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Intervention Review

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Vitamin A supplementation for postpartum women

  1. Julicristie M Oliveira-Menegozzo1,*,
  2. Denise P Bergamaschi2,
  3. Philippa Middleton3,
  4. Christine E East4

Editorial Group: Cochrane Pregnancy and Childbirth Group

Published Online: 6 OCT 2010

Assessed as up-to-date: 26 AUG 2010

DOI: 10.1002/14651858.CD005944.pub2


How to Cite

Oliveira-Menegozzo JM, Bergamaschi DP, Middleton P, East CE. Vitamin A supplementation for postpartum women. Cochrane Database of Systematic Reviews 2010, Issue 10. Art. No.: CD005944. DOI: 10.1002/14651858.CD005944.pub2.

Author Information

  1. 1

    School of Public Health, University of Sao Paulo, Department of Nutrition, São Paulo, SP, Brazil

  2. 2

    University of Sao Paulo, Departamento de Epidemiologia-Estatistica, Sao Paulo, Brazil

  3. 3

    The University of Adelaide, ARCH: Australian Research Centre for Health of Women and Babies, Discipline of Obstetrics and Gynaecology, Adelaide, South Australia, Australia

  4. 4

    Pregnancy Research Centre, Department of Perinatal Medicine, Royal Women's Hospital, Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia

*Julicristie M Oliveira-Menegozzo, Department of Nutrition, School of Public Health, University of Sao Paulo, Av Dr Arnaldo, 715, São Paulo, SP, Cep 01246-904, Brazil. julicristie@yahoo.com. cristie@usp.br.

Publication History

  1. Publication Status: New
  2. Published Online: 6 OCT 2010

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This is not the most recent version of the article. View current version (25 MAR 2016)

