title: Multivitamin supplementation in HIV-positive pregnant women: impact on depression and quality of life in a resource-poor setting.
abstract: 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.
authors.affiliation: Program in Infectious Disease and Social Change, Department of Social Medicine, Harvard Medical School, Boston, MA 02115, USA. mksfawzi@msn.com
authors.forename: M C
authors.initials: MC
authors.lastname: Smith Fawzi
authors.forename: S F
authors.initials: SF
authors.lastname: Kaaya
authors.forename: J
authors.initials: J
authors.lastname: Mbwambo
authors.forename: G I
authors.initials: GI
authors.lastname: Msamanga
authors.forename: G
authors.initials: G
authors.lastname: Antelman
authors.forename: R
authors.initials: R
authors.lastname: Wei
authors.forename: D J
authors.initials: DJ
authors.lastname: Hunter
authors.forename: W W
authors.initials: WW
authors.lastname: Fawzi
mesh_terms: 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*
chemical_list: D014815:Vitamins