Effect of vitamin A supplementation with BCG vaccine at birth on vitamin A status at 6 wk and 4 mo of age.
BACKGROUND
The effect of vitamin A supplementation (VAS) at birth on subsequent vitamin A status has not been studied.


OBJECTIVE
The objective was to study the effect of 50,000 IU vitamin A administered with BCG vaccine at birth on vitamin A status in both sexes.


METHODS
Within a randomized placebo-controlled trial of VAS, we obtained blood from 614 children at 6 wk of age and from 369 mother-infant pairs at 4 mo of age. We assessed vitamin A status on the basis of serum retinol-binding protein (RBP) and measured serum C-reactive protein to monitor for concurrent infections.


RESULTS
RBP concentrations indicated vitamin A deficiency in 32% of the children at age 6 wk and in 16% at age 4 mo. VAS was not associated with higher RBP concentrations overall or in either sex. However, the effect of VAS varied with maternal education (P for interaction = 0.004): At age 6 wk, VAS was associated with higher (9%; 95% CI: 2, 17%) RBP concentrations in children of noneducated mothers but not in children of educated mothers. Overall, RBP concentrations increased between 6 wk and 4 mo of age. The increase correlated inversely with the number of diphtheria-tetanus-pertussis (DTP) vaccines received in the interval (P = 0.009), particularly in girls (P for interaction = 0.01) and in vitamin A recipients (P = 0.01).


CONCLUSIONS
Overall, VAS at birth had no effect on vitamin A status. However VAS may temporarily improve vitamin A status in the subgroup of children of noneducated mothers. In vitamin A recipients, subsequent DTP vaccines affected vitamin A status negatively. The main trial was registered at clinicaltrials.gov as NCT00168597.
Fisker
Ane B
AB
Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau. a.fisker@bandim.org
Lisse
Ida M
IM
Aaby
Peter
P
Erhardt
Juergen G
JG
Rodrigues
Amabelia
A
Bibby
Bo M
BM
Benn
Christine S
CS
D000375:Aging; D001500:BCG Vaccine / Q000008:administration & dosage; D002097:C-Reactive Protein / Q000032:analysis; D019587:Dietary Supplements; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D004522:Educational Status; D005260:Female; D006169:Guinea-Bissau / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009035:Mothers / Q000523:psychology; D009752:Nutritional Status; D049590:Postpartum Period; D012177:Retinol-Binding Proteins / Q000032:analysis; D014801:Vitamin A / Q000008:administration & dosage* / Q000097:blood*; D014802:Vitamin A Deficiency / Q000097:blood* / Q000453:epidemiology
D001500:BCG Vaccine; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D012177:Retinol-Binding Proteins; D014801:Vitamin A; D002097:C-Reactive Protein