References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Ayah 2007 {published data only}
  • Ayah RA, Mwaniki DL, Magnussen P, Tedstone AE, Marshall T, Alusala D, et al. The effects of maternal and infant supplementation on vitamin A status: a randomised trial in Kenya. British Journal of Nutrition 2007;98:422-30.
Bhaskaram 2000 {published data only}
  • Bhaskaram P, Balakrishna N. Effect of administration of 200,000 IU of vitamin A to women within 24 hrs after delivery on response to PPV administered to the newborn. Indian Pediatrics 1998;35:217-22.
  • Bhaskaram P, Balakrishna N, Nair M, Sivakumar B. Vitamin A deficiency in infants: effects of postnatal maternal vitamin A supplementation on the growth and vitamin A status. Nutrition Research 2000;20:769-78.
Darboe 2007 {published data only}
  • Darboe MK, Thurnham DI, Morgan G, Adegbola RA, Secka O, Solon JA, et al. Effectiveness of an early supplementation scheme of high-dose vitamin A versus standard WHO protocol in Gambian mothers and infants: a randomised controlled trial. Lancet 2007;369:2088-96.
Idindili 2007 {published data only}
  • Idindili B, Masanja H, Urassa H, Bunini W, Van Jaarsveld P, Aponte JJ, et al. Randomized controlled safety and efficacy trial of 2 vitamin A supplementation schedules in Tanzania infants. American Journal of Clinical Nutrition 2007;85:1312-9.
Newton 2005 {published data only}
  • Newton S, Cousens S, Owusu-Agyei S, Filteau S, Stanley C, Linsell L, et al. Vitamin A supplementation does not affect infants' immune responses to polio and tetanus vaccines. Journal of Nutrition 2005;135:2669-73.
RETIBETA Project {published data only}
  • Filteau SM, Rice AL, Ball JJ, Chakraborty J, Stoltzfus R, De Francisco A, et al. Breast milk immune factors in Bangladeshi women supplemented postpartum with retinol or beta-carotene. American Journal of Clinical Nutrition 1999;69:953-8.
  • Rice AL, Stoltzfus RJ, De Francisco A, Chakraborty J, Kjolhede CL, Wahed MA. Maternal vitamin A or beta-carotene supplementation in lactating Bangladeshi women benefits mothers and infants but does not prevent subclinical deficiency. Journal of Nutrition 1999;129:356-65.
  • Rice AL, Stoltzfus RJ, De Francisco A, Kjolhede CL. Evaluation of serum retinol, the modified-relative-dose-response ratio, and breast-milk vitamin A as indicators of response to postpartum maternal vitamin A supplementation [see comments]. American Journal of Clinical Nutrition 2000;71:799-806.
  • Rice AL, Stoltztus RJ, De Francisco A, Kjolhede CL. Low breast milk vitamin A concentration reflects an increased risk of low liver vitamin A stores in women. Advances in Experimental Medicine and Biology 2000;478:375-6.
Roy 1997 {published data only}
  • Roy SK, Islam A, Molla A, Akramuzzaman SM, Jahan F, Fuchs G. Impact of single megadose of vitamin A at delivery on breastmilk of mothers and morbidity of their infants. European Journal of Clinical Nutrition 1997;51(5):302-7.
Stoltzfus 1993a {published data only}
  • Stoltzfus RJ, Hakimi M, Miller KW, Rasmussen KM, Dawiesh S, Habicht J, et al. High dose vitamin A supplementation of breast-feeding Indonesian mothers: effects on the vitamin A status of mother and infant. Journal of Nutrition 1993;123:666-75.
  • Stoltzfus RJ, Miller KW, Hakimi M, Rasmussen KM. Conjunctival impression cytology as an indicator of vitamin A status in lactating Indonesian women. American Journal of Clinical Nutrition 1993;58:167-73.
Venkatarao 1996 {published data only}
  • Venkatarao T, Ramakrishnan R, Nair NGK, Radhakrishnan S, Sundaramoorthy L, Koya PKM, et al. Effect of vitamin A supplementation to mother and infant on morbidity in infancy. Indian Pediatrics 1996;33(4):279-86.
Vinutha 2000 {published data only}
  • Vinutha B, Mehta MN, Shanbag P. Vitamin A status of pregnant women and effect of post partum vitamin A supplementation. Indian Pediatrics 2000;37:1188-93.
WHO/CHD IVASSG {published data only}
  • Bahl R, Bhandari N, Kant S, Molbak K, Ostergaard E, Bhan MK. Effect of vitamin A administered at expanded program on immunization contacts on antibody response to oral polio vaccine. European Journal of Clinical Nutrition 2002;56(4):321-5.
  • Bahl R, Bhandari N, Wahed MA, Kumar GT, Bhan MK. Vitamin A supplementation of women postpartum and their infants at immunization alters breast milk retinol and infant vitamin A status. Journal of Nutrition 2002;132:3243-8.
  • Bahl R, Frost C, Kirkwood BR, Edmond K, Martines J, Bhandari N, et al. Infant feeding patterns and risks of death and hospitalization in the first half of infancy multicentre cohort study. Bulletin of the World Health Organization 2005;83(6):1-13.
  • WHO/CDC IVASSG. Randomised trial to assess benefits and safety of vitamin A supplementation linked to immunisation in early infancy. WHO/CHD Immunisation-Linked Vitamin A Supplementation Study Group. Lancet 1998;352(9136):1257-63.
ZVITAMBO Study Group {published data only}
  • Humphrey JH, Hargrove JW, Malaba LC, Iliff PJ, Moulton LH, Mutasa K, et al. HIV incidence among post-partum women in Zimbabwe: risk factors and effect of vitamin A supplementation. AIDS 2006;20(10):1437-46.
  • Iliff PJ, Humphrey JH, Mahomva AI, Zvandasara P, Bonduelle M, Malaba L, et al. Tolerance of large doses of vitamin A given to mothers and their babies shortly after delivery. Nutrition Research 1999;19:1437-46.
  • Malaba LC, Iliff PJ, Nathoo KJ, Marinda E, Moulton LH, Zijenah LS, et al. Effect of postpartum maternal or neonatal vitamin A supplementation on infant mortality among infants born to HIV-negative mothers in Zimbabwe. American Journal of Clinical Nutrition 2005;81:454-60.
