Effect of multivitamin and vitamin A supplements on weight gain during pregnancy among HIV-1-infected women.
BACKGROUND
The pattern of weight gain during pregnancy among HIV-infected women is largely unknown. Multivitamin supplementation was shown to be effective in preventing adverse pregnancy outcomes among HIV-positive women. These protective effects could be mediated in part by an improvement in the pattern of gestational weight gain.


OBJECTIVE
We examined the effects of multivitamin and vitamin A supplements on weight gain during the second and third trimesters of pregnancy among HIV-infected women.


METHODS
We enrolled 1075 pregnant, HIV-1-positive women from Dar es Salaam, Tanzania, in a randomized, placebo-controlled trial. Using a 2-by-2 factorial design, we assigned each woman to 1 of 4 regimens: multivitamins (thiamine, riboflavin, niacin, folic acid, and vitamins B-6, B-12, C, and E), vitamin A, multivitamins including vitamin A, or placebo. The women took these oral supplements daily and were weighed monthly until the end of pregnancy.


RESULTS
The mean rate of weight gain was 306 g/wk during the second trimester and 247 g/wk during the third trimester. During the third trimester, average weight gain was significantly greater (by 304 g; 95% CI: 17, 590; P = 0.04) and the risk of low rate of weight gain (<or= 100 g/wk) was significantly lower (relative risk: 0.73; 95% CI: 0.58, 0.93) in women who received multivitamins than in women who did not. Multivitamins including vitamin A were protective against low weight gain during the second trimester compared with multivitamins alone.


CONCLUSIONS
Multivitamin supplementation during pregnancy improves the pattern of weight gain among HIV-infected women.
Villamor
Eduardo
E
Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA. evillamo@hsph.harvard.edu
Msamanga
Gernard
G
Spiegelman
Donna
D
Antelman
Gretchen
G
Peterson
Karen E
KE
Hunter
David J
DJ
Fawzi
Wafaie W
WW
D000328:Adult; D004338:Drug Combinations; D005260:Female; D015658:HIV Infections / Q000473:pathology*; D015497:HIV-1; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000473:pathology*; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D014801:Vitamin A / Q000494:pharmacology*; D014815:Vitamins / Q000008:administration & dosage* / Q000494:pharmacology; D015430:Weight Gain / Q000187:drug effects*
D004338:Drug Combinations; D014815:Vitamins; D014801:Vitamin A