Supplementing newborn infants with vitamin A reduces mortality at age 6 months

Bloem, Martin W MD, PhD

Helen Keller Worldwide; Singapore

Abstracted from:Rahmathullah L, Tielsch JM, Thulasiraj RD et al. Impact of supplementing newborn infants with vitamin A on early infant mortality: community based randomised trial in southern India. BMJ 2003; 327: 254 .

Sources of funding: This study was funded by the Center for Human Nutrition (Bloomberg School of Public Health, John Hopkins University) and the Office of Health and Nutrition (US Agency for International Development, Washington DC), the Bill and Miranda Gates Foundation (Seattle Washington), and Task Force Sight and Life (Basel, Switzerland)

Correspondence to: J M Tielsch, Department of International Health, Bloomberg School of Public Health, John Hopkins University, Baltimore, Maryland, USA. E-mail: [email protected]

Abstract provided by Bazian Ltd., London

Evidence-based Healthcare 8(1):p 30-32, March 2004.

BACKGROUND

Vitamin A supplementation significantly reduces mortality, particularly in children aged 6 months or older. However the effect of supplementation at birth on mortality at age 6 months is not known.

OBJECTIVE

To examine the effects of supplementing newborn infants with vitamin A on mortality at 6 months.

SETTING

Two rural districts of Tamil Nadu, southern India; June 1998 to March 2001.

METHOD

Randomised controlled trial.

PARTICIPANTS

11, 619 newborn infants. All liveborn infants within participating villages were eligible for inclusion. Pregnant women were recruited prior to delivery and were randomised at recruitment. Post-randomisation exclusions included: stillbirths, miscarriages, delivery >20 km outside of the study area and infants who died before arrival of the study team.

INTERVENTION

Vitamin A (two oral doses of 24,000 IU with a 24h interval) or placebo within 48 h after birth. In order to ensure consumption of the complete dose, mothers were encouraged to breast feed the infant immediately after treatment.

OUTCOMES

Mortality within the first 6 months of life.

MAIN RESULTS

Vitamin A supplementation significantly reduced mortality within the first 6 months of life compared with placebo (reduction in total mortality, vitamin A versus placebo 22%, 95% CI 4 to 37%; RR of mortality 0.78, 95% CI 0.63 to 0.97).

AUTHORS' CONCLUSIONS

Vitamin A supplementation within 48 h of birth significantly reduced early infant mortality.