  • Miller MF, Stoltzfus RJ, Iliff PJ, Malaba LC, Mbuya NV, the Zimbabwe Vitamin A for Mothers and Babies Project (ZVITAMBO) Study Group et al. Effect of maternal and neonatal vitamin a supplementation and other postnatal factors on anemia in Zimbabwean infants: a prospective, randomized study. American Journal of Clinical Nutrition 2006;84(1):212-22.
  • Zvandasara P, Hargrove JW, Ntozini R, Chidawanyika H, Mutasa K, Iliff PJ, et al. Mortality and morbidity among postpartum HIV-positive and HIV-negative women in Zimbabwe: risk factors, causes, and impact of single-dose postpartum vitamin A supplementation. Journal of Acquired Immune Deficiency Syndromes 2006;43:107-16.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Ala-Houhala 1988 {published data only}
Basu 2003 {published data only}
Bezerra 2010 {published data only}
  • Bezerra DS, Araujo KF, Azevedo GM, Dimenstein R. Maternal supplementation with retinyl palmitate during immediate postpartum period: potential consumption by infants. Revista de Saude Publica 2009;43(4):572-9.
  • Bezerra DS, de Araujo KF, Azevedo GM, Dimenstein R. A randomized trial evaluating the effect of 2 regimens of maternal vitamin a supplementation on breast milk retinol levels. Journal of Human Lactation 2010;26(2):148-56.
  • Ribeiro KDS, Araújo KF, Dimenstein R. The effect of vitamin A supplementation upon retinol concentration in the colostrum of women in a public maternity hospital. Revista da Associação Médica Brasileira 2009;55(4):452-7.
Canfield 2001 {published data only}
  • Canfield LM, Kaminsky RG, Taren DL, Shaw E, Sander JK. Red palm oil in the maternal diet increases provitamin A carotenoids in breastmilk and serum of the mother-infant dyad. European Journal of Clinical Nutrition 2001;40:30-8.
De Pee 1995 {published data only}
Filteau 1999 {published data only}
Gossage 2000 {published data only}
  • Gossage C, Deyhim M, Moser-Veillon PB, Douglas LW, Kramer TR. Effect of beta-carotene supplementation and lactation on carotenoid metabolism and mitogenic t lymphocyte proliferation. American Journal of Clinical Nutrition 2000;71(4):950-5.
Khan 2007 {published data only}
  • Khan NC, West CE, De Pee S, Bosch D, Phuong HD, Hulshof PJ, et al. The contribution of plant foods to the vitamin A supply of lactating women in Vietnam: a randomized controlled trial. American Journal of Clinical Nutrition 2007;85(4):1112-20.
Lietz 2001 {published data only}
  • Lietz G, Henry CJK, Mulokozi G, Mugyabuso JKL, Ballart A, Ndossi GD, et al. Comparison of the effects of supplemental red palm oil and sunflower oil on maternal vitamin A status. American Journal of Clinical Nutrition 2001;74(4):501-9.
Lietz 2006 {published data only}
  • Lietz G, Mulokozi G, Henry JC, Tomkins AM. Xanthophyll and hydrocarbon carotenoid patterns differ in plasma and breast milk of women supplemented with red palm oil during pregnancy and lactation. Journal of Nutrition 2006;136(7):1821-7.
Ncube 2001 {published data only}
  • Ncube TN, Greiner T, Malaba LC, Gebre-Medhin M. Supplementing lactating women with pureed papaya and grated carrots improved vitamin A status in a placebo-controlled trial. Journal of Nutrition 2001;131:1497-1502.
NNIPS-2 {published data only}
  • Christian P. Effects of prenatal micronutrient supplementation on complications of labor and delivery and puerperal morbidity in rural Nepal. International Journal of Gynecology and Obstetrics 2009;106(1):3-7.
  • Christian P, West KP Jr, Khatry SK, Katz J, LeClerq S, Pradhan EK, et al. Vitamin A or beta-carotene supplementation reduces but does not eliminate maternal night blindness in Nepal. Journal of Nutrition 1998;128:1458-63.
  • Christian P, West KP Jr, Khatry SK, Katz J, LeClerq SC, Pradhan EK, et al. Vitamin A or beta-carotene supplementation reduces symptoms of illness in pregnant and lactating Nepali women. Journal of Nutrition 2000;130:2675-82.
  • Congdon NG, Dreyfuss ML, Christian P, Navitsky RC, Sanchez AM, Wu LSF, et al. Responsiveness of dark adaptation threshold to vitamin A and beta-carotene supplementation in pregnant and lactating women in Nepal. American Journal of Clinical Nutrition 2000;72:1004-9.
  • Katz J, West KP Jr, Khatry SK, Pradhan EK, LeClerq SC, Christian P, et al. Maternal low-dose vitamin A or beta-carotene supplementation has no effect on fetal loss and early infant mortality: a randomized cluster trial in Nepal. American Journal of Clinical Nutrition 2000;71:1570-6.
  • West JP Jr, Katz J, Khatry SK, LeClerq S, Pradhan EK, Shrestha SR, et al. Double blind, cluster randomised trial of low dose supplementation with vitamin a or beta carotene on mortality related to pregnancy in Nepal The NNIPS-2 Study Group. BMJ 1999;317(7183):570-5.
  • Yamini S, West KP Jr, Wu L, Dreyfuss ML, Yang DX, Khatry SK. Circulating levels of retinol, tocopherol and carotenoid in Nepali pregnant and postpartum women following long-term beta-carotene and vitamin A supplementation. European Journal of Clinical Nutrition 2001;55:252-9.
ObaapaVitA {published data only}
  • Kirkwood BR, Hurt L, Amenga-Etego S, Tawiah C, Zandoh C, Danso S, et al. Effect of vitamin A supplementation in women of reproductive age on maternal survival in Ghana (ObaapaVitA): a cluster-randomised, placebo-controlled trial. Lancet 2010;375:1640-9.
Tchum 2006 {published data only}
  • Tchum SK, Tanumihardjo SA, Newton S, Benoist B, Owusu-Agyei S, Arthur FKN, et al. Evaluation of vitamin A supplementation regimens in Ghanaian postpartum mothers with the use of modified-relative-dose-response test. American Journal of Clinical Nutrition 2006;84:1344-9.

