Document Detail


Vitamins and perinatal outcomes among HIV-negative women in Tanzania.
MedLine Citation:
PMID:  17409323     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Prematurity and low birth weight are associated with high perinatal and infant mortality, especially in developing countries. Maternal micronutrient deficiencies may contribute to these adverse outcomes.
METHODS: In a double-blind trial in Dar es Salaam, Tanzania, we randomly assigned 8468 pregnant women (gestational age of fetus, 12 to 27 weeks) who were negative for human immunodeficiency virus infection to receive daily multivitamins (including multiples of the recommended dietary allowance) or placebo. All the women received prenatal supplemental iron and folic acid. The primary outcomes were low birth weight (<2500 g), prematurity, and fetal death.
RESULTS: The incidence of low birth weight was 7.8% among the infants in the multivitamin group and 9.4% among those in the placebo group (relative risk, 0.82; 95% confidence interval [CI], 0.70 to 0.95; P=0.01). The mean difference in birth weight between the groups was modest (67 g, P<0.001). The rates of prematurity were 16.9% in the multivitamin group and 16.7% in the placebo group (relative risk, 1.01; 95% CI, 0.91 to 1.11; P=0.87), and the rates of fetal death were 4.3% and 5.0%, respectively (relative risk, 0.87; 95% CI, 0.72 to 1.05; P=0.15). Supplementation reduced both the risk of a birth size that was small for gestational age (<10th percentile; 10.7% in the multivitamin group vs. 13.6% in the placebo group; relative risk, 0.77; 95% CI, 0.68 to 0.87; P<0.001) and the risk of maternal anemia (hemoglobin level, <11 g per deciliter; relative risk, 0.88; 95% CI, 0.80 to 0.97; P=0.01), although the difference in the mean hemoglobin levels between the groups was small (0.2 g per deciliter, P<0.001).
CONCLUSIONS: Multivitamin supplementation reduced the incidence of low birth weight and small-for-gestational-age births but had no significant effects on prematurity or fetal death. Multivitamins should be considered for all pregnant women in developing countries. (ClinicalTrials.gov number, NCT00197548 [ClinicalTrials.gov].).
Authors:
Wafaie W Fawzi; Gernard I Msamanga; Willy Urassa; Ellen Hertzmark; Paul Petraro; Walter C Willett; Donna Spiegelman
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  The New England journal of medicine     Volume:  356     ISSN:  1533-4406     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-05     Completed Date:  2007-04-10     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1423-31     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2007 Massachusetts Medical Society.
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00197548
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MeSH Terms
Descriptor/Qualifier:
Abortion, Spontaneous / epidemiology,  prevention & control
Adult
Ascorbic Acid / therapeutic use
Birth Weight / drug effects*
Double-Blind Method
Female
Fetal Death / epidemiology,  prevention & control
HIV Seronegativity*
Humans
Incidence
Infant Mortality
Infant, Low Birth Weight
Infant, Newborn
Infant, Small for Gestational Age
Pregnancy
Pregnancy Outcome* / epidemiology
Premature Birth / epidemiology,  prevention & control
Tanzania / epidemiology
Vitamin B Complex / therapeutic use
Vitamin E / therapeutic use
Vitamins / therapeutic use*
Grant Support
ID/Acronym/Agency:
P30 DK040561/DK/NIDDK NIH HHS; P30 DK040561-12/DK/NIDDK NIH HHS; R01 37701//PHS HHS
Chemical
Reg. No./Substance:
0/Vitamins; 12001-76-2/Vitamin B Complex; 1406-18-4/Vitamin E; PQ6CK8PD0R/Ascorbic Acid

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