Villamor Eduardo, Msamanga Gernard, Spiegelman Donna, Antelman Gretchen, Peterson Karen E, Hunter David J, Fawzi Wafaie W
Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.
Am J Clin Nutr. 2002 Nov;76(5):1082-90. doi: 10.1093/ajcn/76.5.1082.
The pattern of weight gain during pregnancy among HIV-infected women is largely unknown. Multivitamin supplementation was shown to be effective in preventing adverse pregnancy outcomes among HIV-positive women. These protective effects could be mediated in part by an improvement in the pattern of gestational weight gain.
We examined the effects of multivitamin and vitamin A supplements on weight gain during the second and third trimesters of pregnancy among HIV-infected women.
We enrolled 1075 pregnant, HIV-1-positive women from Dar es Salaam, Tanzania, in a randomized, placebo-controlled trial. Using a 2-by-2 factorial design, we assigned each woman to 1 of 4 regimens: multivitamins (thiamine, riboflavin, niacin, folic acid, and vitamins B-6, B-12, C, and E), vitamin A, multivitamins including vitamin A, or placebo. The women took these oral supplements daily and were weighed monthly until the end of pregnancy.
The mean rate of weight gain was 306 g/wk during the second trimester and 247 g/wk during the third trimester. During the third trimester, average weight gain was significantly greater (by 304 g; 95% CI: 17, 590; P = 0.04) and the risk of low rate of weight gain (<or= 100 g/wk) was significantly lower (relative risk: 0.73; 95% CI: 0.58, 0.93) in women who received multivitamins than in women who did not. Multivitamins including vitamin A were protective against low weight gain during the second trimester compared with multivitamins alone.
Multivitamin supplementation during pregnancy improves the pattern of weight gain among HIV-infected women.
HIV感染女性孕期体重增加模式在很大程度上尚不明确。多项研究表明，补充多种维生素可有效预防HIV阳性女性出现不良妊娠结局。这些保护作用可能部分是通过改善孕期体重增加模式来实现的。
我们研究了多种维生素和维生素A补充剂对HIV感染女性妊娠中期和晚期体重增加的影响。
我们在坦桑尼亚达累斯萨拉姆招募了1075名HIV-1阳性孕妇，进行一项随机、安慰剂对照试验。采用2×2析因设计，将每位女性分配到4种方案中的1种：多种维生素（硫胺素、核黄素、烟酸、叶酸以及维生素B-6、B-12、C和E）、维生素A、含维生素A的多种维生素或安慰剂。这些女性每天口服这些补充剂，每月称重一次，直至妊娠结束。
妊娠中期体重增加的平均速率为每周306克，妊娠晚期为每周247克。在妊娠晚期，服用多种维生素的女性平均体重增加显著更多（多304克；95%置信区间：17，590；P = 0.04），体重增加速率低（≤100克/周）的风险显著更低（相对风险：0.73；95%置信区间：0.58，0.93）。与单独服用多种维生素相比，含维生素A的多种维生素可预防妊娠中期体重增加不足。
孕期补充多种维生素可改善HIV感染女性的体重增加模式。
