A randomized, placebo-controlled trial of the effect of zinc supplementation during pregnancy on pregnancy outcome in Bangladeshi urban poor.
BACKGROUND
Maternal zinc supplementation has been suggested as a potential intervention to reduce the incidence of low birth weight in developing countries. To date, placebo-controlled trials have all been performed in industrialized countries and the results are inconsistent.


OBJECTIVE
The objective of this study was to evaluate whether zinc supplementation in Bangladeshi urban poor during the last 2 trimesters of pregnancy was associated with pregnancy outcome.


METHODS
We conducted a double-blind, placebo-controlled trial in which 559 women from Dhaka slums, stratified by parity between 12 and 16 wk of gestation, were randomly assigned to receive 30 mg elemental Zn/d (n = 269) or placebo (n = 290). Supplementation continued until delivery. Serum zinc was estimated at baseline and at 7 mo of gestation. Dietary intake was assessed at baseline and anthropometric measurements were made monthly. Weight, length, and gestational ages of 410 singleton newborns were measured within 72 h of birth.


RESULTS
At 7 mo of gestation, serum zinc concentrations tended to be higher in the zinc-supplemented group than in the placebo group (15.9 +/- 4.4 compared with 15.2 +/- 4.3 micromol/L). No significant effect of treatment was observed on infant birth weight (2513 +/- 390 compared with 2554 +/- 393 g; NS) or on gestational age, infant length, or head, chest, or midupper arm circumference. The incidence and distribution of low birth weight, prematurity, and smallness for gestational age also did not differ significantly after zinc supplementation.


CONCLUSIONS
Supplementation with 30 mg elemental Zn during the last 2 trimesters of pregnancy did not improve birth outcome in Bangladeshi urban poor. These results indicate that interventions with zinc supplementation alone are unlikely to reduce the incidence of low birth weight in Bangladesh.
Osendarp
S J
SJ
Centre for Health and Population Research, the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka.
van Raaij
J M
JM
Arifeen
S E
SE
Wahed
M
M
Baqui
A H
AH
Fuchs
G J
GJ
D000886:Anthropometry; D001459:Bangladesh; D001794:Blood Pressure / Q000187:drug effects; D003906:Developing Countries; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D011203:Poverty; D011247:Pregnancy; D011256:Pregnancy Outcome; D014505:Urban Population; D015032:Zinc / Q000097:blood / Q000627:therapeutic use*
D015032:Zinc