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Vitamin A supplementation and BCG vaccination at birth in low birthweight neonates: two by two factorial randomised

Christine Stabell Benn1, Ane Baerent Fisker, Bitiguida Mutna Napirna

  • 1Bandim Health Project, Statens Serum Institut, Copenhagen, Denmark. cb@ssi.dk

BMJ (Clinical Research Ed.)
|March 11, 2010
PubMed

Insights

Vitamin A supplementation at birth for low birthweight neonates in Guinea-Bissau showed no overall benefit and may be harmful to girls. Further research into sex-specific effects of vitamin A is warranted.

Area of Science:

  • Neonatal Health
  • Nutritional Immunology
  • Public Health Interventions

Background:

  • Low birthweight neonates are vulnerable to infections and mortality.
  • Vitamin A supplementation and BCG vaccination are common neonatal interventions.
  • Understanding their combined effects is crucial for optimizing child survival.

Purpose of the Study:

  • To evaluate the impact of vitamin A supplementation and BCG vaccination on mortality in low birthweight neonates.
  • To investigate potential interactions between these interventions.
  • To explore sex-specific effects of vitamin A supplementation.

Main Methods:

  • A randomized, placebo-controlled, 2x2 factorial trial was conducted in Bissau, Guinea-Bissau.
  • 1717 low birthweight neonates received either vitamin A or placebo, and early BCG or late BCG vaccination.
  • Infant mortality was assessed up to 12 months of age.

Main Results:

  • No significant interaction was found between vitamin A and BCG vaccination on mortality.
  • Vitamin A supplementation alone did not significantly affect overall mortality (MRR 1.08).
  • A significant interaction with sex was observed, with vitamin A potentially harmful in girls (MRR 1.42) and beneficial in boys (MRR 0.74) when combined with data from normal birthweight neonates.

Conclusions:

  • Neonatal vitamin A supplementation is not beneficial overall in Guinea-Bissau.
  • Vitamin A supplementation at birth may be harmful to female infants.
  • Future research should focus on the sex-differential effects of vitamin A supplementation.
Abstract

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