Micronutrient Status and Pregnancy Outcomes in HIVinfected Women

Saurabh Mehta, Julia L. Finkelstein, and Wafaie W. Fawzi

Summary Micronutrient deficiencies are widely prevalent in developing regions, especially in vulnerable groups such as HIV-infected pregnant women. Micronutrient supplementation is considered one of the most cost-effective strategies to reduce malnutrition and improve health outcomes.

Maternal multivitamin supplementation (vitamins B-complex, C, and E) has been shown to reduce the incidence of adverse pregnancy outcomes in HIV-infected pregnant women, such as fetal loss, infant low birth weight, small for gestational age, prematurity, and mother-to-child transmission (MTCT) of HIV. On the other hand, supplementation with vitamin A has not demonstrated such benefits; in fact, some trials have found that vitamin A supplementation increases the risk of MTCT of HIV.

The role of other micronutrients such as zinc and selenium has not been well established, and warrants further investigation; indiscriminate supplementation with these nutrients is to be avoided until this becomes clear. Routine iron and folate supplementation for HIV-infected pregnant women is to be continued, as recommended by the World Health Organization; however, there are some concerns regarding the safety of iron supplementation in HIV-infected pregnant women, and further research is urgently needed.

Multivitamin supplementation of HIV-infected pregnant women is strongly recommended. Overall, there is no evidence to support the use of vitamin A supplementation in HIV-positive pregnant women, due to concerns regarding vertical HIV transmission. Additional research is needed to elucidate the effect of other micronutrients including iron, zinc, and selenium on pregnancy outcomes in HIV-infected pregnant women.

Keywords: HIV, AIDS, Micronutrients, Multivitamins, MTCT, Pregnancy outcomes

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