Effects of zinc supplementation during pregnancy on pregnancy outcome in women with history of preterm delivery: a double-blind randomized, placebo-controlled trial. Zinc supplementation during pregnancy: a double blind randomised controlled trial. Oral zinc supplementation in pregnant women and its effect on birth weight: a randomised controlled trial Effect of oral zinc application during pregnancy. The impact of prenatal vitamin A and zinc supplementation on growth of children up to 2 years of age in rural Java, Indonesia. Zinc supplementation during pregnancy in low-income teenagers of Mexican descent: effects on selected blood constituents and on progress and outcome of pregnancy. Trial of zinc supplements in relation to pregnancy outcomes, hematologic indicators, and T cell counts among HIV-1-infected women in Tanzania. Supplementation with micronutrients in addition to iron and folic acid does not further improve the hematologic status of pregnant women in rural Nepal. Zinc supplementation might potentiate the effect of vitamin A in restoring night vision in pregnant Nepalese women. Prenatal iron supplements impair zinc absorption in pregnant Peruvian women. A micronutrient-fortified beverage prevents iron deficiency, reduces anemia and improves the hemoglobin concentration of pregnant Tanzanian women. Maternal zinc supplementation does not affect size at birth or pregnancy duration in Peru. Adding zinc to prenatal iron and folate supplements improves maternal and neonatal zinc status in a Peruvian population. Effects of maternal micronutrient supplementation on fetal loss and infant mortality: a cluster-randomized trial in Nepal. A randomized, placebo-controlled trial of the effect of zinc supplementation during pregnancy on pregnancy outcome in Bangladeshi urban poor. Influence of prenatal iron and zinc supplements on supplemental iron absorption, red blood cell iron incorporation, and iron status in pregnant Peruvian women. Maternal zinc supplementation and growth in Peruvian infants. Zinc supplementation during pregnancy: effects on selected blood constituents and on progress and outcome of pregnancy in low-income women of Mexican descent. Randomized controlled trial of prenatal zinc supplementation and fetal bone growth. Zinc nutritional status during pregnancy: a longitudinal study. Effect of zinc supplementation of pregnant women on the mental and psychomotor development of their children at 5 y of age. Antenatal supplementation with micronutrients and biochemical indicators of status and subclinical infection in rural Nepal. Changes in iron status during pregnancy in peruvian women receiving prenatal iron and folic acid supplements with or without zinc. Zinc supplementation during pregnancy: zinc concentration of serum and hair from low-income women of Mexican descent. Effect of Prenatal Zinc Supplementation on Birthweight The impact of prenatal vitamin A and zinc supplementation on birth size and neonatal survival - a double-blind, randomized controlled trial in a rural area of Indonesia. Effect of joint iron and zinc supplementation on malarial infection and anaemia. Plasma extracellular superoxide dismutase activity in healthy pregnant women is not influenced by zinc supplementation Effect of oral zinc supplementation on copper and haemoglobin levels in pregnant women. Maternal micronutrient supplementation with zinc and β-carotene affects morbidity and immune function of infants during the first 6 months of life Plasma and erythrocyte zinc concentrations and their relationship to dietary zinc intake and zinc supplementation during pregnancy in low-income African-American women. The effect of diet supplementation and addition of zinc in vitro on the growth-supporting property of amniotic fluid in African women. Second-trimester plasma homocysteine levels and pregnancy-induced hypertension, preeclampsia, and intrauterine growth restriction. Failure to taste zinc sulphate solution does not predict zinc deficiency in pregnancy. Randomized controlled trial of prenatal zinc supplementation and the development of fetal heart rate. Serum zinc levels and effects of oral supplementation in pregnant women. The effect of zinc supplementation on pregnancy outcome. Zinc supplementation during pregnancy and effects on mental development and behaviour of infants: a follow-up study Combined iron and zinc supplementation improves haematologic status of pregnant women in Upper West Region of Ghana. Effect of Antenatal Zinc Supplementation on Impetigo in Infants in Bangladesh Effects of a combined micronutrient supplementation on maternal biological status and