and eclampsia and nausea and vomiting during pregnancy than controls. A history of night blindness can be used to identify pregnant women who may require special nutritional support (including vitamin A supplementation) antenatal care and counseling.

Night blindness of pregnancy in rural Nepal—nutritional and health risks

Plasma zinc in hypertension/toxemia and other reproductive variables in adolescent pregnancy.

Pica, iron deficiency, and the medical history

Pica is an eating disorder that is manifested by a craving for oral ingestion of a given substance that is unusual in kind and or quantity. It is a long-standing practice that has far reaching implications for prevention and treatment--implications for public health as well as clinical personnel who work in settings where they have the potential for influencing health knowledge, attitudes, and behaviors of their patients. Pica practices also challenge researchers and social scientists whose work encompass development and refinement of models related to nutritional deficiencies. The body of literature on pica is so fragmented that it is difficult to find a precise summary of the knowns and unknowns about the condition. There is little consistency in defining pica, classifying substances ingested, identifying key characteristics of practicers, recommending treatment, or in projecting outcomes. This review presents a framework for understanding pica as a general practice, summarizes divergent reported hypotheses and conclusions, and illustrates that there is a need for more comprehensive studies of prevalence and incidence and use of deductive as well as inductive research processes.

Broadening the perspective of pica: literature review.

• Young maternal age has been associated with adverse neonatal outcome, particularly an increased incidence of low birth weight ( (AJDC1987;141:1053-1059)

https://jamanetwork.com/HttpHandlers/ArticlePdfHandler.ashx?journal=PEDS&articleId=513688&pdfFileName=archpedi_141_10_017.pdf

Evelyn Calhoun

Papers

, Little HM, Fogelman A, Jennings L, Calhoun E, Dawson EB: Pregnancy in the adolescent. I. Preliminary summary of health status.