Background. Marginal vitamin A deficiency is prevalent in developing countries and in subgroups of industrialized societies; it is associated with increased susceptibility to infections. Marginal vitamin A status may be present at birth; if untreated, it may lead to a greater risk of morbidity due to infectious pathology. We investigated whether low vitamin A status at birth was indicative of moderate to severe morbidity in later infancy.

Subjects. The study comprised 2 groups: 63 infants with cord retinol <20 μg/dl, and 67 infants with cord retinol ≥20 μg/dl, matched by ethnic origin.

Interventions. Hospital records were reviewed after infants completed 12 months of age.

Results. Ratio hospitalizations/ infant, percentage of infants with ≥2 hospitalizations and average number of hospital days were greater(n.s.) in infants with cord retinol <20 μg/dl: 0.38 vs. 0.30, 11.1% vs 6% and 3.1 vs 2.2 days respectively. Differences between groups were greater when a 15 μg/dl cut off retinol level was used: ratio hospitalizations/ infant 0.55 vs 0.27 (n.s.), percent of infants with ≥2 hospitalizations 15.2 vs 6.2 (n.s.) and average number of hospital days 4.24 vs 2.06 (p=0.034) respectively. Main diagnostic categories were infections (including diarrhea) and other respiratory illnesses.

Conclusions. Although most of the differences observed were not statistically significant the consistent trend suggested a greater risk for morbidity in infants with low cord serum retinol. This supports the need to prevent and treat poor vitamin A status in early infancy.