Maternal, newborn, child and adolescent health

Consultation on Neonatal Vitamin A Supplementation Research Priorities

A newborn infant

4-5 December 2008, Geneva, Switzerland

Vitamin A supplementation has been promoted as an essential child-survival intervention for children 6-59 months of age. Recently, the issue of supplementation of neonates with vitamin A was raised as three trials from South Asia (Indonesia, India, and Bangladesh) found a beneficial effect of vitamin A supplementation at birth with reductions in mortality ranging from 15%-64%. However, two other trials from Africa (Zimbabwe and Guinea-Bissau) have shown no effect of vitamin A supplementation during the neonatal period.

In order to better understand these apparently contradictory results, a systematic review of randomized controlled trials was commissioned by the WHO Departments of Child and Adolescent Health and Development (CAH) and of Nutrition for Health and Development (NHD), to evaluate the effect of neonatal vitamin A supplementation on infant mortality, morbidity and adverse effects.

WHO's CAH and NHD Departments, jointly with the Nutrition Section of UNICEF, will now convene an expert consultation to discuss the implications of the findings of the systematic review for future research on neonatal vitamin A supplementation. The consultation will take place at WHO Headquarters in Geneva, Switzerland, on 4-5 December 2008.

The meta-analysis indicated no evidence of a significant effect of the intervention on mortality during the neonatal period or during infancy. There was no evidence of reduction of diarrhoea- or pneumonia-specific mortality in the three studies that reported cause-specific mortality. Effects on morbidity were inconsistent. Overall, no significant risk of adverse effects was documented in association with neonatal vitamin A supplementation.