Journal article
Effect of Synthetic Vitamin A and Probiotics Supplementation for Prevention of Morbidity and Mortality during the Neonatal Period. A Systematic Review and Meta-Analysis of Studies from Low- and Middle-Income Countries
Nutrients, Vol.12(3), p.791
03/01/2020
DOI: 10.3390/nu12030791
PMCID: PMC7146603
PMID: 32192165
Abstract
Background: Suboptimal nutritional status of a newborn is a risk factor for short- and long-term morbidity and mortality. The objectives of this review were to assess the efficacy and effectiveness of neonatal synthetic vitamin A supplementation, dextrose gel and probiotic supplementation for prevention of morbidity and mortality during infancy in low and middle-income countries. Methods: We included randomized trials. Primary outcome was all-cause mortality. We conducted electronic searches on multiple databases. Data were meta-analyzed to obtain relative risk (RR) and 95% confidence interval (CI). Studies for vitamin A and Probiotics were analyzed separately. No studies were found for dextrose gel supplementation during neonatal period. The overall rating of evidence was determined by Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Results: Sixteen studies assessed the effect of vitamin A supplementation during the neonatal period. Based on pooled data from community-based studies only, there was no significant effect of vitamin A on all-cause mortality at age 1 month (RR 0.99, 95% CI 0.90, 1.08), 6 months (RR 0.98; 95% CI 0.89-1.08) and 12 months (RR 1.04, 95% CI 0.94, 1.14) but increased risk of bulging fontanelle (RR 1.53, 95% CI 1.12, 2.09). The overall quality of evidence was high for the above outcomes. Thirty-three studies assessed the effect of probiotic supplementation during the neonatal period and were mostly conducted in the hospital setting. Probiotics reduced the risk of all-cause mortality (RR 0.80, 95% CI 0.66, 0.96), necrotizing enterocolitis (RR 0.46, 95% CI 0.35, 0.59) and neonatal sepsis (RR 0.78, 95% CI 0.70, 0.86). The grade ratings for the above three outcomes were high. Conclusions: Vitamin A supplementation during the neonatal period does not reduce all-cause neonatal or infant mortality in low and middle-income countries in the community setting. Probiotic supplementation during the neonatal period seems to reduce all-cause mortality, NEC, and sepsis in babies born low birth weight and/or preterm in the hospital setting.
Details
- Title: Subtitle
- Effect of Synthetic Vitamin A and Probiotics Supplementation for Prevention of Morbidity and Mortality during the Neonatal Period. A Systematic Review and Meta-Analysis of Studies from Low- and Middle-Income Countries
- Creators
- Aamer Imdad - SUNY Upstate Medical UniversityFaseeha Rehman - SUNY Upstate Medical UniversityEvan Davis - SUNY Upstate Medical UniversitySuzanna Attia - University of KentuckyDeepika Ranjit - SUNY Upstate Medical UniversityGamael Saint Surin - SUNY Upstate Medical UniversitySarah Lawler - SUNY Upstate Medical UniversityAbigail Smith - SUNY Upstate Medical UniversityZulfiqar A. Bhutta - Hospital for Sick Children
- Resource Type
- Journal article
- Publication Details
- Nutrients, Vol.12(3), p.791
- DOI
- 10.3390/nu12030791
- PMID
- 32192165
- PMCID
- PMC7146603
- NLM abbreviation
- Nutrients
- ISSN
- 2072-6643
- eISSN
- 2072-6643
- Publisher
- Mdpi
- Number of pages
- 21
- Grant note
- Bill and Melinda Gates Foundation; Bill & Melinda Gates Foundation OPP1137750 / Center for Global Child Health at The Hospital for Sick Children
- Language
- English
- Date published
- 03/01/2020
- Academic Unit
- Stead Family Department of Pediatrics; Gastroenterology, Hepatology, Pancreatology, and Nutrition
- Record Identifier
- 9984446276802771
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