Vitamin supplementation of HIV-infected women improves postnatal child growth.
BACKGROUND
Linear growth retardation and wasting are common in children born to HIV-infected women. Inexpensive interventions that could improve the postnatal growth pattern of such children are needed.


OBJECTIVE
The objective was to examine the effect of supplementing HIV-infected women with multivitamins or vitamin A and beta-carotene, during and after pregnancy, on the growth of their children during the first 2 y of life.


METHODS
We conducted a randomized placebo-controlled trial in 886 mother-infant pairs in Tanzania. At the first prenatal visit, HIV-infected women were randomly assigned to 1 of 4 daily oral regimens in a 2 x 2 factorial fashion: multivitamins (MV: thiamine, riboflavin, vitamin B-6, niacin, vitamin B-12, vitamin C, vitamin E, and folic acid), preformed vitamin A + beta-carotene (VA/BC), MV including VA/BC, or placebo. Supplementation continued during the first 2 y postpartum and thereafter. Children were weighed and measured monthly, and all received vitamin A supplements after 6 mo of age per the standard of care.


RESULTS
Multivitamins had a significant positive effect on attained weight (459 g; 95% CI: 35, 882; P = 0.03) and on weight-for-age (0.42; 95% CI: 0.07, 0.77; P = 0.02) and weight-for-length (0.38; 95% CI: 0.07, 0.68; P = 0.01) z scores at 24 mo. VA/BC seemed to reduce the benefits of MV on these outcomes. No significant effects were observed on length, midupper arm circumference, or head circumference.


CONCLUSIONS
Supplementation of HIV-infected women with multivitamins (vitamin B complex, vitamin C, and vitamin E) during pregnancy and lactation is an effective intervention for improving ponderal growth in children.
Villamor
Eduardo
E
Department of Nutrition and Community Health, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania. evillamo@hsph.harvard.edu
Saathoff
Elmar
E
Bosch
Ronald J
RJ
Hertzmark
Ellen
E
Baylin
Ana
A
Manji
Karim
K
Msamanga
Gernard
G
Hunter
David J
DJ
Fawzi
Wafaie W
WW
D000328:Adult; D000975:Antioxidants / Q000494:pharmacology; D002657:Child Development / Q000187:drug effects*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D011295:Prenatal Care; D013636:Tanzania / Q000453:epidemiology; D014801:Vitamin A / Q000494:pharmacology; D014815:Vitamins / Q000494:pharmacology*; D019207:beta Carotene / Q000494:pharmacology
D000975:Antioxidants; D014815:Vitamins; D019207:beta Carotene; D014801:Vitamin A