Humphrey J H, Agoestina T, Wu L, Usman A, Nurachim M, Subardja D, Hidayat S, Tielsch J, West K P, Sommer A
Division of Human Nutrition, Department of International Health, Baltimore, MD, USA.
J Pediatr. 1996 Apr;128(4):489-96. doi: 10.1016/s0022-3476(96)70359-1.
To determine whether vitamin A supplementation at birth could reduce infant morbidity and mortality.
We conducted a placebo-controlled trial among 2067 Indonesian neonates who received either 52 micromol (50,000 IU) orally administered vitamin A or placebo on the first day of life. Infants were followed up at 1 year to determine the impact of this intervention on infant mortality. A subgroup (n = 470) was also examined at 4 and 6 months of age to examine the impact on morbidity.
Vital status was confirmed in 89% of infants in both groups at 1 year. There were 19 deaths in the control group and 7 in the vitamin A group (relative risk = 0.36; 95% confidence interval = 0.16, 0.87). The impact was stronger among boys, infants of normal compared with low birth weight, and those of greater ponderal index. Among infants examined at 4 months of age, the 1-week period prevalence of common morbidities was similar for vitamin A and control infants. However, during this same 4-month period, 73% and 51% more control infants were brought for medical treatment for cough (p = 0.008) and fever (p = 0.063), respectively.
Neonatal vitamin A supplementation may reduce the infant mortality rate and the prevalence of severe respiratory infection among young infants.
确定出生时补充维生素A是否可降低婴儿发病率和死亡率。
我们对2067名印度尼西亚新生儿进行了一项安慰剂对照试验，这些新生儿在出生第一天口服了52微摩尔（50,000国际单位）维生素A或安慰剂。对婴儿进行了为期1年的随访，以确定该干预措施对婴儿死亡率的影响。还对一个亚组（n = 470）在4个月和6个月大时进行了检查，以考察对发病率的影响。
两组中89%的婴儿在1岁时的生命状态得到确认。对照组有19例死亡，维生素A组有7例（相对风险 = 0.36；95%置信区间 = 0.16, 0.87）。这种影响在男孩、出生体重正常而非低体重的婴儿以及体质指数较高的婴儿中更为明显。在4个月大时接受检查的婴儿中，维生素A组和对照组婴儿常见疾病的1周患病率相似。然而，在这相同的4个月期间，因咳嗽（p = 0.008）和发烧（p = 0.063）就医的对照组婴儿分别多73%和51%。
新生儿补充维生素A可能会降低婴儿死亡率以及幼儿中严重呼吸道感染的患病率。
