Vitamin A and Zinc Supplementation Among Pregnant Women to Prevent Placental Malaria: A Randomized, Double-Blind, Placebo-Controlled Trial in Tanzania.

Study answer

What this study found

Zinc, but not vitamin A, reduced histopathology-detectable placental malaria; neither supplement improved PCR-detectable placental malaria or birth outcomes. In the unweighted analysis, zinc lowered histopathology-positive placental malaria from 71/690 to 44/671 (RR 0.64, 95% CI 0.44 to 0.91; P=0.01), with a similar marginal structural model estimate (RR 0.62, 95% CI 0.42 to 0.89). Vitamin A had no effect on histopathology-detectable placental malaria (RR 0.99, 95% CI 0.70 to 1.40; P=0.94) and was associated with more severe maternal anemia (17.4% vs 12.8%; RR 1.36, 95% CI 1.05 to 1.76;…

Study & population

Randomized, double-blind, placebo-controlled 2x2 factorial trial in HIV-negative primigravida or secundigravida pregnant women enrolled in the first trimester at 8 antenatal clinics in Dar es Salaam, Tanzania.

Intervention

Participants were randomized to oral, daily tablets started in the first trimester and continued until delivery: vitamin A 2,500 IU/day, zinc sulfate 25 mg/day, vitamin A 2,500 IU plus zinc sulfate 25 mg/day, or placebo.

Key limitation

Outcome analyses used fewer participants than were randomized, with missing placental pathology and PCR data reducing the analyzable samples.

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Original abstract