| Titre : | Maternal postpartum vitamin A supplementation for the prevention of mortality and morbidity in infancy : a systematic review of randomized controlled trials : Perinatal epidemiology. (2010) |
| Auteurs : | GOGIA (Siddhartha) : IND. Max Hospital. Gurgaon Haryana. ; SACHDEV (Harshpal-S) : IND. Sitaram Bhartia Institute of Science and Research. New Delhi. |
| Type de document : | Article |
| Dans : | International journal of epidemiology (vol. 39, n° 5, 2010) |
| Pagination : | 1217-1226 |
| Langues: | Anglais |
| Mots-clés : | Vitamine A ; Mère ; Postpartum ; Supplémentation ; Prévention santé ; Mortalité maternelle ; Mortalité ; Morbidité [épidémiologie] ; Epidémiologie ; Morbidité ; Nourrisson ; Randomisation ; Essai préventif ; Essai thérapeutique ; Homme ; Vitamine |
| Résumé : | [BDSP. Notice produite par INIST-CNRS rFCR0xkC. Diffusion soumise à autorisation]. Background Maternal postpartum vitamin A supplementation (VAS) provides an opportunity to improve vitamin A nutriture of breast fed infants in developing countries and can possibly prevent infant mortality and morbidity attributable to vitamin A deficiency. Objective To evaluate the effect of maternal postpartum VAS on infant mortality, morbidity and adverse effects. Design Systematic review, meta-analysis and meta-regression of randomized controlled trials. Data Electronic databases and abstracts and proceedings of micronutrient sources conferences. Randomized or quasi-randomized, placebo-controlled trials evaluating the effect of postpartum, maternal synthetic VAS on mortality or morbidity within infancy (<1 year), or adverse effects. Results The seven included trials were from developing countries. There was no evidence of a reduced risk of mortality during infancy [relative risk (RR) 1.05,95% confidence interval (CI) 0.92-1.20, P=0.438 ; I2=0%, P=0.940]. No variable emerged as a significant predictor of mortality but data for high-risk groups (high maternal night blindness prevalence and low birth weights) was restricted. Neonatal mortality data was available from a single study, (RR 1.09,95% CI 0.88-1.35 ; P=0.422). In two trials, there was no evidence of a reduced risk of cause-specific mortality. In one trial, there was no evidence of a decrease in either diarrhoea or acute respiratory infection. No adverse effects were reported in the single relevant trial. Conclusions There is no evidence of a mortality or morbidity benefit to the infant following postpartum maternal VAS. Only prevention of infant morbidity or mortality would be sufficient justification for initiating this intervention in public health programmes. |
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