The Effect of a Maternal Double Megadose of Vitamin A Supplement on Serum Levels of Retinol in Children Aged under Six Months

Carmina Silva Dos Santos, Ilma Kruze, Taciana Fernandes, Luciana Marques Andreto, José Natal Figueiroa, Alcides da Silva Diniz, Carmina Silva Dos Santos, Ilma Kruze, Taciana Fernandes, Luciana Marques Andreto, José Natal Figueiroa, Alcides da Silva Diniz

Abstract

Objective. To measure concentrations of serum retinol in children after the use of maternal vitamin A double megadose supplements. Design. Randomized controlled clinical trial. Setting. The study was conducted at two maternity hospitals in the city of Recife, in the northeast region of Brazil between August 2007 and June 2009. Subjects and Methods. 276 children/mothers were recruited after birth and the women received a 200,000 IU capsule of vitamin A. After ten days they were randomly assigned to two treatment groups. One group received a second 200.000 IU capsule, while the other received a placebo. The concentrations of retinol in the serum of the children from each group were measured at 2, 4, and 6 months. Results. 173 children completed the study. There was no difference between the two treatment groups (P = 0.514). The mean base retinol level was lower than that at four and six months (P < 0.001). Conclusions. The maternal double megadose supplement had no additional effect on the serum retinol levels of the children, although concentrations of retinol in the children rose in the first six months of life. This trial is registered with NCT00742937.

Figures

Figure 1
Figure 1
Flowchart of followup.
Figure 2
Figure 2
Mean retinol, by treatment group and duration of followup.

References

    1. World Health Organization. Micronutrient Deficiency Information System (MDIS) Geneva, Switzerland: WHO; 1995. The global prevalence of vitamin a deficiency.
    1. Sedgh G, Guillermo Herrera M, Nestel P, Amin AE, Fawzi WW. Dietary vitamin A intake and nondietary factors are associated with reversal of stunting in children. Journal of Nutrition. 2000;130(10):2520–2526.
    1. Semba RD. The role of vitamin A and related retnoids in immune function. Nutrition Reviews. 1998;56(1):S38–S48.
    1. Rondo PHC, Abbott R, Rodrigues LC, Tomkins AM. Vitamin A, folate, and iron concentrations in cord and maternal blood of intra-uterine growth retarded and appropriate birth weight babies. European Journal of Clinical Nutrition. 1995;49(6):391–399.
    1. World Health Organization. Vitamin A Supplementation. Report of An Informal Consultation, 1-3 March 2000 Yverdon-Les-Bains. Geneva, Switzerland: WHO; 2001.
    1. Barreto ML, Santos LMP, Assis AMO, et al. Effect of vitamin A supplementation on diarrhoea and acute lower- respiratory-tract infections in young children in Brazil. The Lancet. 1994;344(8917):228–231.
    1. Martins MC, Oliveira YP, Coitinho DC, Santos LMP. Panorama das ações de controle da deficiência de vitamina A no Brasil. Revista de Nutrição. 2007;20(1):1–5.
    1. Ross DA. Recommendations for vitamin A supplementation. Journal of Nutrition. 2002;132(supplement 9):2902–2906.
    1. Malaba LC, Iliff PJ, Nathoo KJ, 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(2):454–460.
    1. Tanumihardjo SA, Furr HC, Erdman JW, Jr., Olson JA. Use of the modified relative dose response (MRDR) assay in rats and its application to humans for the measurement of vitamin A status. European Journal of Clinical Nutrition. 1990;44(3):219–224.
    1. WHO. Using ImmunizAtion Contacts as A gateway To eliminating vitamin A Deficiency. Geneva, Switzerland: WHO; 1994.
    1. Medeiros JP, Pfrimer K, Tremeschin MH, Molina MC, Chiarello P. Nutrição E Metabolismo—Consumo alimentar: Visualizando porções. 1 edition. Rio de Janeiro, Brazil: Guanabara Koogan; 2007.
    1. Zaboto CB, Viana RPT, Gil MF. Registro Fotográfico Para Inquéritos Dietéticos: Utensílios E porções. Campinas, Brazil: NEPA/UNICAMP; 1996.
    1. Frisancho AR. The American Journal of Clinical Nutrition. The University of Michigan Press; 1990. Methods and materials. Anthropometric standards for the assessment of growth and nutritional status.
    1. World Health Organization. PhysicAl Status: The Use And InterpretAtion of Anthropometry Report of A WHO Expert Committee. Geneva, Switzerland: WHO; 1995.
    1. 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):302–307.
    1. Dimenstein R, Lourenço RM, Ribeiro KD. Impacto Da Suplementação Com Retinil Palmitato No Pós-Parto Imediato Sobre Os Níveis De retinol Do colostro. Rev Panam Salud Publica; 2007.
    1. Basu S, Sengupta B, Paladhi PKR. Single megadose vitamin A supplementation of Indian mothers and morbidity in breastfed young infants. Postgraduate Medical Journal. 2003;79(933):397–402.
    1. Stoltzfus RJ, Hakimi M, Miller KW, 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(4):666–675.
    1. Tchum SK, Tanumihardjo SA, Newton S, et al. Evaluation of vitamin A supplementation regimens in Ghanaian postpartum mothers with the use of the modified-relative-dose-response test. American Journal of Clinical Nutrition. 2006;84(6):1344–1349.
    1. Darboe MK, Thurnham DI, Morgan G, 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. The Lancet. 2007;369(9579):2088–2096.
    1. Idindili B, Masanja H, Urassa H, et al. Randomized controlled safety and efficacy trial of 2 vitamin A supplementation schedules in Tanzanian infants. American Journal of Clinical Nutrition. 2007;85(5):1312–1319.
    1. Ayah RA, Mwaniki DL, Magnussen P, et al. The effects of maternal and infant vitamin A supplementation on vitamin A status: a randomised trial in Kenya. British Journal of Nutrition. 2007;98(2):422–430.
    1. Bezerra DS, Araújo KF, Azevêdo GMM, Dimenstein R. Suplementação materna com retinil palmitato no pós-parto imediato: consumo potencial por lactentes. Revista de Saúde Pública. 2009;43(4):572–579.

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