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

Abstract

OBJECTIVE:To investigate whether supplementation with vitamin A together with iron of Indonesian pregnant women decreases morbidity and improves growth of their infants during the first year of life. DESIGN: Women from a rural area in West Java, Indonesia, were randomly assigned on an individual basis to double-blind supplementation once weekly from $ 18 weeks of pregnancy until delivery. Supplementation comprised 120 mg iron and 500 mg folic acid with or without 4800 RE vitamin A. Their newborn infants were followed up during the first year of life: weight, length, morbidity and food intake were assessed monthly. RESULTS: Infants whose mothers had taken vitamin A supplements during pregnancy had similar weight, length, weight gain and growth as their counterparts during the follow-up period. The proportions of infants with reported symptoms of morbidity were similar in the vitamin A plus iron group and the iron group. In addition immunisation coverage and feeding mode did not differ between the groups. All infants were breast-fed, but exclusive breast-feeding rapidly declined at 4 months of age. Infants with serum retinol concentrations > 0.70 mmol=l increased their weight and length more during the first 6 months of life and had higher weight-for-age Z-scores during the first year of life than infants with serum retinol concentrations 0.70 mmol=l. Serum retinol concentrations were not associated with morbidity. CONCLUSION: In this study, vitamin A supplementation in conjunction with iron supplementation of pregnant women did not improve growth or reduce morbidity of their infants during the first year of life.

Association of antioxidant vitamins and oxidative stress levels in pregnancy with infant growth during the first year of life

“…Stein et al determined the impact of nutritional supplementation provided during the early childhood of women on the height of the subsequent generation (4) . Lind et al, Mwanri et al and Schmidt et al also reported the effects on growth of children (5,35,36) ; however, they also administered nutritional supplements to the children or pregnant women participating in their studies.…”

Parental BMI and Childhood Undernutrition in India: An Assessment of Intrauterine Influence

“…Maternal underweight is believed to increase the risk for low birth weight and intrauterine growth retardation, 1,6,[9][10][11][12][13][14] leading to undernutrition in infancy and childhood. 1,6,[9][10][11][12][13][15][16][17][18][19][20][21][22][23][24] Although nutritional stress during pregnancy may influence childhood nutritional status, many confounding factors could generate noncausal links between maternal nutritional status and offspring outcomes. One approach to strengthen causal inference in assessments of intrauterine influence is to compare the strength of associations between an exposure among mothers and offspring outcomes and the same exposure among fathers and offspring outcomes.…”

Effects of Multimicronutrient Supplementation during Pregnancy on Postnatal Growth of Children under 5 Years of Age: A Meta-Analysis of Randomized Controlled Trials

“…We identified seven titles in Chinese [24]–[30] and thirty titles in English [11]–[13], [15], [16], [22], [23], [31]–[54] that were potentially eligible. Of the seven Chinese studies, five were about effects of one or two micronutrients supplementation during pregnancy on posterity growth and were excluded [25]–[29].…”

“…The average birth weight of children in the multimicronutrient supplementation group was heavier than that of the children in the iron+folic group in the trial from Iran, the difference did not persist postnatally [15]. However, Schmidt et al [16] failed to observe any differences of height gain between multimicronutrient and control groups during the first year of infancy. By contrast, children in the multimicronutrient group seemed to grow faster than their counterpart in the control group in the study by Zekavat et al, though the net height did not differ significantly [15].…”