newborn anthropometrics measurements: a randomized double-blind, placebo-controlled trial in apparently healthy pregnant women A study of the effect of oral zinc supplementation during pregnancy on pregnancy outcome. Zinc supplementation to HIV-1-infected pregnant women: Effects on maternal anthropometry, viral load, and early mother-to-child transmission Maternal serum zinc level and its relation with neonatal birth weight. Zinc taste test in pregnant women and its correlation with serum zinc level. Zinc and IGF-I concentrations in pregnant women with anemia before and after supplementation with iron and/or zinc. Zinc status and dietary intake of pregnant women, Alexandria, Egypt. Maternal zinc supplementation reduces diarrheal morbidity in peruvian infants. Effects of alternative maternal micronutrient supplements on low birth weight in rural Nepal: double blind randomised community trial Adding zinc to prenatal iron and folate tablets improves fetal neurobehavioral development. Zinc supplementation during pregnancy and effects on growth and morbidity in low birthweight infants: a randomsied placebo controlled trial Effect of smoking on plasma ferritin concentrations in pregnant women. Differing effects of low and high bulk maternal dietary supplements during pregnancy. Adolescent pregnancy: associations among body weight, zinc nutriture, and pregnancy outcome. Zinc supplementation during pregnancy: a double blind randomised controlled trial
OBJECTIVES The aim of this study was to assess the effect of high dose zinc ( Zn ) supplement during pregnancy in pregnancy outcome in healthy pregnant women with a previous preterm delivery in Isfahan , Iran . METHODS A double-blind placebo-controlled r and omized clinical trial was conducted between January 2007 and June 2008 . Eighty-four pregnant women with a previous preterm delivery age 19 to 35 years were r and omly allocated to receive either 50 mg/day Zn as Zn sulfate or placebo from 12 to 16 weeks of gestation till delivery . Pregnancy outcome was assessed in term of incidence of intrauterine growth retardation ( IUGR ) , birth weight , crown-heel length , head circumference , Apgar score , and gestational age at delivery . RESULTS The mean birth head circumference was higher in Zn supplemented group than in the placebo group ( 35.0 cm vs. 33.7 cm , P < 0.05 ) . Although gestational age at delivery ( 37.1 week vs. 36.7 week ) and birth weight ( 2960.6 g vs. 2819.0 g ) of babies born in Zn supplemented group was slightly higher than placebo group , it was not statistically significant . No significant differences were seen for infant length , Apgar score , and IUGR . CONCLUSIONS Adding Zn supplementation during pregnancy to routine care of women with a previous preterm delivery had no significant effect on the gestational age at delivery and birth weight but increased the birth head circumference OBJECTIVE --To see whether zinc supplementation during pregnancy improves maternal and fetal outcome . DESIGN -- Prospect i ve study started at booking and continued till discharge of mother and baby from the maternity hospital . Mothers were r and omly assigned to receive zinc supplementation or placebo in a double blind trial . SETTING --Mothers booking at one hospital . PATIENTS --Women booking before 20 weeks of gestation who agreed to take part in the study . 494 Mothers were followed up till the end of pregnancy . There was no difference between the groups given zinc and placebo in their social or medical background s. INTERVENTIONS --Mothers in the active treatment group received one capsule of 20 mg elemental zinc daily and those in the placebo treated group a capsule identical in appearance and taste with the active capsule but which contained inert substances . MAIN OUTCOME MEASURE -- Various adverse outcomes were tested , including maternal bleeding , hypertension , complications of labour and delivery , gestational age , Apgar scores , and neonatal abnormalities . The main outcome measure was birth weight . RESULTS --There were no differences whatsoever between mothers given a zinc supplement and those given a placebo . CONCLUSION --Zinc supplementation in pregnancy in the United Kingdom does not seem to offer any benefits to the mother or her fetus Pakistan lies in a zinc deficient area where oral zinc supplementation has been advocated for various reasons . A double blind , r and omised case-control study was carried out on pregnant women to evaluate the effects of  oral zinc supplementation  on the weights of newborns .  