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Vitamin A supplementation for the prevention of morbidity and mortality in infants six months of age or less

  1. Siddhartha Gogia1,*,
  2. Harshpal S Sachdev2

Editorial Group: Cochrane Neonatal Group

Published Online: 5 OCT 2011

Assessed as up-to-date: 29 NOV 2010

DOI: 10.1002/14651858.CD007480.pub2

How to Cite

Gogia S, Sachdev HS. Vitamin A supplementation for the prevention of morbidity and mortality in infants six months of age or less. Cochrane Database of Systematic Reviews 2011, Issue 10. Art. No.: CD007480. DOI: 10.1002/14651858.CD007480.pub2.

Author Information

  1. 1

    Max Hospital, Pediatrics, Gurgaon, Haryana, India

  2. 2

    Sitaram Bhartia Institute of Science and Research, Pediatrics and Clinical Epidemiology, New Delhi, India

*Siddhartha Gogia, Pediatrics, Max Hospital, Gurgaon, Haryana, India. gogiasiddhartha@gmail.com.

Publication History

  1. Publication Status: New
  2. Published Online: 5 OCT 2011

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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. References to ongoing studies
  4. Additional references
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 vitamin A supplementation on vitamin A status: a randomised trial in Kenya. The British Journal of Nutrition 2007;98(2):422-30. [PUBMED: 17391562]
Baqui 1995 {published data only}
  • Baqui AH, de Francisco A, Arifeen SE, Siddique AK, Sack RB. Bulging fontanelle after supplementation with 25,000 IU of vitamin A in infancy using immunization contacts. Acta Paediatrica (Oslo, Norway: 1992) 1995;84(8):863-6. [PUBMED: 7488807]
Benn 2008 {published and unpublished data}
  • Benn CS, Diness BR, Roth A, Nante E, Fisker AB, Lisse IM, et al. Effect of 50,000 IU vitamin A given with BCG vaccine on mortality in infants in Guinea-Bissau: randomised placebo controlled trial. BMJ 2008;336(7658):1416-20. [PUBMED: 18558641]
  • Nante JE, Diness BR, Ravn H, Roth A, Aaby P, Benn CS. No adverse events after simultaneous administration of 50 000 IU vitamin A and Bacille Calmette-Guerin vaccination to normal-birth-weight newborns in Guinea-Bissau. European Journal of Clinical Nutrition 2008;62(7):842-8. [PUBMED: 17538544]
Benn 2010 {published data only (unpublished sought but not used)}
  • Benn CS, Fisker AB, Napirna BM, Roth A, Diness BR, Lausch KR, et al. Vitamin A supplementation and BCG vaccination at birth in low birthweight neonates: two by two factorial randomised controlled trial. BMJ 2010;340:c1101. [PUBMED: 20215360]
  • Diness BR, Christoffersen D, Pedersen UB, Rodrigues A, Fischer TK, Andersen A, et al. The effect of high-dose vitamin A supplementation given with Bacille Calmette-Guerin vaccine at birth on infant rotavirus infection and diarrhea: a randomized prospective study from Guinea-Bissau. Journal of Infectious Diseases 2010;202(Supplement):S241-51.
Bhaskaram 1998 {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(3):217-22. [PUBMED: 9707874]
de Francisco 1993 {published data only}
  • de Francisco A, Chakraborty J, Chowdhury HR, Yunus M, Baqui AH, Siddique AK, et al. Acute toxicity of vitamin A given with vaccines in infancy. Lancet 1993;342(8870):526-7. [PUBMED: 8102669]
Humphrey 1996 {published data only}
  • Agoestina T, Humphrey JH, Taylor GA, Usman A, Subardja D, Hidayat S, et al. Safety of one 52-mumol (50,000 IU) oral dose of vitamin A administered to neonates. Bulletin World Health Organisation 1994;72(6):859-68.
  • Humphrey JH, Agoestina T, Wu L, Usman A, Nurachim M, Subardja D, et al. Impact of neonatal vitamin A supplementation on infant morbidity and mortality. Journal of Pediatrics 1996;128(4):489-96.
Katz 2000 {published data only}
  • 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. The American Journal of Clinical Nutrition 2000;71(6):1570-6. [PUBMED: 10837300]
Kirkwood 2010 {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(9726):1640-9. [PUBMED: 20435345]
Klemm 2008 {published data only}
  • Klemm RD, Labrique AB, Christian P, Rashid M, Shamim AA, Katz J, et al. Newborn vitamin A supplementation reduced infant mortality in rural Bangladesh. Pediatrics 2008;122(1):e242-50. [PUBMED: 18595969]
Malaba 2005 {published data only}
  • 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(10):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. The American Journal of Clinical Nutrition 2005;81(2):454-60.
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. The Journal of Nutrition 2005;135(11):2669-73. [PUBMED: 16251628]
Rahmathullah 2003 {published data only}
  • Rahmathullah L. Effect of receiving a weekly dose of vitamin A equivalent to the recommended dietary allowances among pre school children on mortality in south India. Indian Journal of Pediatrics 1991;58(6):837-47. [PUBMED: 1818881]
  • Rahmathullah L, Tielsch JM, Thulasiraj RD, Bloem MW, Osrin D. Supplementing newborn infants with vitamin A reduces mortality at age 6 months. Evidence-Based Healthcare 2004;8:30-2.
  • Rahmathullah L, Tielsch JM, Thulasiraj RD, Katz J, Coles C, Devi S, et al. Impact of supplementing newborn infants with vitamin A on early infant mortality: community based randomised trial in southern India. BMJ 2003;327(7409):254.
  • Tielsch JM, Rahmathullah L, Thulasiraj RD, Katz J, Coles C, Sheeladevi S, et al. Newborn vitamin A dosing reduces the case fatality but not incidence of common childhood morbidities in South India. The Journal of Nutrition 2007;137(11):2470-4.
Semba 2001 {published data only}
  • Semba RD, Munasir Z, Akib A, Melikian G, Permaesih D, Muherdiyantiningsih, et al. Integration of vitamin A supplementation with the Expanded Programme on Immunization: lack of impact on morbidity or infant growth. Acta Paediatrica 2001;90(10):1107-11. [PUBMED: 11697418]
Stabell 1995 {published data only}
  • Stabell C, Balé C, Pedro da Silva A, Olsen J, Aaby P. No evidence of fontanelle-bulging episodes after vitamin A supplementation of 6- and 9-month-old infants in Guinea Bissau. European Journal of Clinical Nutrition 1995;49(1):73-4. [PUBMED: 7713054]
Venkatarao 1996 {published data only}
  • Venkatarao T, Ramakrishnan R, Nair NG, Radhakrishnan S, Sundaramoorthy L, Koya PK, et al. Effect of vitamin A supplementation to mother and infant on morbidity in infancy. Indian Pediatrics 1996;33(4):279-86. [PUBMED: 8772901]
West 1995 {published data only}
  • West KP Jr, Katz J, Shrestha SR, LeClerq SC, Khatry SK, Pradhan EK, et al. Mortality of infants < 6 mo of age supplemented with vitamin A: a randomized, double-masked trial in Nepal. The American Journal of Clinical Nutrition 1995;62(1):143-8. [PUBMED: 7598058]
  • West KP Jr, Khatry SK, LeClerq SC, Adhikari R, See L, Katz J, et al. Tolerance of young infants to a single, large dose of vitamin A: a randomized community trial in Nepal. Bulletin of the World Health Organization 1992;70(6):733-9. [PUBMED: 1486669]
WHO 1998 {published and unpublished data}
  • WHO/CHD Immunisation-Linked Vitamin A Supplementation Study Group. Randomised trial to assess benefits and safety of vitamin A supplementation linked to immunisation in early infancy. Lancet 1998;352(9136):1257-63. [PUBMED: 9788455]

