Effect of vitamin supplementation to HIV-infected pregnant women on the micronutrient status of their infants

Objective: We examined whether supplementation with vitamin A and/or vitamins B, C, and E to HIV-infected women during pregnancy and lactation is related to increased concentrations of vitamins A, B12, and E in their infants during the first 6 months of life. Design: We carried out a randomized clinical trial among 716 mother - infant pairs in Dar-es- Salaam, Tanzania. Women were randomly allocated to receive a daily oral dose of one of four regimens: vitamin A, multivitamins ( B, C, and E), multivitamins including A, or placebo. Supplementation started at first prenatal visit and continued after delivery throughout the breastfeeding period. The serum concentration of vitamins A, E and B12 was measured in infants at 6 weeks and 6 months postpartum. Results: Maternal vitamin A supplementation increased serum retinol in the infants at 6 weeks ( mean difference = 0.09 mu mol/l, P<0.0001) and 6 months ( mean difference = 0.06 mu mol/l, P = 0.0002), and decreased the prevalence of vitamin A deficiency, but had no impact on serum vitamins E or B12. Multivitamins increased serum vitamin B12 at 6 weeks and 6 months ( mean differences = 176 pmol/ l, P<0.0001 and 127 pmol/ l, P<0.0001, respectively) and vitamin E ( mean differences = 1.8 mu mol/l, P = 0.0008 and 1.1 mu mol/ l, P = 0.004, respectively) and decreased the prevalence of vitamin B12 deficiency. Conclusions: Vitamin supplementation to HIV-1-infected women is effective in improving the vitamin status of infants during the first 6 months of age.