title: The effect of neonatal vitamin A supplementation on growth in the first year of life among low-birth-weight infants in Guinea-Bissau: two by two factorial randomised controlled trial.
abstract: BACKGROUND
  Vitamin A supplementation (VAS) may amplify the effect of vaccines. We therefore investigated if neonatal VAS given with and without Bacille Calmette-Guérin (BCG) vaccine to low-birth-weight (LBW) neonates had an effect on growth in the first year of life. We hypothesised that VAS would be particularly beneficial when provided with BCG.
  
  
  METHODS
  We conducted a randomised two-by-two factorial trial in Guinea-Bissau; 1,717 LBW neonates were randomly allocated to VAS or placebo at birth as well as early or the usual postponed BCG vaccination. Anthropometric measurements were obtained at 2, 6, and 12 months after inclusion.
  
  
  RESULTS
  Overall there was no effect of neonatal VAS on growth in the first year of life. By 2 months, VAS tended to have a beneficial effect on weight and head circumference when given with BCG but not when given without BCG (interaction: weight-for-age p = 0.07 and head circumference-for-age: p = 0.06). By 6 months, there was a beneficial effect of VAS on head circumference and weight among children who had not received DTP vaccine 2 months after inclusion (weight: 0.18 (0.00; 0.36) and head circumference 0.27 (0.06; 0.48)), but no beneficial effect among those who had received DTP.
  
  
  CONCLUSIONS
  The results support other trials indicating that neonatal VAS does not have consistent effects on childhood growth and if anything the effects seem to be temporary. They also show that the effect may differ by vaccination status, being beneficial when given with BCG at birth and when DTP is delayed.
  
  
  BACKGROUND
  www.ClinicalTrials.gov (NCT00168610).
authors.forename: Sofie
authors.initials: S
authors.lastname: Biering-Sørensen
authors.forename: Ane Bærent
authors.initials: AB
authors.lastname: Fisker
authors.forename: Henrik
authors.initials: H
authors.lastname: Ravn
authors.forename: Luis
authors.initials: L
authors.lastname: Camala
authors.forename: Ivan
authors.initials: I
authors.lastname: Monteiro
authors.forename: Peter
authors.initials: P
authors.lastname: Aaby
authors.forename: Christine Stabell
authors.initials: CS
authors.lastname: Benn
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage; D001500:BCG Vaccine / Q000008:administration & dosage; D001835:Body Weight; D019587:Dietary Supplements; D005260:Female; D005500:Follow-Up Studies; D006169:Guinea-Bissau / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D014611:Vaccination; D014801:Vitamin A / Q000008:administration & dosage*; D014802:Vitamin A Deficiency / Q000453:epidemiology / Q000517:prevention & control*; D014815:Vitamins / Q000008:administration & dosage
chemical_list: D000276:Adjuvants, Immunologic; D001500:BCG Vaccine; D014815:Vitamins; D014801:Vitamin A