TABLE 35.

Neonatal Vitamin A Supplementation

SourceLocation and Type of TrialInterventionPerinatal/Neonatal Outcome
Humphrey et al576Indonesia, urban hospital setting; RPCT2067 newborn infants were allocated to receive 1 oral dose of 52 μmol vitamin A plus 23 μmol vitamin E (n = 1034) or placebo (<0.1 μmol vitamin A plus 23 μmol vitamin E) (n = 1033), on the first day of life.Supplementation had no effect on NMR. The probability of survival during the first year of life, however, was greater in the vitamin A-supplemented than the control infants (OR: 0.36; CI: 0.16–0.87).
West et al578Nepal, rural setting; DBRPCTNewborns (n = 11 918) were randomized to either an intervention group (n = 6086) or a placebo group (n = 5832). Newborns in the intervention group received a single oral dose of vitamin A (15 000 retinol equivalent [RE] [∼3 drops of oil]); newborns in the placebo group received 75 RE (250 IU).The cumulative OR of death after 4 mo of the supplementation trial suggested a modest protective effect for vitamin A (OR: 0.9) but this pattern then changed in the second year and the OR returned to 1.11 (CI: 0.86–1.42) after 24 mo; no impact overall on neonatal mortality was observed.
Rahmathullah et al577India; rural setting; DBRCTInfants (n = 11 619) were randomly assigned to receive either 24 000 IU of vitamin A twice within a 24-h interval beginning within 48 h of birth, or to receive a placebo.Infants in the vitamin A group had a 22% reduction in total mortality (CI: 4–37%) compared with those in the placebo group. Vitamin A had an impact on mortality between 2 wk and 3 mo after treatment, with no additional impact after 3 mo.