Effects of vitamin A supplementation during pregnancy and early lactation on body weight of South African HIV-infected women

Effects of vitamin A supplementation during pregnancy and early lactation o n maternal weight among HIV-1-seropositive South African women were examine d. Three hundred twelve HIV-seropositive pregnant women between 28 and 32 w eeks gestation were studied as part of a randomized, double-blind, placebo- controlled trial at the King Edward VIII Hospital in Durban, South Africa. Patients were randomized to receive placebo or 5,000 IU of retinyl palmitat e and 30 mg of beta-carotene daily during pregnancy. At delivery, patients received placebo or 200,000 IU of retinyl palmitate. The main outcome measu res were prenatal and postnatal maternal weight and weight loss at three mo nths after delivery as measured in body mass index (BMI). Supplementation o f vitamin A was not associated with improvements in prepartum weight gain b ut was significantly associated with improved weight retention three to six months after delivery (p=0.02). The benefit of vitamin A supplementation a ppeared to be confined to subgroups with baseline CD4+ count <200 cells/<mu >L and serum retinol 0-20 mug/dL. Similar trends were observed in maintenan ce of postpartum BMI. However, no statistically significant associations we re observed. Although there was no benefit of vitamin A supplementation on prepartum weight gain, a benefit on maintenance of postnatal weight was obs erved. The benefit was highest among those who were vitamin A-deficient or whose CD4+ count was <200 cells/<mu>L presupplementation. In populations fo r whom antiretroviral therapy is not readily available or accessible, the f inding that vitamin A may improve postpartum weight lends some hope to a re latively inexpensive treatment which could be used for helping ameliorate s ome weight loss which is common during HIV infection.