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

Baylin, Ana; Villamor, Eduardo; Rifai, Nader; Msamanga, Gernard; Fawzi, Wafaie W.

doi:10.1038/sj.ejcn.1602201

Cited by 42 publications

(31 citation statements)

References 48 publications

(57 reference statements)

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“…Although additional studies of the effects of vitamin E supplementation on tocopherol concentrations in breast milk were not available for comparison, the findings from our study are consistent with those from Baylin et al (2005) who reported that MV supplementation was associated with increased serum vitamin E in breastfed infants at 6 weeks and 6 months of age and reduced serum retinol in infants at 6 weeks of age. Changes in nutrient concentrations with MV supplementation, including a decrease in retinol, might be attributed to the a-tocopherol content of the supplement.…”

Section: Discussionsupporting

confidence: 82%

Effect of vitamin supplementation on breast milk concentrations of retinol, carotenoids and tocopherols in HIV-infected Tanzanian women

et al. 2007

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Background/Objective: The effect of daily prenatal and postnatal vitamin supplementation on concentrations of breast milk nutrients is not well characterized in HIV-infected women. We examined the impact of vitamin supplementation during pregnancy and lactation on breast milk concentrations of retinol, carotenoids and tocopherols during the first year postpartum among 626 HIV-infected Tanzanian women. Subjects/Methods: We conducted a randomized, double-blind, placebo-controlled trial. Women were assigned to one of four daily oral supplements: vitamin A þ b-carotene (VA þ BC); multivitamins (MV; B, C and E); MV þ VA þ BC or placebo. Concentrations of breast milk nutrients were determined by high-performance liquid chromatography at birth and every 3 months thereafter. Results: Supplementation with VA þ BC increased concentrations of retinol, b-carotene and a-carotene at delivery by 4799, 1791 and 84 nmol l À1 , respectively, compared to no VA þ BC (all Po0.0001). MV supplementation did not increase concentrations of a-tocopherol or d-tocopherol at delivery but significantly decreased concentrations of breast milk g-tocopherol and retinol. Although concentrations of all nutrients decreased significantly by 3 months postpartum, retinol, a-carotene and b-carotene concentrations were significantly higher among those receiving VA þ BC at 3, 6 and 12 months compared to no VA þ BC. a-Tocopherol was significantly higher, while g-tocopherol concentrations were significantly lower, among women receiving MV compared to no MV at 3, 6 and 12 months postpartum. Conclusions: Sustained supplementation of HIV-infected breastfeeding mothers with MV could be a safe and effective intervention to improve vitamin E concentrations in breast milk. VA þ BC supplementation increases concentrations of breast milk retinol but it is not recommended in HIV-infected mothers due to the elevated risk of vertical transmission.

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Section: Discussionsupporting

confidence: 82%

Effect of vitamin supplementation on breast milk concentrations of retinol, carotenoids and tocopherols in HIV-infected Tanzanian women

et al. 2007

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“…24 In addition, improvements in the mother's immune status 13 may result in less morbidity, more energy, and ability to stimulate her child, resulting in improvements in developmental scores. In a similar way, improvement of child multivitamin status throughout the supplement period, including observed increases in serum vitamins B 12 and E in these children, 16 may also be associated with reduced morbidity, particularly among initially nutritionally deficient children, 33 and as a result affect their mental and psychomotor development. 34 Both vitamins E and C are antioxidants that are believed to enhance immune responses and phagocytosis.…”

Section: Discussionmentioning

confidence: 92%

“…14 Vitamin A supplementation during pregnancy has also been shown to reduce the risk for preterm delivery among HIV-infected women. 15 Baylin et al 16 demonstrated that vitamin A supplements that are given to HIV-infected mothers during pregnancy and lactation increases serum vitamin A in their infants during the first 6 months of life. Similarly, multivitamin supplements (B, C, and E) increase serum vitamins B 12 and E.…”

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confidence: 99%

Effect of Maternal Multivitamin Supplementation on the Mental and Psychomotor Development of Children Who Are Born to HIV-1–Infected Mothers in Tanzania

