Maternal HIV infection is a particular problem of sub-Saharan Africa, where > 13 million women of childbearing age are infected. Pregnant women who are HIV positive are at serious risk for low birth weight infants or preterm delivery. The progression of HIV infection is usually accompanied by opportunistic infections, diminished dietary intake, and nutrient malabsorption, resulting in weight loss. In an article appearing in the American Journal of Clinical Nutrition, Villamor et al. studied a large group of pregnant, HIV positive women from Dar es Salaam, Tanzania and the effects that several different regimes of multivitamin supplement had on their pregnancy outcomes. They found that, during the third trimester, women who took multivitamins gained significantly more weight than women who did not.

Nine hundred and fifty-seven pregnant HIV-positive women who were between 12 and 27 weeks of gestation were enrolled at 4 clinics in Tanzania. The women averaged 25 years old, with an average weight of 57 kg at their first clinic visit. They were randomly assigned to participate in 1 of 4 regimes: a multivitamin supplement that did not include vitamin A; a vitamin A-alone supplement; a multivitamin supplement that included vitamin A; or, a placebo. During the third trimester, multivitamin use was associated with a small increase in weight gain (averaging 304 g) when compared to the placebo. The risk of weight loss or low weight gain after 26 weeks of gestation was 30% less among women who took multivitamins. Though there was no positive overall association between vitamin A and weight gain, women who received both vitamin A and a multivitamin gained more weight in the second trimester than any of the other groups, and had a 29% lower risk of low weight gain at term.

The authors suggest that multivitamins may possibly improve weight loss patterns in pregnant women by slowing the progression of HIV disease, or by reducing the incidence and severity o
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Contact: Elizabeth Horowitz
horowitz@ascn.faseb.org
301-530-7038
American Journal of Clinical Nutrition
24-Oct-2002

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