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Ahmed 2003
  • Ahmed F, Azim A, Akhtaruzzaman M. Vitamin A deficiency in poor, urban, lactating women in Bangladesh: factors influencing vitamin A status. Public Health Nutrition 2003;6(5):447-52.
Allen 2002
  • Allen LH, Haskell M. Estimating the potential for vitamin A toxicity in women and young children. Journal of Nutrition 2002;132(9 Suppl):2907S-2919S.
Butte 2002
  • Butte NF, Lopez-Alarcon MG, Garza C. Nutrient adequacy of exclusive breastfeeding for the term infant during the first six months of life. Expert consultation on the optimal duration of exclusive breastfeeding. Geneva: WHO, 2002.
Christian 1998
Dancheck 2005
  • Dancheck B, Nussenblatt V, Ricks MO, Kumwenda N, Neville MC, Moncrief DT, et al. Breast milk retinol concentrations are not associated with systemic inflammation among breast-feeding women in Malawi. Journal of Nutrition 2005;135(2):223-6.
De Pee 1995
Dijkhuizen 2004
  • Dijkhuizen MA, Wieringa FT, West CE, 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. American Journal of Clinical Nutrition 2004;80(5):1299-307.
Egger 1997
FAO/WHO 2001
  • Food and Agriculture Organization of United Nations/World Health Organization. Human vitamin and mineral requirements. Report of a joint FAO/WHO expert consultation, Bangkok, Thailand. Bangkok: FAO, 2001.
Fawzi 1993
Filteau 1993
  • Filteau SM, Morris SS, Abbott RA, Tomkins AM, Kirkwood BR, Arthur P, et al. Influence of morbidity on serum retinol of children in a community-based study in northern Ghana. American Journal of Clinical Nutrition 1993;58:192-7.
FNB 2000
  • Food, Nutrition Board. Vitamin A. Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. Washington DC: National Academy Press, 2000.
Garcia-Casal 1998
  • García-Casal MN, Layrisse M, Solano L, Baron MA, Arguello F, Llovera D, et al. Vitamin A and beta-carotene can improve nonheme iron absorption from rice, wheat and corn by humans. Journal of Nutrition 1998;128(3):646-50.
Glasziou 1993
Haider 2006
Harbord 2006
Higgins 2009
  • Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.2 [updated September 2009]. The Cochrane Collaboration, 2009. Available from www.cochrane-handbook.org.
IVACG 2004
  • International Vitamin A Consultative Group (IVACG). Conversion factors for vitamin A and carotenoids. Washington: IVACG Secretariat, 2004.
Jang 2000
  • Jang JT, Green JB, Beard JL, Green MH. Kinetic analysis shows that iron deficiency decreases liver vitamin A mobilization in rats. Journal of Nutrition 2000;130:1291-6.
JivitA-1 Trial
  • Christian P, West Jr KP, Labrique A, Klemm R, Rashid M, Shamim AA, et al. Effects of maternal vitamin A or beta-carotene supplementation on maternal and infant mortality in rural Bangladesh: The JivitA-1 Trial. Micronutrient Forum; 2007 April 16-18; Istanbul, Turkey. 2007:Abstract No: W121.
Lynch 1997
Munoz 2000
  • Muñoz EC, Rosado JL, Lopez P, Furr HC, Allen LH. Iron and zinc supplementation improves indicators of vitamin A status of Mexican preschoolers. American Journal of Clinical Nutrition 2000;71(3):789-94.
Newton 2008
  • Newton S, Owusu-Agyei S, Kirkwood B. Is there any monitoring of the quality of vitamin A capsules used in supplementation programs?. American Journal of Clinical Nutrition 2007;86(4):1254.
Oliveira 2008a
Rahman 2001
  • Rahman MM, Vermund SH, Wahed MA, Fuchs GJ, Baqui AH, Alvarez JO. Simultaneous zinc and vitamin A supplementation in Bangladeshi children: randomised double blind controlled trial. BMJ 2001;323:314-8.
Rasmussen 1998
  • Rasmussen K. Vitamin A needs during pregnancy and lactation for the health of the mother and her fetus or infant. Safe vitamin A dosage during pregnancy and lactation: recommendations and report of a consultation. Micronutrient Initiative. Geneva: WHO, 1998:8-12.