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
Basu 2003 {published data only}
  • Basu S, Sengupta B, Paladhi PK. Single megadose vitamin A supplementation of Indian mothers and morbidity in breastfed young infants. Postgraduate Medical Journal 2003;79(933):397-402. [PUBMED: 12897218]
Benn 2000 {published data only}
  • Benn CS, Lisse IM, Bale C, Michaelsen KF, Olsen J, Hedegaard K, et al. No strong long-term effect of vitamin A supplementation in infancy on CD4 and CD8 T-cell subsets. A community study from Guinea-Bissau, West Africa. Annals of Tropical Paediatrics 2000;20(4):259-64. [PUBMED: 11219162]
Bhaskaram 1997 {published data only}
  • Bhaskaram P, Rao KV. Enhancement in seroconversion to measles vaccine with simultaneous administration of vitamin A in 9-months-old Indian infants. Indian Journal of Pediatrics 1997;64(4):503-9.
Coles 2001 {published data only}
  • Coles CL, Rahmathullah L, Kanungo R, Thulasiraj RD, Katz J, Santhosham M, et al. Vitamin A supplementation at birth delays pneumococcal colonization in South Indian infants. The Journal of Nutrition 2001;131(2):255-61. [PUBMED: 11160543]
Coutsoudis 1999 {published data only}
  • Coutsoudis A, Pillay K, Spooner E, Kuhn L, Coovadia HM. Randomized trial testing the effect of vitamin A supplementation on pregnancy outcomes and early mother-to-child HIV-1 transmission in Durban, South Africa. South African Vitamin A Study Group. AIDS 1999;13(12):1517-24.
  • Kennedy CM, Coutsoudis A, Kuhn L, Pillay K, Mburu A, Stein Z, et al. Randomized controlled trial assessing the effect of vitamin A supplementation on maternal morbidity during pregnancy and postpartum among HIV-infected women. Journal of Acquired Immune Deficiency Syndromes 2000;24(1):37-44. [PUBMED: 10877493]
Dimenstein 2007 {published data only}
  • Dimenstein R, Lourenco RM, Ribeiro KD. Impact on colostrum retinol levels of immediate postpartum supplementation with retinyl palmitate [Impacto da suplementacao com retinil palmitato no pos-parto imediato sobre os niveis de retinol do colostro ]. Revista Panamericana de Salud Publica = Pan American Journal of Public Health 2007;22(1):51-4. [PUBMED: 17931488]
Fawzi 2002 {published data only}
  • Fawzi WW, Msamanga GI, Hunter D, Renjifo B, Antelman G, Bang H, et al. Randomized trial of vitamin supplements in relation to transmission of HIV-1 through breastfeeding and early child mortality. AIDS 2002;16(14):1935-44.
  • Fawzi WW, Msamanga GI, Spiegelman D, Urassa EJ, McGrath N, Mwakagile D, et al. Randomised trial of effects of vitamin supplements on pregnancy outcomes and T cell counts in HIV-1-infected women in Tanzania. Lancet 1998;351(9114):1477-82. [PUBMED: 9605804]
Humphrey 2006 {published data only}
  • Humphrey JH, Iliff PJ, Marinda ET, Mutasa K, Moulton LH, Chidawanyika H, et al. Effects of a single large dose of vitamin A, given during the postpartum period to HIV-positive women and their infants, on child HIV infection, HIV-free survival, and mortality. The Journal of Infectious Diseases 2006;193(6):860-71. [PUBMED: 16479521]
Kumwenda 2002 {published data only}
  • Kumwenda N, Miotti PG, Taha TE, Broadhead R, Biggar RJ, Jackson JB, et al. Antenatal vitamin A supplementation increases birth weight and decreases anemia among infants born to human immunodeficiency virus-infected women in Malawi. Clinical Infectious Diseases 2002;35(5):618-24.
Mahalanabis 1997 {published data only}
  • Mahalanabis D, Rahman MM, Wahed MA, Islam MA, Habte D. Vitamin A megadoses during early infancy on serum retinol concentration and acute side effects and residual effects on 6 month follow-up. Nutrition Research 1997;17(4):649-9.
