Maternal multivitamin supplementation reduces the risk of diarrhoea among HIV-exposed children through age 5 years.

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 2x2 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]. (c) The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions please e-mail: journals.permissions@oup.com.