Retinol and riboflavin supplementation decreases the prevalence of anemia in Chinese pregnant women taking iron and folic Acid supplements.
In rural China, many pregnant women in their third trimester suffer from anemia (48%) and iron deficiency (ID; 42%), often with coexisting deficiencies of retinol and riboflavin. We investigated the effect of retinol and riboflavin supplementation in addition to iron plus folic acid on anemia and subjective well-being in pregnant women. The study was a 2-mo, double-blind, randomized trial. Subjects (n = 366) with anemia [hemoglobin (Hb) </= 105 g/L] were randomly assigned to 4 groups, all receiving 60 mg/d iron and 400 mug/d folic acid. The iron+folic acid (IF) group (n = 93) served as reference, the iron+folic acid+retinol group (IFA) (n = 91) was treated with 2000 mug retinol, the iron+folic acid+riboflavin group (IFB) (n = 91) with 1.0 mg riboflavin, and the iron+folic acid+retinol+riboflavin group (IFAB) (n = 91) with retinol and riboflavin. After the 2-mo intervention, the Hb concentration increased in all 4 groups (P < 0.001). The increase in the IFAB group was 5.4 +/- 1.1 g/L greater than in the IF group (P < 0.001). The reduced prevalence of anemia (Hb < 110g/L) and ID anemia were significantly greater in the groups supplemented with retinol and /or riboflavin than in the IF group. Moreover, gastrointestinal symptoms were less prevalent in the IFA group than in the IF group (P < 0.05) and improved well-being was more prevalent in the groups receiving additional retinol and/or riboflavin than in the IF group (P < 0.05). Thus, a combination of iron, folic acid, retinol, and riboflavin was more effective than iron plus folic acid alone. Multimicronutrient supplementation may be worthwhile for pregnant women in rural China.
Ma
Ai G
AG
Institute of Human Nutrition, Medical College of Qingdao University, 266021 Qingdao, China. aiguom502@hotmail.com
Schouten
Evert G
EG
Zhang
Feng Z
FZ
Kok
Frans J
FJ
Yang
Fang
F
Jiang
Dian C
DC
Sun
Yong Y
YY
Han
Xiu X
XX
D000328:Adult; D000740:Anemia / Q000453:epidemiology / Q000517:prevention & control*; D002681:China / Q000453:epidemiology; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D005865:Gestational Age; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007501:Iron / Q000008:administration & dosage / Q000627:therapeutic use*; D018579:Patient Selection; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000517:prevention & control; D015995:Prevalence; D012256:Riboflavin / Q000008:administration & dosage / Q000627:therapeutic use*; D014801:Vitamin A / Q000008:administration & dosage / Q000627:therapeutic use*
D006454:Hemoglobins; D014801:Vitamin A; D005492:Folic Acid; D007501:Iron; D012256:Riboflavin