et al. 2006

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OBJECTIVES. To determine the association between maternal multivitamin supplementation and the mental and psychomotor development of children who are born to HIV-1-infected mothers in Tanzania, as secondary endpoints in a randomized trial that investigated the effect of maternal multivitamin supplementation on HIV-1 vertical transmission and progression.METHODS. The Bayley Scales of Infant Development, 2nd Edition, were administered at 6, 12, and 18 months of age to a subset of children (N ϭ 327). We assessed the effect of vitamin A and multivitamin (vitamins B, C, and E) supplementation using linear regression models and Cox proportional hazard models for the Mental Development Index, the Psychomotor Development Index, and raw scores separately.RESULTS. Multivitamin supplementation was associated significantly with a mean increase in Psychomotor Development Index score of 2.6 (95% confidence interval: 0.1-5.1). Multivitamins were also significantly protective against the risk for developmental delay on the motor scale (relative risk: 0.4; 95% confidence interval: 0.2-0.7) but not on the Mental Development Index. Vitamin A supplementation had no significant effect on these outcomes.CONCLUSIONS. Maternal multivitamin supplements provide a low-cost intervention to reduce the risk for developmental delays among infants who are born to HIVpositive mothers in developing countries. McGRATH, et al by guest on May 11, 2018 http://pediatrics.aappublications.org/ Downloaded from A LTHOUGH STUDIES HAVE sought to improve mental and psychomotor development in children through protein energy 1 and multivitamin child supplements, 2-4 few have examined the effect of maternal supplements on infant development. Nutritional deficiencies are common in children in developing countries. 5 In 1996, 43% of preschool Tanzanian children were stunted (low height for age). 6 Vitamin A, iodine, and iron deficiencies are also prevalent. 7-9 Pepping et al 8 found that vitamin A deficiency was a significant problem in Tanzania, with 1.5% of the preschool age children whom they surveyed having xerophthalmia and 1.6% having Bitot's spots. In addition, children are have HIV-1 infection; antenatal HIV-1 seroprevalence has been ϳ12% since 1995 in Dar es Salaam. 10 Because multivitamin deficiencies are associated with faster HIV disease progression in adults 11 and higher risk for infant morbidity, 12 they may have a negative impact on the mental and psychomotor development of the child.Daily consumption of multivitamin supplements by HIV-1-infected pregnant women has been shown to delay significantly the progression of HIV disease. 13 Multivitamin supplements also resulted in significant reductions in the risk for low birth weight (LBW), severe preterm birth, and fetal loss and improved the immunologic profile of the mothers and increased their hemoglobin concentrations. 14 Vitamin A supplementation during pregnancy has also been shown to reduce the risk for preterm delivery among HIV-infected women. 15 Baylin et al 16 demonstrated that vit...

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“…Maternal nutritional status can be an important factor determining the micronutrient status of a breastfed infant (Dijkhuizen et al, 2001Baylin et al, 2005). Supplementation with micronutrients during pregnancy has the advantage of addressing the needs of both mothers and infants simultaneously.…”

Section: Introductionmentioning

confidence: 99%

Maternal micronutrient supplementation with zinc and β-carotene affects morbidity and immune function of infants during the first 6 months of life

Wieringa

Dijkhuizen

Muhilal³

et al. 2010

Eur J Clin Nutr

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Background/Objectives: Micronutrient deficiencies are prevalent worldwide, and a major cause of infant death. Supplementation with multiple micronutrients during pregnancy might improve micronutrient status of the newborn, thereby reducing morbidity and death. Moreover, maternal supplementation might affect the newborn's immune development. Therefore, this study investigated the effects of maternal zinc and b-carotene supplementation on the infant's morbidity and immune function during the first 6 months of life. Subjects/Methods: Mothers were supplemented during pregnancy with b-carotene and/or zinc, in addition to iron and folic acid, in a randomized, double-blind controlled trial. Newborn infants (n ¼ 136) were followed up for 6 months. Results: Infants born from mothers receiving zinc during pregnancy had significantly fewer episodes of diarrhoea than infants born from mothers not receiving zinc (0.2 and 0.4, respectively), but more episodes of cough (1.3 and 0.9 respectively) during the first 6 months. Maternal b-carotene supplementation had no effect on infants' morbidity. Cytokine production in the newborns was affected by maternal zinc and b-carotene supplementation, with zinc supplementation giving higher interleukin-6 production (16% higher), and b-carotene supplementation leading to lower interferon-g production (36% lower). Conclusions: This study shows that maternal supplementation with zinc and b-carotene affected the newborn's immune development in specific ways, but only maternal zinc supplementation significantly affected morbidity in the infants. Addition of zinc to routine iron and folic acid supplements for pregnant women could be an effective way to reduce diarrhoeal disease during the first 6 months of life, albeit at the expense of more episodes of cough.

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

Cited by 42 publications

References 48 publications

Effect of vitamin supplementation on breast milk concentrations of retinol, carotenoids and tocopherols in HIV-infected Tanzanian women

Effect of vitamin supplementation on breast milk concentrations of retinol, carotenoids and tocopherols in HIV-infected Tanzanian women

Effect of Maternal Multivitamin Supplementation on the Mental and Psychomotor Development of Children Who Are Born to HIV-1–Infected Mothers in Tanzania

Maternal micronutrient supplementation with zinc and β-carotene affects morbidity and immune function of infants during the first 6 months of life

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