| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Original Research Communications |
1 From the Department of International Health, the Center for Human Nutrition, the Sight and Life Institute, and the Dean's Office, Johns Hopkins School of Hygiene and Public Health, Baltimore, and the Nepal Nutrition Intervention Project Sarlahi and Tribhuvan University, Kathmandu, Nepal.
Background: The effect of vitamin A supplementation on the survival of infants aged <6 mo is unclear. Because most infant deaths occur in the first few month of life, maternal supplementation may improve infant survival.
Objectives: The objective was to assess the effect of maternal vitamin A or ß-carotene supplementation on fetal loss and survival of infants <6 mo of age.
Design: Married women of reproductive age in 270 wards of Sarlahi district, Nepal, were eligible to participate. Wards were randomly assigned to have women receive weekly doses of 7000 µg retinol equivalents as retinyl palmitate (vitamin A), 42 mg all-trans-ß-carotene, or placebo. Pregnancies were followed until miscarriage, stillbirth, maternal death, or live birth of one or more infants, who were followed through 24 wk of age.
Results: A total of 43559 women were enrolled; 15832 contributed 17373 pregnancies and 15987 live born infants to the trial. The rate of fetal loss was 92.0/1000 pregnancies in the placebo group, comparable with rates in the vitamin A and ß-carotene groups, which had relative risks of 1.06 (95% CI: 0.91, 1.25) and 1.03 (95% CI: 0.87, 1.19), respectively. The 24-wk mortality rate was 70.8/1000 live births in the placebo group, comparable with rates in the vitamin A and ß-carotene groups, which had relative risks of 1.05 (95% CI: 0.87, 1.25) and 1.03 (95% CI: 0.86, 1.22), respectively.
Conclusions: Small weekly doses of vitamin A or ß-carotene given to women before conception, during pregnancy, and through 24 wk postpartum did not improve fetal or early infant survival in Nepal.
Key Words: Vitamin A • ß-carotene • infant mortality • child survival • fetal loss • maternal supplementation • Nepal • the Nepal Nutrition Intervention Project-Sarlahi Study Group
This article has been cited by other articles:
|
|
 |
|
  S. Gogia and H. S. Sachdev Neonatal vitamin A supplementation for prevention of mortality and morbidity in infancy: systematic review of randomised controlled trials BMJ, March 27, 2009; 338(mar27_1): b919 - b919. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P Christian, G L Darmstadt, L Wu, S K Khatry, S C LeClerq, J Katz, K P West Jr, and R K Adhikari The effect of maternal micronutrient supplementation on early neonatal morbidity in rural Nepal: a randomised, controlled, community trial Arch. Dis. Child., August 1, 2008; 93(8): 660 - 664. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. M. Tielsch, L. Rahmathullah, R. D. Thulasiraj, J. Katz, C. Coles, S. Sheeladevi, R. John, and K. Prakash Newborn Vitamin A Dosing Reduces the Case Fatality but Not Incidence of Common Childhood Morbidities in South India J. Nutr., November 1, 2007; 137(11): 2470 - 2474. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. B Fisker, I. M Lisse, P. Aaby, J. G Erhardt, A. Rodrigues, B. M Bibby, and C. S Benn Effect of vitamin A supplementation with BCG vaccine at birth on vitamin A status at 6 wk and 4 mo of age Am. J. Clinical Nutrition, October 1, 2007; 86(4): 1032 - 1039. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. L Surles, J. P Mills, A. R Valentine, and S. A Tanumihardjo One-time graded doses of vitamin A to weanling piglets enhance hepatic retinol but do not always prevent vitamin A deficiency Am. J. Clinical Nutrition, October 1, 2007; 86(4): 1045 - 1053. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z. A. Bhutta, G. L. Darmstadt, B. S. Hasan, and R. A. Haws Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence Pediatrics, February 1, 2005; 115(2/S1): 519 - 617. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A Dijkhuizen, F. T Wieringa, C. E West, and Muhilal Zinc plus {beta}-carotene supplementation of pregnant women is superior to {beta}-carotene supplementation alone in improving vitamin A status in both mothers and infants Am. J. Clinical Nutrition, November 1, 2004; 80(5): 1299 - 1307. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Christian, K. P West, S. K Khatry, S. C Leclerq, E. K Pradhan, J. Katz, S. R. Shrestha, and A. Sommer Effects of maternal micronutrient supplementation on fetal loss and infant mortality: a cluster-randomized trial in Nepal Am. J. Clinical Nutrition, December 1, 2003; 78(6): 1194 - 1202. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Christian, J. Shrestha, S. C. LeClerq, S. K. Khatry, T. Jiang, T. Wagner, J. Katz, and K. P. West Jr Supplementation with Micronutrients in Addition to Iron and Folic Acid Does Not Further Improve the Hematologic Status of Pregnant Women in Rural Nepal J. Nutr., November 1, 2003; 133(11): 3492 - 3498. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Rahmathullah, J. M Tielsch, R D Thulasiraj, J. Katz, C. Coles, S. Devi, R. John, K. Prakash, A V Sadanand, N Edwin, et al. Impact of supplementing newborn infants with vitamin A on early infant mortality: community based randomised trial in southern India BMJ, July 31, 2003; 327(7409): 254. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Christian Micronutrients and Reproductive Health Issues: An International Perspective J. Nutr., June 1, 2003; 133(6): 1969S - 1973. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. H.D. Fall, C. S. Yajnik, S. Rao, A. A. Davies, N. Brown, and H. J.W. Farrant Micronutrients and Fetal Growth J. Nutr., May 1, 2003; 133(5): 1747S - 1756. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M. d. L. Costello and D. Osrin Micronutrient Status during Pregnancy and Outcomes for Newborn Infants in Developing Countries J. Nutr., May 1, 2003; 133(5): 1757S - 1764. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Christian, S. K Khatry, J. Katz, E. K Pradhan, S. C LeClerq, S. R. Shrestha, R. K Adhikari, A. Sommer, and K. P West Jr Effects of alternative maternal micronutrient supplements on low birth weight in rural Nepal: double blind randomised community trial BMJ, March 15, 2003; 326(7389): 571 - 571. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Katz, K. P. West Jr, L. Wu, S. K. Khatry, E. K. Pradhan, P. Christian, S. C. LeClerq, and S. R. Shrestha Determinants of Maternal Vitamin A or Beta-Carotene Supplementation Coverage: Village-Based Female Distributors in Nepal Am J Public Health, July 1, 2002; 92(7): 1105 - 1107. [Full Text] [PDF]
|
|
|
|
 |
|
 J. Katz, K. P West Jr, S. K Khatry, S. C LeClerq, P. Christian, E. K. Pradhan, and S. R. Shrestha Twinning rates and survival of twins in rural Nepal Int. J. Epidemiol., August 1, 2001; 30(4): 802 - 807. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Friis, E. Gomo, P. Kastel, P. Ndhlovu, N. Nyazema, H. Krarup, and K. F. Michaelsen HIV and other predictors of serum {beta}-carotene and retinol in pregnancy: a cross-sectional study in Zimbabwe Am. J. Clinical Nutrition, June 1, 2001; 73(6): 1058 - 1065. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Christian, K. P. West Jr., S. K. Khatry, S. C. LeClerq, E. Kimbrough-Pradhan, J. Katz, and S. R. Shrestha Maternal Night Blindness Increases Risk of Mortality in the First 6 Months of Life among Infants in Nepal J. Nutr., May 1, 2001; 131(5): 1510 - 1512. [Abstract] [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
