title: Adding zinc to prenatal iron and folate supplements improves maternal and neonatal zinc status in a Peruvian population.
abstract: BACKGROUND
  Maternal zinc deficiency during pregnancy may be widespread among women in developing countries, but few data are available on whether prenatal zinc supplementation improves maternal and neonatal zinc status.
  
  
  OBJECTIVE
  We studied whether maternal zinc supplementation improved the zinc status of mothers and neonates participating in a supplementation trial in a shantytown in Lima, Peru.
  
  
  METHODS
  Beginning at gestation week 10-24, 1295 mothers were randomly assigned to receive prenatal supplements containing 60 mg Fe and 250 microg folate, with or without 15 mg Zn. Venous blood and urine samples were collected at enrollment, at gestation week 28-30, and at gestation week 37-38. At birth, a sample of cord vein blood was collected. We measured serum zinc concentrations in 538 women, urinary zinc concentrations in 521 women, and cord zinc concentrations in 252 neonates.
  
  
  RESULTS
  At 28-30 and 37-38 wk, mothers receiving zinc supplements had higher serum zinc concentrations than mothers who did not receive zinc (8.8 +/- 1.9 compared with 8.4 +/- 1.5 micromol/L and 8.6 +/- 1.5 compared with 8.3 +/- 1.4 micromol/L, respectively). Urinary zinc concentrations were also higher in mothers who received supplemental zinc (P < 0.05). After adjustment for covariates and confounding factors, neonates of mothers receiving zinc supplements had higher cord zinc concentrations than neonates of mothers who did not receive zinc (12.7 +/- 2.3 compared with 12.1 +/- 2.1 micromol/L). Despite supplementation, maternal and neonatal zinc concentrations remained lower than values reported for well-nourished populations.
  
  
  CONCLUSIONS
  Adding zinc to prenatal iron and folate tablets improved maternal and neonatal zinc status, but higher doses of zinc are likely needed to further improve maternal and neonatal zinc status in this population.
authors.affiliation: Center for Human Nutrition, Department of International Health, The Johns Hopkins School of Hygiene and Public Health, Baltimore, MD 21205, USA. lcaulfie@jhsph.edu
authors.forename: L E
authors.initials: LE
authors.lastname: Caulfield
authors.forename: N
authors.initials: N
authors.lastname: Zavaleta
authors.forename: A
authors.initials: A
authors.lastname: Figueroa
mesh_terms: D000328:Adult; D019587:Dietary Supplements; D004522:Educational Status; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D005492:Folic Acid / Q000008:administration & dosage*; D006397:Hematinics / Q000008:administration & dosage*; D006801:Humans; D007231:Infant, Newborn; D007501:Iron / Q000008:administration & dosage*; D009752:Nutritional Status / Q000187:drug effects*; D010568:Peru; D011247:Pregnancy; D011295:Prenatal Care; D015032:Zinc / Q000097:blood / Q000172:deficiency* / Q000627:therapeutic use* / Q000652:urine
chemical_list: D006397:Hematinics; D005492:Folic Acid; D007501:Iron; D015032:Zinc