Vitamin A supplementation and neonatal mortality in the developing world: a meta-regression of cluster-randomized trials

OBJECTIVE: To assess the relationship between the prevalence of vitamin A deficiency among pregnant women and the effect of neonatal vitamin A supplementation on infant mortality. METHODS: Studies of neonatal supplementation with vitamin A have yielded contradictory findings with regard to its effec...

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Main Authors: Michael Anthony Rotondi, Nooshin Khobzi
Format: Article
Language:English
Published: The World Health Organization 2010-09-01
Series:Bulletin of the World Health Organization
Online Access:http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862010000900014&lng=en&tlng=en
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author Michael Anthony Rotondi
Nooshin Khobzi
author_facet Michael Anthony Rotondi
Nooshin Khobzi
author_sort Michael Anthony Rotondi
collection DOAJ
description OBJECTIVE: To assess the relationship between the prevalence of vitamin A deficiency among pregnant women and the effect of neonatal vitamin A supplementation on infant mortality. METHODS: Studies of neonatal supplementation with vitamin A have yielded contradictory findings with regard to its effect on the risk of infant death, possibly owing to heterogeneity between studies. One source of that heterogeneity is the prevalence of vitamin A deficiency among pregnant women, which we examined using meta-regression techniques on eligible individual and cluster-randomized trials. Adapting standard techniques to control for the inclusion of a cluster-randomized trial, we modelled the logarithm of the relative risk of infant death comparing vitamin A supplementation at birth to a standard treatment, as a linear function of the prevalence of vitamin A deficiency in pregnant women. FINDINGS: Meta-regression analysis revealed a statistically significant linear relationship between the prevalence of vitamin A deficiency in pregnant women and the observed effectiveness of vitamin A supplementation at birth. In regions where at least 22% of pregnant women have vitamin A deficiency, giving neonates vitamin A supplements will have a protective effect against infant death. CONCLUSION: A meta-regression analysis is observational in nature and may suffer from confounding bias. Nevertheless, our study suggests that vitamin A supplementation can reduce infant mortality in regions where this micronutrient deficiency is common. Thus, neonatal supplementation programmes may prove most beneficial in regions where the prevalence of vitamin A deficiency among pregnant women is high.
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spelling doaj.art-8d8ac73f01ba4545b351b8e457172cef2024-03-02T16:46:36ZengThe World Health OrganizationBulletin of the World Health Organization0042-96862010-09-01889697702S0042-96862010000900014Vitamin A supplementation and neonatal mortality in the developing world: a meta-regression of cluster-randomized trialsMichael Anthony Rotondi0Nooshin Khobzi1University of Western OntarioUniversity of Western OntarioOBJECTIVE: To assess the relationship between the prevalence of vitamin A deficiency among pregnant women and the effect of neonatal vitamin A supplementation on infant mortality. METHODS: Studies of neonatal supplementation with vitamin A have yielded contradictory findings with regard to its effect on the risk of infant death, possibly owing to heterogeneity between studies. One source of that heterogeneity is the prevalence of vitamin A deficiency among pregnant women, which we examined using meta-regression techniques on eligible individual and cluster-randomized trials. Adapting standard techniques to control for the inclusion of a cluster-randomized trial, we modelled the logarithm of the relative risk of infant death comparing vitamin A supplementation at birth to a standard treatment, as a linear function of the prevalence of vitamin A deficiency in pregnant women. FINDINGS: Meta-regression analysis revealed a statistically significant linear relationship between the prevalence of vitamin A deficiency in pregnant women and the observed effectiveness of vitamin A supplementation at birth. In regions where at least 22% of pregnant women have vitamin A deficiency, giving neonates vitamin A supplements will have a protective effect against infant death. CONCLUSION: A meta-regression analysis is observational in nature and may suffer from confounding bias. Nevertheless, our study suggests that vitamin A supplementation can reduce infant mortality in regions where this micronutrient deficiency is common. Thus, neonatal supplementation programmes may prove most beneficial in regions where the prevalence of vitamin A deficiency among pregnant women is high.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862010000900014&lng=en&tlng=en
spellingShingle Michael Anthony Rotondi
Nooshin Khobzi
Vitamin A supplementation and neonatal mortality in the developing world: a meta-regression of cluster-randomized trials
Bulletin of the World Health Organization
title Vitamin A supplementation and neonatal mortality in the developing world: a meta-regression of cluster-randomized trials
title_full Vitamin A supplementation and neonatal mortality in the developing world: a meta-regression of cluster-randomized trials
title_fullStr Vitamin A supplementation and neonatal mortality in the developing world: a meta-regression of cluster-randomized trials
title_full_unstemmed Vitamin A supplementation and neonatal mortality in the developing world: a meta-regression of cluster-randomized trials
title_short Vitamin A supplementation and neonatal mortality in the developing world: a meta-regression of cluster-randomized trials
title_sort vitamin a supplementation and neonatal mortality in the developing world a meta regression of cluster randomized trials
url http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862010000900014&lng=en&tlng=en
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