Multivitamin supplementation in HIV-positive pregnant women: impact on depression and quality of life in a resource-poor setting.
OBJECTIVE
The primary objective of this study was to examine the effect of vitamin supplementation on health-related quality of life and the risk of elevated depressive symptoms comparable to major depressive disorder (MDD) in HIV-positive pregnant women in Dar es Salaam, Tanzania.


METHODS
From April 1995 to July 1997, 1078 HIV-positive pregnant women were enrolled in a randomized controlled trial. We examined the effects of vitamin supplementation on quality of life and the risk of elevated depressive symptoms, assessed longitudinally every 6-12 months.


RESULTS
A substantial prevalence of elevated depressive symptoms (42%) was observed in HIV-positive pregnant women. Multivitamin supplementation (B-complex, C and E) demonstrated a protective effect on depression [relative risk (RR)=0.78; P=0.005] and quality of life [RR=0.72 for social functioning (P=0.001) and vitality (P=0.0001); RR=0.70 for role-physical (P=0.002)]; however, vitamin A showed no effect on these outcomes.


CONCLUSIONS
Multivitamin supplementation (B-complex, C and E) resulted in a reduction in risk of elevated depressive symptoms comparable to MDD and improvement in quality of life in HIV-positive pregnant women in Tanzania.
Smith Fawzi
M C
MC
Program in Infectious Disease and Social Change, Department of Social Medicine, Harvard Medical School, Boston, MA 02115, USA. mksfawzi@msn.com
Kaaya
S F
SF
Mbwambo
J
J
Msamanga
G I
GI
Antelman
G
G
Wei
R
R
Hunter
D J
DJ
Fawzi
W W
WW
D000328:Adult; D003863:Depression / Q000178:diet therapy* / Q000821:virology; D019587:Dietary Supplements; D018450:Disease Progression; D004311:Double-Blind Method; D005260:Female; D015658:HIV Infections / Q000178:diet therapy* / Q000523:psychology; D015497:HIV-1 / Q000254:growth & development*; D006801:Humans; D007231:Infant, Newborn; D008137:Longitudinal Studies; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000178:diet therapy* / Q000523:psychology; D011788:Quality of Life; D014815:Vitamins / Q000627:therapeutic use*
D014815:Vitamins