%0 Journal Article
%T The Effects of Two Maternal Vitamin A Supplementation Regimens on Serum Retinol in Postpartum Mothers: A Randomised Controlled Trial in Brazil
%A Luciana Marques Andreto
%A Ilma Kruze Grande de Arruda
%A Ariani Impieri Souza
%A Jos¨¦ Natal Figueiroa
%A Alcides da Silva Diniz
%J ISRN Public Health
%D 2012
%R 10.5402/2012/121697
%X Objective. To test whether the serum retinol level in mothers supplemented with 400,000£¿IU of vitamin A is higher than in those supplemented with 200,000£¿IU and to estimate duration of the protective effect of vitamin A supplementation in the serum retinol level. Methods. Double-blind, randomised controlled trial performed in two hospitals in the state of Pernambuco in northeast Brazil. Three hundred twelve mothers were recruited immediately postpartum. All women received a capsule containing 200,000£¿IU of vitamin A, and 10 days after delivery, they were randomly assigned to one of two treatment groups. One group received a second capsule containing vitamin A and the other group received a placebo. Each group was invited back after 2, 4, and 6 months for serum retinol analyses. Results. No difference was found between the two groups in serum maternal retinol concentration at 2 months (2.13 versus 2.03£¿¦Ìmol/L), 4 months (2.20 versus 2.24£¿¦Ìmol/L) or 6 months (2.29 versus 2.31£¿¦Ìmol/L). Because there was no further effect and because this population has a level of vitamin A deficiency considered mild, our results do not support a proposal to increase the dosing schedule for vitamin A in postpartum women as recommended by the IVACG. 1. Introduction Estimates show that each year approximately 20 million pregnant women living in areas at risk for vitamin A deficiency (VAD) have low concentrations of retinol (<0.70£¿¦Ìmol/L) in blood. In the Americas and Brazil VAD prevalence estimates are around 8% and 5%, respectively [1]. The Brazilian Northeast is one of the poorest regions of the country with a 46% Human Poverty Index. A study in a big city of the Northeast region observed a 25% prevalence of inadequate serum retinol concentration among breastfeeding women [2]. The World Health Organisation (WHO) recommends mass supplementation with a megadose of vitamin A in the immediate postpartum period in countries where VAD is endemic [3]. Several randomised controlled clinical trials have shown that vitamin A supplementation in areas at risk for VAD can significantly reduce child mortality [4¨C6]. However, there is still no consensus on whether the vitamin A supplementation during pregnancy produces the same benefits in reducing maternal morbidity and mortality [7]. Although a strategy for supplementation during the immediate postpartum period has been implemented in several countries (including Brazil), there are still doubts regarding the most effective regimen. Investigations have warned that a dose of 200,000, IU seems to be insufficient to correct subclinical
%U http://www.hindawi.com/journals/isrn.public.health/2012/121697/