RevMan 2008 [Computer program]
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Rice 2000
  • Rice AL, Stoltzfus RJ, De Francisco A, Kjolhede CL. Evaluation of serum retinol, the modified-relative-dose-response ratio, and breast-milk vitamin A as indicators of response to postpartum maternal vitamin A supplementation. American Journal of Clinical Nutrition 2000;71(3):799-806.
Rondó 1997
  • Rondó PH, Abbott R, Tomkins AM. Vitamin A and intrauterine growth retardation. Journal of Pediatrics 1997;73:335-9.
Rosales 1999
  • Rosales FJ, Jang JT, Pinero DJ, Erikson KM, Beard JL, Ross AC. Iron deficiency in young rats alters the distribution of vitamin A between plasma and liver and between hepatic retinol and retinyl esters. Journal of Nutrition 1999;129:1223-8.
Ross 2002
  • Ross DA. Recommendations for vitamin A supplementation. Journal of Nutrition 2002;131:2902S-2906S.
Sommer 1993
  • Sommer A. Clinical signs of xerophthalmia. IVACG. A brief guide to current methods of assessing vitamin A status. Washington DC: The Nutrition Foundation, 1993:37.
Stoltzfus 1993b
  • Stoltzfus RJ, Habicht JP, Rasmussen KM, Hakimi M. Evaluation of indicators for use in vitamin A intervention trials targeted at women. International Journal of Epidemiology 1993;123(4):666-75.
Stoltzfus 1993c
  • Stoltzfus RJ, Miller KW, Hakimi M, Rasmussen KM. Conjunctival impression cytology as an indicator of vitamin A status in lactating Indonesian women. American Journal of Clinical Nutrition 1993;58(2):167-73.
Strube 2002
  • Strube YNJ, Beard JL, Ross AC. Iron deficiency and marginal vitamin A deficiency affect growth, hematological indices and the regulation of iron metabolism genes in rats. Journal of Nutrition 2002;132:3607-15.
Suharno 1993
  • Suharno D, West CE, Muhilal, Karyadi D, Hautvast JG. Supplementation with vitamin A and iron for nutritional anaemia in pregnant women in West Java, Indonesia. Lancet 1993;342(8883):1235-8.
Van den Broek 2002
Walczyk 2003
  • Walczyk T, Davidsson L, Rossander-Hulthen L, Hallberg L, Hurrell RF. No enhancing effect of vitamin A on iron absorption in humans. American Journal of Clinical Nutrition 2003;77(1):144-9.
West 1997
  • West KP, LeClerq SC, Shrestha SR, Wu LS, Pradhan EK, Khatry SK, et al. Effects of vitamin A on growth of vitamin A-deficient children: field studies in Nepal. Journal of Nutrition 1997;127(10):1957-65.
West 2002
  • West KP Jr. Extent of vitamin A deficiency among preschool children and women of reproductive age. Journal of Nutrition 2002;132:285S-2866S.
WHO 1995
  • World Health Organization. Global prevalence of vitamin A deficiency. Micronutrient Deficiency Information System, No 2 (WHO/NUT/95.3). Vol. 2, Geneva: WHO, 1995.
WHO 1996
  • World Health Organization. Indicators for assessing vitamin A deficiency and their application in monitoring and evaluating intervention programmes. (WHO/NUT/96.1). Geneva: WHO, 1996.
WHO 1998
  • World Health Organization. Safe vitamin A dosage during pregnancy and lactation: recommendations and report of a consultation. Micronutrient Initiative. Geneva: WHO, 1998.
WHO 2009
  • World Health Organization. Global prevalence of vitamin A deficiency in population at risk 1995-2005: WHO database of vitamin A deficiency. Geneva: WHO, 2009.
WHO 2010
  • World Health Organization. World health statistics 2010. Geneva: WHO, 2010.
Yang 2005
  • Yang HM, Mao M, Wan CM. Vitamin A for treating measles in children. Cochrane Database of Systematic Reviews 2005, Issue 4. [DOI: 10.1002/14651858.CD001479]

References to other published versions of this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Oliveira 2008b
  • Oliveira JM, East CE, Bergamashi DP. Vitamin A supplementation for breastfeeding mothers: a systematic review. Journal of Paediatrics and Child Health 2008;44(Suppl 1):A88.