Multivitamin supplementation in HIV-positive pregnant women: impact on depression and quality of life in a resource-poor setting

Authors


Dr Mary C. Smith Fawzi, Program in Infectious Disease and Social Change, Department of Social Medicine, Harvard Medical School, 641 Huntington Ave., Boston, MA 02115, USA. Tel: +1 (617) 432 2574; fax: +1 (617) 432 5300; e-mail: mksfawzi@msn.com

Abstract

Objectives

The primary objective of this study was to examine the effect of vitamin supplementation on health-related quality of life and the risk of elevated depressive symptoms comparable to major depressive disorder (MDD) in HIV-positive pregnant women in Dar es Salaam, Tanzania.

Methods

From April 1995 to July 1997, 1078 HIV-positive pregnant women were enrolled in a randomized controlled trial. We examined the effects of vitamin supplementation on quality of life and the risk of elevated depressive symptoms, assessed longitudinally every 6–12 months.

Results

A substantial prevalence of elevated depressive symptoms (42%) was observed in HIV-positive pregnant women. Multivitamin supplementation (B-complex, C and E) demonstrated a protective effect on depression [relative risk (RR)=0.78; P=0.005] and quality of life [RR=0.72 for social functioning (P=0.001) and vitality (P=0.0001); RR=0.70 for role-physical (P=0.002)]; however, vitamin A showed no effect on these outcomes.

Conclusions

Multivitamin supplementation (B-complex, C and E) resulted in a reduction in risk of elevated depressive symptoms comparable to MDD and improvement in quality of life in HIV-positive pregnant women in Tanzania.

Ancillary