scholarly journals Early neonatal vitamin A supplementation and infant mortality: an individual participant data meta-analysis of randomised controlled trials

2018 ◽  
Vol 104 (3) ◽  
pp. 217-226 ◽  
Author(s):  
Keyword(s):  
Infant Mortality ◽  
Vitamin A ◽  
Maternal Education ◽  
Vitamin A Deficiency ◽  
Population Characteristics ◽  
Infant Survival ◽  
Vitamin A Supplementation ◽  
Maternal Vitamin ◽  
Early Infant ◽  
The Impact

BackgroundBiannual vitamin A supplementation is a well-established survival tool for preschool children 6 months and older in vitamin A deficient populations but this schedule misses the opportunity to intervene on most young infant deaths. Randomised trials of neonatal vitamin A supplementation (NVAS) in the first few days of life to assess its impact on under 6-month mortality in low/middle-income countries have had varying results.MethodsInvestigators of 11 published randomised placebo-controlled NVAS trials (n=163 567 children) reanalysed their data according to an agreed plan and pooled the primary outcomes of mortality from supplementation through 6 and 12 months of age using random effects models and meta-regression. One investigator withdrew but allowed use of the data.FindingsOverall there was no effect of NVAS on infant survival through 6 (risk ratio (RR) 0.97; 95% CI 0.89 to 1.06) or 12 months of age (RR 1.00; 95% CI 0.93 to 1.08) but results varied by study population characteristics.NVAS significantly reduced 6-month mortality among the trials conducted in Southern Asia (RR 0.87; 95% CI 0.77 to 0.98), in contexts with moderate or severe vitamin A deficiency (defined as 10% or higher proportion of women with serum retinol <0.7 µmol/L or 5% or more women with night blindness) (RR 0.87; 95% CI 0.80 to 0.94), early infant mortality was 30 or more per 1000 live births (RR 0.91; 95% CI 0.85 to 0.98), 75% or more of infant mortality occurred in the first 6 months of life (RR 0.92; 95% CI 0.84 to 1.01), or where >32% mothers had no schooling (RR 0.88; 95% CI 0.80 to 0.96). NVAS did not reduce mortality in the first 6 months of life in trials conducted in Africa, in contexts characterised by a low prevalence of vitamin A deficiency, lower rates of infant mortality and where maternal education was more prevalent. There was a suggestion of increased infant mortality in trials conducted in Africa (RR 1.07; 95% CI 1.00 to 1.15).Individual-level characteristics such as sex, birth weight, gestational age and size, age at dosing, parity, time of breast feeding initiation, maternal education and maternal vitamin A supplementation did not modify the impact of NVAS.ConclusionNVAS reduced infant mortality in South Asia, in contexts where the prevalence of maternal vitamin A deficiency is moderate to severe and early infant mortality is high; but it had no beneficial effect on infant survival in Africa, in contexts where the prevalence of maternal vitamin A deficiency is lower, early infant mortality is low.

scholarly journals Impact of Maternal Daily Oral Low-Dose Vitamin A Supplementation on the Mother–Infant Pair: A Randomised Placebo-Controlled Trial in China

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2370
Author(s):  
Ye Ding ◽  
Ping Hu ◽  
Yue Yang ◽  
Fangping Xu ◽  
Fang Li ◽  
...  
Keyword(s):  
Health Status ◽  
Breast Milk ◽  
Vitamin A ◽  
Low Dose ◽  
Maternal Serum ◽  
Control Group ◽  
Vitamin A Supplementation ◽  
Maternal Vitamin ◽  
Vitamin A Status ◽  
Lactating Mothers

Background: The nutritional status of vitamin A in lactating mothers and infants is still not optimistic. Due to the dietary habits and dietary restrictions of postpartum customs in China, vitamin A supplementation has been advocated as a potential strategy to improve vitamin A status of lactating mothers with inadequate dietary vitamin A intake. Existing clinical trials are limited to single or double high-dose maternal administrations. However, in China, vitamin A supplements are readily available in the form of daily oral low-dose supplements, and the effect of these is unknown. This study aimed to evaluate the effects of daily oral low-dose vitamin A supplementation on the retinol levels in the serum and breast milk of lactating mothers and the health status of infants in China. Methods: Lactating mothers who met the inclusion criteria and planned to continue exclusive breastfeeding were randomly assigned to receive either daily oral vitamin A and D drops (one soft capsule of 1800 IU vitamin A and 600 IU vitamin D2), or a matching placebo for 2 months. Before and after the intervention, dietary intake was investigated by instant photography, and the retinol concentration in maternal serum and breast milk was determined by ultra-high performance liquid chromatography-tandem mass spectrometry. During the trial, the health status of infants was diagnosed by a paediatrician or reported by lactating mothers. A total of 245 participants completed the study, with 117 in the supplementation group and 128 in the control group. Results: After the 2-month intervention, maternal serum retinol concentrations increased in the supplementation group with no change in the control group. Although breast milk retinol concentrations decreased significantly in both groups, the decrease in the supplementation group was significantly lower than that in the control group. However, maternal vitamin A supplementation was not associated with a lower risk of infant febrile illness, respiratory tract infection, diarrhoea, and eczema. Conclusions: Daily oral low-dose vitamin A supplementation is helpful in improving maternal vitamin A status, despite having no effect on infant health status through breast milk.

