United Press International; Thursday May 14 9:21 PM EDT
Meta L. Levin, UPI Science News

In a new study, researchers found the multivitamin not only reduced fetal deaths, low birth-weight and severe preterm births, but improved the mother's health as well.

The team of researchers from the Harvard School of Public Health in Boston and the Muhimili University College of Health Sciences in Dar es Salaam, Tanzania, published their work in the British medical journal The Lancet.

Nearly 13 percent of mothers in Tanzania and up to 30 percent of those in neighboring countries are HIV positive.

Dr. Wafaie W. Fawzi, assistant professor of international nutrition at the Harvard School of Public Health and lead author on the study, said: "The idea of this study was to determine whether an inexpensive intervention would have at least some protective effect. The cost is reasonably attractive compared to other interventions."

Newly developed combination antiviral therapies for HIV/AIDS are expensive. HIV-infected pregnant women have higher risks than uninfected women of fetal deaths, low birth-weight babies, preterm birth and slow fetal growth. The babies also are at higher risk for HIV infection, with greater infant mortality among both infected and uninfected children.

The 1,075 women in the study all came to a government clinic, and all were between 12 and 27 weeks pregnant.

They were divided into four groups: those who received a placebo; those who only received vitamin A; those who received a multivitamin excluding vitamin A; and those receiving a multivitamin including vitamin A. All the groups received daily doses of iron and folate supplements and weekly doses of prophylactic antimalarial medication, which is standard prenatal care in Tanzania.

Previous studies have focused on vitamin A, which was shown in this study not to have an effect. Those receiving multivitamins had approximately 40 percent fewer fetal deaths, low birth-weight babies, or severe preterm births. Researchers also found the multivitamins significantly improved the mother's immune status. Fawzi said, "The improvement in the immune status was sustained after delivery." Multivitamins used in the study had slightly higher amounts of B vitamins (1,2, 6 and 12), folate, C and E than those commonly available in over-the-counter vitamin preparations. He said this was done because those infected with HIV typically have a lower nutrient absorption rate.

All the pregnant HIV-positive women are now on multivitamins and are being tracked to learn if the supplements resulted in an improvement in their clinical condition. The babies also will be tested to learn if HIV transmission from the mothers is reduced. That information is expected within a year. Long-term HIV transmission results from the babies may be hard to interpret since most of the women breastfeed their babies.

Officials followed the World Health Organization code in informing the women of the possible risks of nursing an infant while HIV positive, but most cannot afford baby formula. They felt the benefits of breastfeeding outweighed possible negative affects, Fawzi said.

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