title: Vitamin A or beta-carotene supplementation reduces symptoms of illness in pregnant and lactating Nepali women.
abstract: The contribution of nutritional interventions to the reduction in maternal morbidity rates in developing countries is not well known. We assessed the impact of weekly vitamin A and beta-carotene supplementation on the prevalence of pregnancy and postpartum illness symptoms among 15,832 Nepali women in a placebo-controlled, double-masked, cluster-randomized trial. There was no impact of either supplement on morbidity rates reported up to 28 wk of gestation, inclusive. However, in late pregnancy (>28 wk), symptoms of nausea, faintness and night blindness were reduced with vitamin A, but not beta-carotene, supplementation. Vitamin A supplementation shortened the length of labor by 1.5 h 50 min among nulliparous and multiparous women, respectively. Both interventions reduced the postpartum prevalence of at least four loose stools and night blindness. beta-Carotene supplementation also reduced symptoms of high fever postpartum. The mean number of days of any reported illness symptoms was 3-4 per wk throughout pregnancy. Among women receiving vitamin A, the total number of days of illness symptoms accrued over the last 12 wk of pregnancy was lower by 5 d compared with the placebo recipients. We found the burden of pregnancy-related illness symptoms to be high in this rural area of Nepal where antenatal care is poor and most deliveries occur at home. Maternal vitamin A or beta-carotene supplementation resulted in a reduction in the prevalence of selected illness symptoms during late pregnancy, at the time of birth and during 6 mo postpartum, suggesting that a diet adequate in vitamin A may be important for improving women's reproductive health.
authors.affiliation: Johns Hopkins School of Public Health, Baltimore, Maryland, USA.
authors.forename: P
authors.initials: P
authors.lastname: Christian
authors.forename: K P
authors.initials: KP
authors.lastname: West
authors.forename: S K
authors.initials: SK
authors.lastname: Khatry
authors.forename: J
authors.initials: J
authors.lastname: Katz
authors.forename: S C
authors.initials: SC
authors.lastname: LeClerq
authors.forename: E
authors.initials: E
authors.lastname: Kimbrough-Pradhan
authors.forename: S M
authors.initials: SM
authors.lastname: Dali
authors.forename: S R
authors.initials: SR
authors.lastname: Shrestha
mesh_terms: D000328:Adult; D016000:Cluster Analysis; D004311:Double-Blind Method; D005260:Female; D005865:Gestational Age; D006801:Humans; D007743:Labor, Obstetric / Q000187:drug effects; D007774:Lactation / Q000187:drug effects; D009325:Nausea / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D009390:Nepal / Q000453:epidemiology; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000517:prevention & control*; D015995:Prevalence; D011644:Puerperal Disorders / Q000453:epidemiology* / Q000517:prevention & control*; D014801:Vitamin A / Q000627:therapeutic use*; D019207:beta Carotene / Q000627:therapeutic use*
chemical_list: D019207:beta Carotene; D014801:Vitamin A