Vitamin A and Zinc Supplementation among Pregnant Women to Prevent Placental Malaria: A Randomized, Double-Blind, Placebo-Controlled Trial in Tanzania
| العنوان: | Vitamin A and Zinc Supplementation among Pregnant Women to Prevent Placental Malaria: A Randomized, Double-Blind, Placebo-Controlled Trial in Tanzania |
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| المؤلفون: | Donna Spiegelman, Kevin C. Kain, Anne Marie Darling, Nilupa S. Gunaratna, Robert Mongi, Drucilla J. Roberts, Ferdinand Mugusi, Christopher Duggan, Ajibola I Abioye, Analee J. Etheredge, Davidson H. Hamer, Wafaie W. Fawzi, Said Aboud |
| المصدر: | The American Journal of Tropical Medicine and Hygiene. :16-0599 |
| بيانات النشر: | American Society of Tropical Medicine and Hygiene, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | 0301 basic medicine, medicine.medical_specialty, Placenta, Placebo-controlled study, Lower risk, Polymerase Chain Reaction, Sensitivity and Specificity, Tanzania, law.invention, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, Randomized controlled trial, Pregnancy, law, Virology, medicine, Humans, 030212 general & internal medicine, Malaria, Falciparum, Vitamin A, 030109 nutrition & dietetics, Intention-to-treat analysis, business.industry, Obstetrics, Pregnancy Outcome, Articles, medicine.disease, Zinc, Infectious Diseases, Pregnancy Complications, Parasitic, Relative risk, Dietary Supplements, Small for gestational age, Female, Parasitology, business, Malaria |
| الوصف: | Vitamin A and zinc are important for immune function and may improve host defense against malaria and reduce the risk of adverse pregnancy outcomes. Our objective was to determine whether daily oral supplementation with either or both nutrients starting in the first trimester reduces the risk of placental malaria and adverse pregnancy outcomes. We undertook a randomized, double-blind placebo-controlled trial with a factorial design among 2,500 human immunodeficiency virus-negative primigravid or secundigravid pregnant women in their first trimester of pregnancy in Dar es Salaam, Tanzania. We randomly allocated equal numbers of participants to 2,500 IU of vitamin A, 25 mg of zinc, both 2,500 IU of vitamin A and 25 mg of zinc, or a placebo until delivery. A total of 625 participants were allocated to each treatment group. Our primary outcome, placental malaria infection (past or current), was assessed in all randomized participants for whom placental samples were obtained at delivery (N = 1,404), which represents 56% of total participants and 62% of all pregnancies lasting 28 weeks or longer (N = 2,266). Birth outcomes were obtained for 2,434 of the 2,500 randomized participants. Secondary outcomes included small for gestational age (SGA) births and prematurity. All analyses were intent to treat. Those who received zinc had a lower risk of histopathology-positive placental malaria compared with those who did not receive zinc (risk ratio = 0.64, 95% confidence interval = 0.44, 0.91), but neither nutrient had an effect on polymerase chain reaction-positive malaria, SGA, or prematurity. No safety concerns were identified. We recommend additional studies in other geographic locations to confirm these findings. |
| تدمد: | 1476-1645 0002-9637 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1187d3b0c668d4bef2a9e9ea815ce974Test https://doi.org/10.4269/ajtmh.16-0599Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....1187d3b0c668d4bef2a9e9ea815ce974 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14761645 00029637 |
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