scholarly journals The impact of different doses of vitamin A supplementation on male and female mortality. A randomised trial from Guinea-Bissau

2011 ◽  
Vol 11 (1) ◽  
Author(s):  
Dorthe Yakymenko ◽  
Christine S Benn ◽  
Cesario Martins ◽  
Birgitte R Diness ◽  
Ane B Fisker ◽  
...  
Keyword(s):  
Vitamin A ◽  
Randomised Trial ◽  
Female Mortality ◽  
Vitamin A Supplementation ◽  
Male And Female ◽  
Guinea Bissau ◽  
The Impact ◽  
Different Doses

scholarly journals Effect of maternal vitamin A supplementation on retinol concentration in colostrum

2015 ◽  
Vol 91 (1) ◽  
pp. 81-86 ◽  
Author(s):  
Evellyn C. Grilo ◽  
Mayara S.R. Lima ◽  
Lahyana R.F. Cunha ◽  
Cristiane S.S. Gurgel ◽  
Heleni A. Clemente ◽  
...  
Keyword(s):  
Vitamin A ◽  
Vitamin A Supplementation ◽  
Maternal Vitamin ◽  
Retinol Concentration

Vitamin A Supplementation and Measles

1995 ◽  
Vol 16 (9) ◽  
pp. 358-359
Author(s):  
Glenn J. Fennelly
Keyword(s):  
Vitamin A ◽  
Acute Phase ◽  
Vitamin A Deficiency ◽  
Serum Levels ◽  
Morbidity And Mortality ◽  
Serum Retinol ◽  
Vitamin A Supplementation

Vitamin A deficiency resulting from inadequate intake or induced by infection is associated with increased morbidity and mortality. Measles, the major single infectious cause of mortality in children worldwide, is more severe in children who have preexisting vitamin A deficiency. Several recent studies suggest that: 1) measles is associated with depressed serum levels of vitamin A; 2) hyporetinemia, defined as a serum retinol of less than 0.7 µmol/L, is associated with increased mortality from measles, especially in children younger than 2 years of age; and 3) vitamin A will decrease the risk of complications and death when administered during the acute phase of illness (within 5 days of the onset of rash).

scholarly journals Maternal low-dose vitamin A or β-carotene supplementation has no effect on fetal loss and early infant mortality: a randomized cluster trial in Nepal

2000 ◽  
Vol 71 (6) ◽  
pp. 1570-1576 ◽  
Author(s):  
Joanne Katz ◽  
Keith P West ◽  
Subarna K Khatry ◽  
Elizabeth K Pradhan ◽  
Steven C LeClerq ◽  
...  
Keyword(s):  
Infant Mortality ◽  
Vitamin A ◽  
Low Dose ◽  
Fetal Loss ◽  
Cluster Trial ◽  
Early Infant ◽  
Β Carotene

scholarly journals Effect of vitamin A on severity of acute diarrhea in children

2013 ◽  
Vol 53 (3) ◽  
pp. 125
Author(s):  
Marlisye Marpaung ◽  
Supriatmo Supriatmo ◽  
Atan Baas Sinuhaji
Keyword(s):  
Vitamin A ◽  
Acute Diarrhea ◽  
Vitamin A Deficiency ◽  
Stool Consistency ◽  
Chi Square ◽  
Vitamin A Supplementation ◽  
Body Weights ◽  
Group 2 ◽  
Stool Volume ◽  
Group 1

Background Vitamin A deficiency may increase the risk or bea cause of diarrhea. Many studies have been conducted on theefficacy of vitamin A in the management of acute diarrhea, butthe outcomes remain inconclusive.Objective To determine the effectiveness of vitamin A in reducingthe severity of acute diarrhea in children.Methods We performed a single􀁈blind􀁈randomized controlledtrial in the Secanggang District, Langkat Regency, North ofSumatera, from August 2009 to January 2010 in children aged6 months to 5 years, who had diarrheas. Subjects were dividedinto two groups. Group 1 received a single dose of vitamin A(100,000 IU for subjects aged 6 to 11 month old or with bodyweights :s 10 kg, or 200,000 IU for subjects aged 2: 12 month oldor with body weights> 10 kg). Group 2 received a single doseof placebo. The establishment of severity was based on changesin diarrheal frequency, stool consistency, volume and durationof diarrhea after treatment. We performed independent T􀁈testand Chi square tests for statistical analyses. The study was anintention􀁈to􀁈treat analysis.Results We enrolled 120 children who were randomized intotwo groups of 60 subjects each. Group 1, received vitamin Aand group 2 received a placebo. The results showed significantdifferences between the two groups in stool volume starting onthe first day (95%CI 192.30 to 3237.51; P􀁉O.OOI), as well asdiarrheal frequency (P=O.OOl) and stool consistency (P=O.OOl)on the second day observation and duration of diarrhea followingtreatment (95%CI - 40.60 to - 25.79; P􀁉O.OOI;).Conclusions Vitamin A supplementation is effective in reducingthe severity of acute diarrhea in children under five years of age.[Paediatr lndones. 2013;53:125-31.]

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