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ORIGINAL RESEARCH COMMUNICATION |
1 From the Department of Epidemiology, Institute of Public Health, University of Copenhagen (HF); the Blair Research Laboratory, Ministry of Health, Harare, Zimbabwe (EG); the Department of Immunology, University of Zimbabwe, Harare, Zimbabwe (EG); the Department of Clinical Pharmacology, University of Zimbabwe, Harare, Zimbabwe (NN); the Department of Medical Laboratory Sciences, University of Zimbabwe, Harare, Zimbabwe (PN); the Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark (HK); and the Department of Human Nutrition, Royal Veterinary and Agricultural University, Frederiksberg, Denmark (PK and KFM)
Background: Multiple micronutrient deficiencies may contribute to low birth weight, which is a major global determinant of mortality.
Objective: We assessed the effect of prenatal multimicronutrient supplementation on gestational length and birth size.
Design: We conducted a randomized, placebo-controlled, double-blind effectiveness trial among antenatal care attendees in Harare, Zimbabwe. Pregnant women (22–35 wk of gestation) were randomly allocated to receive a multimicronutrient or placebo supplement daily until delivery. Supplementation with iron and folic acid was part of antenatal care.
Results: Of 1669 women, birth data were available from 1106 (66%), of whom 360 (33%) had HIV infection. The mean gestational length was 39.1 wk, and 16.6% of the women had a gestational length < 37 wk. The mean birth weight was 3030 g, and 10.5% of the infants had a birth weight < 2500 g. Multimicronutrient supplementation was associated with tendencies for increased gestational length (0.3 wk; 95% CI: –0.04, 0.6 wk; P = 0.06), birth weight (49 g; –6, 104 g; P = 0.08), and head circumference (0.2 cm; –0.02, 0.4 cm; P = 0.07) but was not associated with low birth weight (birth weight < 2500 g) (relative risk: 0.84; 0.59, 1.18; P = 0.31). The effect of multimicronutrient supplementation on birth weight was not significantly different between HIV-uninfected (26 g; –38, 91 g) and HIV-infected (101 g; –3, 205 g) subjects (interaction, P > 0.10).
Conclusion: Antenatal multimicronutrient supplementation may be one strategy to increase birth size.
Key Words: Pregnancy • micronutrient supplementation • HIV • gestational length • birth size • low birth weight • Zimbabwe
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