Maternal vitamin A and β-carotene supplementation and risk of bacterial vaginosis: a randomized controlled trial in rural Bangladesh.
What this study found
Weekly vitamin A supplementation reduced bacterial vaginosis risk, and beta-carotene also showed benefit for some BV outcomes. For vitamin A, adjusted BV prevalence was lower postpartum and across either follow-up time point: OR 0.69 (0.50, 0.94) postpartum and 0.71 (0.52, 0.96) for either; adjusted incidence was also reduced postpartum and overall: RR 0.57 (0.40, 0.80) and 0.60 (0.41, 0.87). For beta-carotene, the adjusted BV prevalence for either time point was also lower, OR 0.72 (0.53, 0.99), with adjusted incidence for either time point RR 0.66 (0.43, 1.01). Neither intervention showed…
- Study & population
- Cluster-randomized, placebo-controlled trial in pregnant women from rural northeastern Bangladesh.
- Intervention
- Pregnant women were assigned to weekly observed direct dosing from pregnancy enrollment until 3 mo postpartum with either vitamin A 7000 lg retinol equivalents as retinyl palmitate or beta-carotene 42 mg, both given as gelatin supplements.
- Key limitation
- Outcome data were incomplete at each time point, with varying analyzed sample sizes across baseline, third trimester, and postpartum assessments.
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Open PDFOriginal abstract
BACKGROUND Bacterial vaginosis (BV) in pregnancy is linked to preterm birth, but its risk factors are not well understood. Micronutrient deficiencies may be associated with an increased risk of this condition. OBJECTIVE We assessed the effect of weekly vitamin A or β-carotene supplementation during pregnancy until 3 mo postpartum on BV risk in rural northeastern Bangladesh. DESIGN In this cluster-randomized, placebo-controlled trial, 33 clusters (n = 33) were randomly assigned to 3 groups. Women (n = 1812) were examined for BV by using self-administered swabs and the Nugent scoring method in early pregnancy, at 32 wk of gestation, and at 3 mo postpartum. RESULTS The prevalence of BV in early pregnancy, before supplementation, was 7.6% (95% CI: 6.3%, 9.1%) overall. Neither the prevalence nor the incidence of BV in the third trimester differed by supplement group. However, the prevalence (OR: 0.71; 95% CI: 0.52, 0.98) and incidence (RR: 0.58; 95% CI: 0.41, 0.81) of BV at 3 mo postpartum was lower among women in the vitamin A group (9.1% and 6.7%, respectively) than in the placebo group (12.4% and 11.8%, respectively), but not in the β-carotene group. Both vitamin A and β-carotene reduced the prevalence and incidence of BV at both time points (ie, third trimester and 3 mo postpartum) by 30-40% compared with placebo (all P < 0.05). CONCLUSIONS Weekly vitamin A supplementation reduced the risk of maternal BV in this rural Bangladeshi population. Enhancement of vitamin A status before and during pregnancy may reduce the risk of BV in areas with vitamin A deficiency. This trial is registered at clinicaltrials.gov as NCT00198822.