| Double blind, cluster randomised trial of low dose supplementation with vitamin A or beta carotene on mortality related to pregnancy in Nepal. The NNIPS-2 Study Group. | |
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MedLine Citation:
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PMID: 10037634 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To assess the impact on mortality related to pregnancy of supplementing women of reproductive age each week with a recommended dietary allowance of vitamin A, either preformed or as beta carotene. DESIGN: Double blind, cluster randomised, placebo controlled field trial. SETTING: Rural southeast central plains of Nepal (Sarlahi district). SUBJECTS: 44 646 married women, of whom 20 119 became pregnant 22 189 times. INTERVENTION: 270 wards randomised to 3 groups of 90 each for women to receive weekly a single oral supplement of placebo, vitamin A (7000 micrograms retinol equivalents) or beta carotene (42 mg, or 7000 micrograms retinol equivalents) for over 31/2 years. MAIN OUTCOME MEASURES: All cause mortality in women during pregnancy up to 12 weeks post partum (pregnancy related mortality) and mortality during pregnancy to 6 weeks postpartum, excluding deaths apparently related to injury (maternal mortality). RESULTS: Mortality related to pregnancy in the placebo, vitamin A, and beta carotene groups was 704, 426, and 361 deaths per 100 000 pregnancies, yielding relative risks (95% confidence intervals) of 0. 60 (0.37 to 0.97) and 0.51 (0.30 to 0.86). This represented reductions of 40% (P<0.04) and 49% (P<0.01) among those who received vitamin A and beta carotene. Combined, vitamin A or beta carotene lowered mortality by 44% (0.56 (0.37 to 0.84), P<0.005) and reduced the maternal mortality ratio from 645 to 385 deaths per 100 000 live births, or by 40% (P<0.02). Differences in cause of death could not be reliably distinguished between supplemented and placebo groups. CONCLUSION: Supplementation of women with either vitamin A or beta carotene at recommended dietary amounts during childbearing years can lower mortality related to pregnancy in rural, undernourished populations of south Asia. |
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Authors:
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K P West; J Katz; S K Khatry; S C LeClerq; E K Pradhan; S R Shrestha; P B Connor; S M Dali; P Christian; R P Pokhrel; A Sommer |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: BMJ (Clinical research ed.) Volume: 318 ISSN: 0959-8138 ISO Abbreviation: BMJ Publication Date: 1999 Feb |
Date Detail:
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Created Date: 1999-03-30 Completed Date: 1999-03-30 Revised Date: 2013-04-17 |
Medline Journal Info:
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Nlm Unique ID: 8900488 Medline TA: BMJ Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 570-5 Citation Subset: AIM; IM |
Affiliation:
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Johns Hopkins School of Hygiene and Public Health, Division of Human Nutrition, Room 2041, 615 N Wolfe Street, Baltimore, MD 21205, USA. kwest@jhsph.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Oral Adult Cause of Death Cluster Analysis Dietary Supplements Double-Blind Method Female Humans Maternal Mortality Nepal / epidemiology Pregnancy Pregnancy Complications / mortality*, prevention & control Rural Health / statistics & numerical data Vitamin A / administration & dosage* beta Carotene / administration & dosage* |
| Chemical | |
Reg. No./Substance:
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11103-57-4/Vitamin A; 7235-40-7/beta Carotene |
| Comments/Corrections | |
Comment In:
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BMJ. 1999 Oct 30;319(7218):1202; author reply 1203
[PMID:
10610158
]
BMJ. 1999 Oct 30;319(7218):1201-2; author reply 1203 [PMID: 10541530 ] BMJ. 1999 Feb 27;318(7183):551-2 [PMID: 10037611 ] BMJ. 1999 Oct 30;319(7218):1202-3 [PMID: 10610159 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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