Nasim Khavari1, Hongyu Jiang2, Karim Manji3, Gernard Msamanga3, Donna Spiegelman4, Wafaie Fawzi4, Christopher Duggan5. 1. Division of GI/Nutrition, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA Department of Pediatrics, Stanford University, Palo Alto, CA 94306, USA. 2. Division of GI/Nutrition, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA. 3. Departments of Community Medicine and Pediatrics, Muhimbili University of Health and Allied Sciences, United Nations Road, Dar es Salaam, Tanzania. 4. Departments of Nutrition, Epidemiology, Biostatistics, Global Health and Population, Harvard School of Public Health, Boston, MA 02115, USA. 5. Division of GI/Nutrition, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA Christopher.Duggan@childrens.harvard.edu.
Abstract
BACKGROUND: The aim of this study was to determine whether maternal vitamin supplementation affects long-term mortality and morbidity of children born to HIV-infected mothers. METHODS: In total, 1078 HIV-infected pregnant woman were enrolled in a double-blind, 2×2 factorial, randomised, placebo-controlled trial in Tanzania. Data were collected for 874 children at monthly clinic visits through a median age of 51 months. RESULTS:Maternal receipt of multivitamins (HR=0.93; 95% CI: 0.70-1.22) or vitamin A (HR=1.00; 95% CI: 0.76-1.32) did not affect all-cause child mortality through age 5 years. Among HIV-negative children, maternal multivitamin supplementation was associated with a lower mortality rate up to 5 years (HR=0.60; 95% CI: 0.38-0.95), primarily in children <2 years of age. Maternal vitamin A supplementation did not significantly affect child mortality up to 5 years (HR=0.76; 95% CI: 0.48-1.20). Children born to mothers who received multivitamins had a lower risk of all types of diarrhoea (RR=0.86; 95% CI: 0.75-0.98) through 5 years of age. The reduced risk of watery diarrhoea persisted in children from 2-5 years of age (RR=0.71; 95% CI: 0.54-0.95). CONCLUSIONS:Maternal vitamin supplementation during pregnancy and lactation may be associated with long-lasting affects in HIV-exposed children [ClinicalTrials.gov Identifier: NCT00197743].
RCT Entities:
BACKGROUND: The aim of this study was to determine whether maternal vitamin supplementation affects long-term mortality and morbidity of children born to HIV-infected mothers. METHODS: In total, 1078 HIV-infected pregnant woman were enrolled in a double-blind, 2×2 factorial, randomised, placebo-controlled trial in Tanzania. Data were collected for 874 children at monthly clinic visits through a median age of 51 months. RESULTS: Maternal receipt of multivitamins (HR=0.93; 95% CI: 0.70-1.22) or vitamin A (HR=1.00; 95% CI: 0.76-1.32) did not affect all-cause child mortality through age 5 years. Among HIV-negative children, maternal multivitamin supplementation was associated with a lower mortality rate up to 5 years (HR=0.60; 95% CI: 0.38-0.95), primarily in children <2 years of age. Maternal vitamin A supplementation did not significantly affect child mortality up to 5 years (HR=0.76; 95% CI: 0.48-1.20). Children born to mothers who received multivitamins had a lower risk of all types of diarrhoea (RR=0.86; 95% CI: 0.75-0.98) through 5 years of age. The reduced risk of watery diarrhoea persisted in children from 2-5 years of age (RR=0.71; 95% CI: 0.54-0.95). CONCLUSIONS: Maternal vitamin supplementation during pregnancy and lactation may be associated with long-lasting affects in HIV-exposed children [ClinicalTrials.gov Identifier: NCT00197743].
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