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Previous issue date: 2008-07-03 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Vitamin A deficiency (VAD) is a serious public health problem in developing countries, and as a therapeutic and prophylactic measure retinil palmitate is being supplemented. Nevertheless its efficacy has been questioned. The objective of the study was to evaluate the supplementation of two retinil palmitate megadosis on the serum retinol levels of post partum healthy mothers from Dr. Jos? Pedro Bezerra (Hospital Santa Catarina) hospital, Natal - RN. The enrolled women (n=199) were randomly distributed into three studied groups and supplemented with retinil palmitate immediately after delivery with a single 200,000 IU dose (group S1), two 200,000 IU dose (group S2) with 24h difference between the doses, or no supplementation (group C). Among women selected, 143 remained until the end of the study. The influence of vitamin A dietary intake was evaluated during pregnancy and after 30 days of delivery. The average intake of the population was reasonable, but a high prevalence of inadequate intake was found. Retinol in colostrums and mature milk was determined by high performance liquid chromatography (HPLC). The retinol average in colostrums and mature milk in the supplemented and control groups were adequate according to the reference values. In colostrums, women from groups C, S1 and S2 presented retinol averages by milk volume of 94.8 ? 40.2 ?g/dL, 92.2 ? 50.0 ?g/dL and 91.8 ? 53.7 ?g/dL, respectively. No difference was found between these averages (p=0.965), this was also seen when the values where expressed as ?g/g of fat (p=0.905). After 30 days of delivery, retinol per milk volume differed between the control group (36.6 ? 17.5 ?g/dL) and groups supplemented with 200,000 IU (51.0 ? 28.8 ?g/dL) or 400,000 IU (55.2 ? 31.6 ?g/dL) of retinil palmitate (p<0,05). Nevertheless, when S1 and S2 groups where compared, no significant difference was found (p=0.97). Considering retinol/g of fat, the means were 12.7 ? 6.7 ?g/g, 15.6 ? 8.3 ?g/g and 17.2 ? 8.9 ?g/g for groups C, S1 and S2, respectively, with significant difference between groups S2 and C (p=0,01). Subclinical VAD prevalence showed a serious public health problem in the study population (32% in colostrums and 31.5% in mature milk). When analyzing the groups separately, the group which received two doses (200,000 IU + 200,000 IU) presented the lowest VAD prevalence (20.7%). Retinil palmitate supplementations of 200,000 IU and 400,000 IU (divided in two doses) in the immediate post partum showed no significant difference. Nevertheless, the 400,000 IU (divided in two doses) supplementation showed a reduction in VAD / A defici?ncia de vitamina A (DVA) ? um grave problema de sa?de p?blica nos pa?ses em desenvolvimento e por este motivo tem-se implementado a suplementa??o com retinil palmitato como medida terap?utica e profil?tica. Entretanto, a sua efic?cia tem sido questionada. O estudo objetivou avaliar o efeito da suplementa??o materna de duas megadoses de retinil palmitato (200.000 UI cada uma) no p?s-parto, sobre os n?veis de retinol no leite materno de lactantes saud?veis do hospital Dr. Jos? Pedro Bezerra (Hospital Santa Catarina), Natal - RN. As mulheres recrutadas (n=199) foram distribu?das aleatoriamente em tr?s grupos de estudo e suplementadas com retinil palmitato no p?s-parto imediato com dose ?nica de 200.000 UI (grupo S1), dose dupla de 200.000 UI espa?adas de 24h (grupo S2) ou n?o receberam suplementa??o (grupo C). Dentre as mulheres originalmente selecionadas, 143 permaneceram at? o fim do experimento. Foi verificada a influ?ncia do consumo alimentar de vitamina A durante a gesta??o e ap?s 30 dias do parto. O consumo m?dio da popula??o foi satisfat?rio, por?m ainda foi encontrada uma expressiva preval?ncia de consumo inadequado. O retinol no leite colostro e no leite maduro de 30 dias foi determinado por Cromatografia L?quida de Alta Efici?ncia (CLAE). As m?dias de retinol nos leites colostro e maduro dos grupos suplementados e controle, apresentaram-se adequadas em rela??o aos valores de refer?ncia. No leite colostro, as mulheres dos grupos C, S1 e S2 apresentaram m?dias de retinol por volume de leite de 94,8 ? 40,2 ?g/dL; 92,2 ? 50,0 ?g/dL e 91,8 ? 53,7 ?g/dL, respectivamente, n?o sendo encontrada diferen?a entre estas (p=0,965), o que tamb?m ocorreu quando expresso em ?g/g gordura (p=0,905). No p?s-parto de 30 dias, o retinol por volume de leite diferiu entre o grupo controle (36,6 ? 17,5 ?g/dL) e os grupos suplementados com 200.000 UI (51,0 ? 28,8 ?g/dL) ou 400.000 UI (55,2 ? 31,6 ?g/dL) de retinil palmitato (p<0,05). Por?m, quando S1 e S2 foram comparados entre si, n?o foi encontrada diferen?a significativa (p=0,97). Considerando-se o retinol/g de gordura, as m?dias foram 12,7 ? 6,7 ?g/g; 15,6 ? 8,3 ?g/g e 17,2 ? 8,9 ?g/g para os grupos C, S1 e S2, respectivamente, havendo diferen?a significativa entre S2 e C (p=0,01). A preval?ncia de defici?ncia subcl?nica de Vitamina A revelou um grave problema de sa?de p?blica (32% no leite colostro e 31,5% no leite maduro) na popula??o. Analisando-se os grupos separadamente, aquele que recebeu dose dupla (200.000 UI + 200.000 UI) apresentou o menor percentual de DVA (20,7%). As suplementa??es de 200.000 UI e 400.000 UI de retinil palmitato (dividida em duas doses) no p?s-parto imediato, n?o mostraram diferen?a significativa. Entretanto, considerando o ?ltimo tratamento, foi observada uma diminui??o da preval?ncia de DVA
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/12541 |
| Date | 03 July 2008 |
| Creators | Bezerra, Danielle Soares |
| Contributors | CPF:18095640425, http://lattes.cnpq.br/8520928220989866, Trugo, Nadia Maria Frizzo, CPF:34354581787, http://lattes.cnpq.br/5329320616835283, Holland, N?ly, CPF:58173676615, http://lattes.cnpq.br/4003215644662100, Dimenstein, Roberto |
| Publisher | Universidade Federal do Rio Grande do Norte, Programa de P?s-Gradua??o em Bioqu?mica, UFRN, BR, Bioqu?mica; Biologia Molecular |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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