TY - JOUR
T1 - Maternal low-dose vitamin A or β-carotene supplementation has no effect on fetal loss and early infant mortality
T2 - A randomized cluster trial in Nepal
AU - Katz, Joanne
AU - West, Keith P.
AU - Khatry, Subarna
AU - Pradhan, Elizabeth K.
AU - LeClerq, Steven C.
AU - Christian, Parul
AU - Wu, Lee Shu Fune
AU - Adhikari, Ramesh K.
AU - Shrestha, Sharada R.
AU - Sommer, Alfred
AU - Pokhrel, Ram P.
AU - Dali, Sanu M.
AU - Dahal, Bhakta Raj
AU - Dreyfuss, Michele
AU - Stoltzfus, Rebecca
AU - Tielsch, James M
AU - Yamini-Roodsari, Sedigheh
AU - Acharya, Noor Nath
AU - Mandal, Dev N.
AU - Connor, Paul
AU - Schulze, Kerry
AU - Shakya, Tirtha R.
AU - Hackman, Andre
AU - Clemens, Gwendolyn
PY - 2000/6
Y1 - 2000/6
N2 - 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 β-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-β-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 43 559 women were enrolled; 15832 contributed 17 373 pregnancies and 15 987 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 β-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 β-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 β-carotene given to women before conception, during pregnancy, and through 24 Wk postpartum did not improve fetal or early infant survival in Nepal.
AB - 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 β-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-β-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 43 559 women were enrolled; 15832 contributed 17 373 pregnancies and 15 987 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 β-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 β-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 β-carotene given to women before conception, during pregnancy, and through 24 Wk postpartum did not improve fetal or early infant survival in Nepal.
KW - Child survival
KW - Fetal loss
KW - Infant mortality
KW - Maternal supplementation
KW - Nepal
KW - The Nepal Nutrition Intervention Project- Sarlahi Study Group
KW - Vitamin A
KW - β-carotene
UR - http://www.scopus.com/inward/record.url?scp=0034123256&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0034123256&partnerID=8YFLogxK
U2 - 10.1093/ajcn/71.6.1570
DO - 10.1093/ajcn/71.6.1570
M3 - Article
C2 - 10837300
AN - SCOPUS:0034123256
SN - 0002-9165
VL - 71
SP - 1570
EP - 1576
JO - American Journal of Clinical Nutrition
JF - American Journal of Clinical Nutrition
IS - 6
ER -