Does Vitamin A Supplementation at Birth Prime a Beneficial Response to Subsequent Doses.
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Date
2015
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Abstract
Objectives: A previous follow-up study of a neonatal vitamin A supplementation (NVAS) trial in Guinea-Bissau indicated that NVAS primed for a beneficial response to subsequent VAS in girls. We aimed to test this hypothesis in another study population.
Methods: In 2004-2007 we conducted a NVAS trial in Guinea-Bissau randomising newborns 2:1 to VAS (50,000 IU or 25,000 IU) or placebo. We followed the children to 24 months and registered reception of subsequent VAS provided in campaigns or by our assistants. Mortality according to NVAS and subsequent VAS between 6 months (the earliest age of subsequent VAS) and 24 months was compared in Cox proportional-hazards models.
Results: Among 6048 children enrolled in the NVAS-trial, 5507 children (91%) remained in the study area after 6 months of age. Between 6 months and the first VAS opportunity, 33 non-accident deaths occurred (28 NVAS, 5 placebo). NVAS was associated with a mortality rate ratio (MRR) of 2.71 (1.04-7.04). After reception of VAS, 12 children died (7 NVAS, 5 placebo) and the MRR was 0.69 (0.22-2.18), p=0.07 for different effect of NVAS before and after subsequent VAS. The effect was similar in boys and girls.
Conclusions: The effect of NVAS tended to differ by reception of a subsequent VAS, but we could not confirm that the effect differed for girls only. More studies are needed to identify in which situations VAS is beneficial and in which it is not, in order to define a vitamin A policy which optimises the impact on child survival.
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Fisker Ane Bærent, Balde Ibraima, Aaby Peter, Benn Christine Stabell. Does Vitamin A Supplementation at Birth Prime a Beneficial Response to Subsequent Doses. European Journal of Nutrition & Food Safety. 2015 Special issue; 5(5): 580-581.