Effect of vitamin A and β carotene supplementation on women's health

Much research has been devoted to child health in populations deficient in vitamin A 1 2 but much less to maternal health. On p 570 West et al present a report based on a large field trial in Nepal which examines the health benefits to women of supplementation with vitamin A or βcarotene.3 Vitamin A is found only in foods of animal origin, whereas β>carotene is the main vitamin A precursor of plant origin. The authors used a hard endpoint —all-cause maternal mortality—in a strong design, and they found that both vitamin A and βcarotene were effective. More work needs to be done, however, before supplementation is recommended for populations such as Nepal's.

Women of childbearing age were allocated according to area of residence, by cluster randomisation, to one of three dietary interventions: a single weekly oral supplement of either placebo, vitamin A, or βcarotene. Female field workers gave participating women their assigned supplement and recorded health related information during weekly home visits.

Among the 44646 participating women, 20119 became pregnant once and 2070twice. The main endpoint was maternal deaths from any cause during pregnancy …