Impact of neonatal vitamin A supplementation on infant morbidity and mortality

• Published in: The Journal of pediatrics 1996-04, Vol.128 (4), p.489-496
• Main Authors: Humphrey, Jean H., Agoestina, Tina, Wu, Lee, Usman, Ali, Nurachim, Muhammad, Subardja, Dedi, Hidayat, Syarief, Tielsch, James, West, Keith P., Sommer, Alfred
• Format: Article
• Language: English
• Subjects: bebes; Biological and medical sciences; Birth Weight; carence en vitamine; complement alimentaire; deficiencia de vitaminas; enfant en bas age; Female; General and cellular metabolism. Vitamins; human nutrition; Humans; indonesia; indonesie; Infant Mortality; Infant, Newborn; infants; Male; Medical sciences; morbidite; Morbidity; morbosidad; mortalidad; mortalite; mortality; nutricion humana; nutrition humaine; Pharmacology. Drug treatments; retinol; suplementos; supplements; Survival Rate; Tropical medicine; Vitamin A - administration & dosage; Vitamin A - therapeutic use; vitamin deficiencies; vitaminas; vitamine; vitamins
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/S0022-3476(96)70359-1

OBJECTIVE: To determine whether vitamin A supplementation at birth could reduce infant morbidity and mortality. STUDY DESIGN: We conducted a placebo-controlled trial among 2067 Indonesian neonates who received either 52 μmol (50,000 IU) orally administered vitamin A or placebo on the first day of life. Infants were followed up at 1 year to determine the impact of this intervention on infant mortality. A subgroup (n = 470) was also examined at 4 and 6 months of age to examine the impact on morbidity. RESULTS: Vital status was confirmed in 89% of infants in both groups at 1 year. There were 19 deaths in the control group and 7 in the vitamin A group (relative risk = 0.36; 95% confidence interval = 0.16, 0.87). The impact was stronger among boys, infants of normal compared with low birth weight, and those of greater ponderal index. Among infants examined at 4 months of age, the 1-week period prevalence of common morbidities was similar for vitamin A and control infants. However, during this same 4-month period, 73% and 51% more control infants were brought for medical treatment for cough ( p =0.008) and fever ( p = 0.063), respectively. CONCLUSIONS: Neonatal vitamin A supplementation may reduce the infant mortality rate and the prevalence of severe respiratory infection among young infants. (J P EDIATR 1996;128:489-96)