Miller 2006 {published data only}
  • Miller MF, Stoltzfus RJ, Iliff PJ, Malaba LC, Mbuya NV, Humphrey JH. Effect of maternal and neonatal vitamin A supplementation and other postnatal factors on anemia in Zimbabwean infants: a prospective, randomized study. The American Journal of Clinical Nutrition 2006;84(1):212-22. [PUBMED: 16825698]
Newton 2007 {published data only}
  • Newton S, Owusu-Agyei S, Ampofo W, Zandoh C, Adjuik M, Adjei G, et al. Vitamin A supplementation enhances infants' immune responses to hepatitis B vaccine but does not affect responses to Haemophilus influenzae type b vaccine. The Journal of Nutrition 2007;137(5):1272-7. [PUBMED: 17449592]
Rahman 1995 {published data only}
  • Rahman MM, Mahalanabis D, Wahed MA, Islam MA, Habte D. Administration of 25,000 IU vitamin A doses at routine immunisation in young infants. European Journal of Clinical Nutrition 1995;49(6):439-45. [PUBMED: 7656887]
Rahman 1996 {published data only}
  • Rahman MM, Mahalanabis D, Alvarez JO, Wahed MA, Islam MA, Habte D, et al. Acute respiratory infections prevent improvement of vitamin A status in young infants supplemented with vitamin A. The Journal of Nutrition 1996;126(3):628-33. [PUBMED: 8598547]
Rahman 1997 {published data only}
  • Rahman MM, Mahalanabis D, Alvarez JO, Wahed MA, Islam MA, Habte D. Effect of early vitamin A supplementation on cell-mediated immunity in infants younger than 6 mo. The American Journal of Clinical Nutrition 1997;65(1):144-8. [PUBMED: 8988926]
Rahman 1998 {published data only}
  • Rahman MM, Alvarez JO, Mahalanabis D, Wahed MA, Islam MA, Habte D, et al. Effect of vitamin A administration on response to oral polio vaccination. Nutrition Research 1998;18(7):1125-33.
Rahman 1999 {published data only}
  • Rahman MM, Mahalanabis D, Hossain S, Wahed MA, Alvarez JO, Siber GR, et al. Simultaneous vitamin A administration at routine immunization contact enhances antibody response to diphtheria vaccine in infants younger than six months. The Journal of Nutrition 1999;129(12):2192-5. [PUBMED: 10573548]
Rao 1976 {published data only}
  • Rao KS, Shatrugna V. Effect of vitamin A supplementation of plasma progesterone levels in pregnancy. The Indian Journal of Medical Research 1976;64(9):1261-6. [PUBMED: 795768]
Rice 1999 {published data only}
  • 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. The Journal of Nutrition 1999;129(2):356-65. [PUBMED: 10024613]
Rice 2000 {published data only}
  • 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. The American Journal of Clinical Nutrition 2000;71(3):799-806. [PUBMED: 10702176]
Roy 1997 {published data only}
  • Roy SK, Islam A, Molla A, Akramuzzaman SM, Jahan F, Fuchs G. Impact of a 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. [PUBMED: 9152680]
Schmidt 2002 {published data only}
  • Schmidt MK, Muslimatun S, Schultink W, West CE, Hautvast JG. Randomised double-blind trial of the effect of vitamin A supplementation of Indonesian pregnant women on morbidity and growth of their infants during the first year of life. European Journal of Clinical Nutrition 2002;56(4):338-46. [PUBMED: 11965510]
Stoltzfus 1993 {published data only}
  • Stoltzfus RJ, Hakimi M, Miller KW, Rasmussen KM, Dawiesah S, Habicht JP, et al. High dose vitamin A supplementation of breast-feeding Indonesian mothers: effects on the vitamin A status of mother and infant. The Journal of Nutrition 1993;123(4):666-75. [PUBMED: 8463867]
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(11):1188-93. [PUBMED: 11086300]

