Postpartum thiamine deficiency in a Karen displaced population

Am J Clin Nutr. 2001 Dec;74(6):808-13. doi: 10.1093/ajcn/74.6.808.

Abstract

Background: Before its recognition, infantile beriberi was the leading cause of infant death in camps for displaced persons of the Karen ethnic minority on Thailand's western border.

Objective: This study aimed to document thiamine status in the peripartum period to examine the current supplementation program and the correlation between the clinical manifestations of thiamine deficiency and a biochemical measure of thiamine status.

Design: Women were enrolled prospectively at 30 wk of gestation and were followed up weekly until delivery and at 3 mo postpartum. Thiamine supplementation during pregnancy was based on patient symptoms.

Results: At 3 mo postpartum, thiamine deficiency reflected by an erythrocyte transketolase activity (ETKA) > or = 1.20% was found in 57.7% (15/26) of mothers, 26.9% (7/26) of whom had severe deficiency (ETKA > 1.25%). No significant associations between ETKA and putative maternal symptoms or use of thiamine supplements were found.

Conclusions: Biochemical postpartum thiamine deficiency is still common in Karen refugee women. This situation may be improved by educating lactating women to reduce their consumption of thiaminase-containing foods and by implementing an effective thiamine supplementation program.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cohort Studies
  • Dietary Supplements
  • Erythrocytes / enzymology
  • Female
  • Humans
  • Hydrolases / administration & dosage
  • Hydrolases / adverse effects
  • Infant, Newborn
  • Lactation / blood*
  • Milk, Human / chemistry
  • Postpartum Period
  • Pregnancy / blood*
  • Pregnancy Outcome
  • Prenatal Care
  • Prospective Studies
  • Refugees*
  • Thailand / epidemiology
  • Thiamine / administration & dosage*
  • Thiamine Deficiency / blood
  • Thiamine Deficiency / drug therapy
  • Thiamine Deficiency / epidemiology*
  • Transketolase / blood

Substances

  • Transketolase
  • Hydrolases
  • thiaminase II
  • Thiamine