Nutrition and HIV/AIDS: A Training Manual - Linkages Project

Table 4 Recommended iron and folic acid supplements for pregnant women toprevent anemia (slide 23)Prevalence ofanemia in pregnantwomen in the areaDoseDuration< 40% 60 mg iron + 400 mcg folicacid daily (where ironsupplements containing400mcg folic acid are notavailable, an ironsupplement with a lowerlevel of folic acid may beused)>40 % 60 mg iron + 400 mcg folicacid daily (where ironsupplements containing 400mcg folic acid are notavailable, an ironsupplement with a lowerlevel of folic acid may beused)6 months in pregnancy (or ifstarted late, extend to postnatalperiod for a total of 6months. If this is notpossible, increase the doseto 120 mg iron in pregnancy)6 months in pregnancy plus 3months post-partum (for atotal of 9 months)Source: WHO/BASICS/UNICEF 1999Data on other micronutrient intake for HIV-infected pregnant and lactating womenare limited. Only Fawzi et al (1998) have studied this issue, among pregnant andlactating HIV-infected women in Tanzania. In this randomly assigned placebocontrolledtrial, HIV-infected pregnant women at 12-27 weeks gestation receivedeither a daily prenatal supplement of vitamin A (1,667 mcg RE, or 5,000 IU,preformed vitamin A plus 30 mg or 5,000 mcg RE of beta-carotene], a multivitamincontaining folic acid, thiamin, riboflavin, niacin, and vitamins C, B 6 , B 12 and E, boththe vitamin A and multivitamin, or neither (placebo group). The study showed nosignificant effect on the risk of HIV transmission from either vitamin A ormultivitamin supplementation. However, the multivitamin supplements, not thevitamin A, decreased the risk of fetal mortality. The researchers concluded thatmultivitamin supplementation is a low–cost way to reduce adverse pregnancyoutcomes in HIV-1-infected women.The pregnant adolescent girl has an increased need for iron, folic acid, and zinc. Amultivitamin supplement, where available, can help meet these increased needs.136