References to ongoing studies

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
Bhandari 2010 {unpublished data only}
  • Bhandari N, et al. Efficacy of neonatal vitamin A supplementation in improving child survival in Haryana, India: generation of evidence necessary for informing global policy - NeoVitA Trial. Ongoing study June 2010.
Bhutta 2010 {unpublished data only}
  • Bhutta ZA, et al. Newborn Vitamin A (VA) Supplementation Pilot Project, Pakistan. Ongoing study January 2007.
Edmond 2010 {unpublished data only}
  • Edmond K, et al. Efficacy of newborn vitamin A supplementation in improving child survival in rural Ghana: generation of evidence necessary for informing global policy - - NeoVitA. Ongoing study August 2010.
Fawzi 2010 {unpublished data only}
  • Fawzi W, et al. Efficacy of newborn vitamin A supplementation in improving child survival in Tanzania: generation of evidence necessary for informing global policy - Neovita. Ongoing study August 2010.

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
Adamson 2006
Awasthi 2007
  • Awasthi S, Peto R, Read S, Bundy D. Six-monthly vitamin A from 1 to 6 years of age. DEVTA: cluster randomised trial in 1 million children in North India. www.ctsu.ox.ac.uk/projects/devta/istanbul-vit-a-lecture.ppt. Accessed May 29, 2008.
Beaton 1993
  • Beaton GH, Martorell R, Aronson KJ, Edmonston B, McCabe G, Ross AC, et al. Effectiveness of Vitamin A supplementation in the control of young child morbidity and mortality in developing countries. ACC/SCN State of the Art Series, Nutrition Policy Discussion Paper No. 13. 1993.
Benn 2008a
  • Benn CS, Whittle H, Fisker A, Aaby P. Neonatal vitamin A supplementation in South Asia: Rapid implementation or understanding the variation?. BMJ 2008:www.bmj.com/cgi/eletters/336/7658/1385#198676. Accessed December 3, 2008.
Bhutta 2008
  • Bhutta ZA, Ahmed T, Black RE, Cousens S, Dewey K, Giugliani E, et al. for the Maternal and Child Undernutrition Study Group. What works? Interventions for maternal and child undernutrition and survival. Lancet 2008;371(9610):417-40.
Bhutta 2008b
Black 2010
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Christian 2001
  • Christian P, West KP Jr, Khatry SK, LeClerq SC, Kimbrough-Pradhan E, Katz J, et al. Maternal night blindness increases risk of mortality in the first 6 months of life among infants in Nepal. Journal of Nutrition 2001;131(5):1510-2.
Christian 2003
  • Christian P, West KP, Khatry SK, Leclerq SC, Pradhan EK, Katz J, et al. Effects of maternal micronutrient supplementation on fetal loss and infant mortality: a cluster-randomized trial in Nepal. American Journal of Clinical Nutrition 2003;78(6):1194-202.
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Darboe 2007
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Darlow 2007
de Benoist 2001
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FAO/WHO 1988
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Fawzi 1993
Fawzi 2006
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Jones 2003
Kapil 2005
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Kirkwood 2010b
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Kongnyuy 2009
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Miller 2002
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Sachdev 2008
Shey 2002
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Stephensen 2001
Tielsch 2007
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Webb 2007
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Wiysonge 2005
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Zeitlin 1992
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