Villamor Eduardo, Saathoff Elmar, Bosch Ronald J, Hertzmark Ellen, Baylin Ana, Manji Karim, Msamanga Gernard, Hunter David J, Fawzi Wafaie W
Department of Nutrition and Community Health, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania.
Am J Clin Nutr. 2005 Apr;81(4):880-8. doi: 10.1093/ajcn/81.4.880.
Linear growth retardation and wasting are common in children born to HIV-infected women. Inexpensive interventions that could improve the postnatal growth pattern of such children are needed.
The objective was to examine the effect of supplementing HIV-infected women with multivitamins or vitamin A and beta-carotene, during and after pregnancy, on the growth of their children during the first 2 y of life.
We conducted a randomized placebo-controlled trial in 886 mother-infant pairs in Tanzania. At the first prenatal visit, HIV-infected women were randomly assigned to 1 of 4 daily oral regimens in a 2 x 2 factorial fashion: multivitamins (MV: thiamine, riboflavin, vitamin B-6, niacin, vitamin B-12, vitamin C, vitamin E, and folic acid), preformed vitamin A + beta-carotene (VA/BC), MV including VA/BC, or placebo. Supplementation continued during the first 2 y postpartum and thereafter. Children were weighed and measured monthly, and all received vitamin A supplements after 6 mo of age per the standard of care.
Multivitamins had a significant positive effect on attained weight (459 g; 95% CI: 35, 882; P = 0.03) and on weight-for-age (0.42; 95% CI: 0.07, 0.77; P = 0.02) and weight-for-length (0.38; 95% CI: 0.07, 0.68; P = 0.01) z scores at 24 mo. VA/BC seemed to reduce the benefits of MV on these outcomes. No significant effects were observed on length, midupper arm circumference, or head circumference.
Supplementation of HIV-infected women with multivitamins (vitamin B complex, vitamin C, and vitamin E) during pregnancy and lactation is an effective intervention for improving ponderal growth in children.
感染艾滋病毒的妇女所生儿童中，线性生长发育迟缓及消瘦现象较为常见。因此需要一些低成本的干预措施来改善这些儿童出生后的生长模式。
本研究旨在探讨在孕期及产后为感染艾滋病毒的妇女补充多种维生素、维生素A和β-胡萝卜素对其子女出生后头两年生长发育的影响。
我们在坦桑尼亚的886对母婴中开展了一项随机安慰剂对照试验。在首次产前检查时，将感染艾滋病毒的妇女以2×2析因设计随机分配至4种每日口服方案中的一种：多种维生素（MV：硫胺素、核黄素、维生素B-6、烟酸、维生素B-12、维生素C、维生素E和叶酸）、预形成的维生素A+β-胡萝卜素（VA/BC）、包含VA/BC的MV或安慰剂。补充剂在产后头两年及之后持续服用。每月对儿童进行体重和身高测量，所有儿童在6月龄后按照标准护理方案接受维生素A补充剂。
多种维生素对24月龄时的体重增加值（459克；95%CI：35，882；P = 0.03）、年龄别体重（0.42；95%CI：0.07，0.77；P = 0.02）和身长别体重（0.38；95%CI：0.07，0.68；P = 0.01）z评分有显著的正向影响。VA/BC似乎降低了MV对这些指标的有益作用。在身长、上臂中部周长或头围方面未观察到显著影响。
孕期及哺乳期为感染艾滋病毒的妇女补充多种维生素（复合维生素B、维生素C和维生素E）是改善儿童体格生长的有效干预措施。
