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Zinc plus ß-carotene supplementation of pregnant women is superior to ß-carotene supplementation alone in improving vitamin A status in both mothers and infants^1,2,3,4

¹ From the Division of Human Nutrition and Epidemiology, Wageningen University, Wageningen, Netherlands (MAD, FTW, and CEW); the Nutrition Research and Development Centre, Bogor, Indonesia (MAD, FTW, and M); the Departments of Internal Medicine (MAD and FTW) and Gastroenterology and Hepatology (CEW), University Medical Centre Nijmegen, Nijmegen, Netherlands

Background: Deficiencies of vitamin A, iron, and zinc are prevalent in women and infants in developing countries. Supplementation during pregnancy can benefit mother and infant.

Objective: We examined whether supplementation during pregnancy with iron and folic acid plus ß-carotene or zinc or both improves the micronutrient status of mothers and infants postpartum.

Design: Pregnant women (n = 170) were supplemented daily only during pregnancy with ß-carotene (4.5 mg), zinc (30 mg), or both or placebo plus iron (30 mg) and folic acid (0.4 mg) in a randomized, double-blind, placebo-controlled trial. Micronutrient status was assessed 1 and 6 mo postpartum.

Results: Six months postpartum, plasma retinol concentrations were higher in the women who received zinc during pregnancy than in women who did not. Infants born to mothers supplemented with ß-carotene + zinc had higher plasma retinol concentrations, with the frequency of vitamin A deficiency reduced by >30% compared with the other 3 groups. Breast-milk ß-carotene concentrations were higher in all women supplemented with ß-carotene, but breast-milk retinol concentrations were higher only in women who received ß-carotene + zinc. Zinc concentrations did not differ among groups in mothers and infants.

Conclusions: Zinc supplementation during pregnancy improved the vitamin A status of mothers and infants postpartum, which indicates a specific role of zinc in vitamin A metabolism. Addition of both ß-carotene and zinc to iron supplements during pregnancy could be effective in improving the vitamin A status of mothers and infants.

Key Words: Infants • breast milk • vitamin A deficiency • zinc • pregnancy • iron • growth • ß-carotene • folic acid • Indonesia