No significant difference was found in the birth weights between the cases supplemented with 20 mg elemental zinc and controls receiving oral placebos ( p = 0.57 ) The beneficial effects of the oral application of zinc aspartate in pregnancy is investigated in a r and omly selected study group of 179 patients and a control group of 345 patients . This study confirms the prophylactic effectiveness of zinc replacement in reducing the overall complication rate for both mother and fetus and in particular for large-for- date and small-for- date infants . The therapy is well tolerated and accepted by the patients and causes no side effects . The results are in line with those of other working groups reporting on zinc as an important element with protective effects on fetal growth and development in pregnancy OBJECTIVE To determine whether prenatal vitamin A and /or Zn supplementation affects postnatal growth . DESIGN Follow-up of a r and omized controlled trial monitoring growth in children from birth up to 24 months of age . SETTING Central Java , Indonesia . SUBJECTS Children ( n 343 ) of mothers participating in a double-blinded , r and omized controlled study of vitamin A and /or Zn supplementation during pregnancy . We report the effects of prenatal supplementation on infant growth , measured as weight-for-age Z-scores ( WAZ ) , height-for-age Z-scores ( HAZ ) and weight-for-height Z-scores ( WHZ ) , from 0 to 24 months , as well as differences in growth faltering among the supplementation groups . RESULTS For HAZ , the absolute differences between the vitamin A-only and vitamin A + Zn groups at 3 and 9 months were 0·34 SD and 0·37 SD , respectively , and the absolute difference between the vitamin A-only and Zn-only groups at 18 months was 0·31 SD . Compared with placebo , none of the supplements affected growth . Defining growth faltering as a downward crossing of two or more major percentile lines , 50 - 75 % of the children were found to be growth faltering within 9 months of age , whereas 17 % and 8 % scored < -2 SD for WAZ and HAZ , respectively . Prenatal supplementation did not reduce the prevalence of growth faltering . CONCLUSIONS Prenatal vitamin A supplementation had a small but significant effect on postnatal growth of children 's length until 18 months of age compared with supplementation with either vitamin A + Zn or Zn alone , but not compared with placebo . It had no effects on other anthropometric measures and did not reduce the prevalence of growth faltering . Future studies should duplicate these findings before recommendations can be made As a follow-up of our study of pregnant women , we report effects of zinc supplementation during pregnancy in another population of 138 Hispanic teenagers in Los Angeles . Teenagers were r and omized ( double-blind ) to a control or zinc-supplemented group and received similar daily vitamin and mineral supplements except for 20 mg zinc added to the zinc-supplemented group 's capsules . Initially , mean dietary zinc intakes of both groups were about 50 % of the Recommended Dietary Allowance and their mean serum zinc levels did not differ significantly ( 69.8 + /- 11.2 micrograms/dl in control and 69.0 + /- 11.4 micrograms/dl in zinc-supplemented group ) . Zinc supplementation did not maintain mean serum zinc levels during pregnancy but , as in our earlier study , it reduced ( p = 0.018 ) the number of low serum zinc values ( less than or equal to 53 micrograms/dl ) in late pregnancy . Zinc supplementation did not affect outcome of pregnancy but serum zinc levels were lower ( p = 0.038 ) in teenagers with pregnancy-induced hypertension than in normotensives BACKGROUND In observational studies , the zinc status of HIV-infected persons has been associated with both positive and adverse clinical outcomes . Such endpoints may affect the risk of adverse birth outcomes among HIV-infected women . OBJECTIVE We examined the effects of zinc supplements on birth outcomes , hematologic indicators , and counts of T lymphocyte subsets among 400 HIV-infected pregnant women . DESIGN Eligible women between 12 and 27 wk of gestation were r and omly assigned to daily oral supplementation with either 25 mg Zn or placebo between recruitment and 6 wk after delivery . All women received iron , folic acid , and multivitamin supplements irrespective of the experimental assignment . RESULTS We observed no significant differences in birth weight , duration of gestation , or fetal and neonatal mortality between women in the zinc and placebo groups . Hemoglobin concentrations increased between baseline and 6 wk postpartum in both groups . However , the rise in hemoglobin over this period was significantly lower ( P = 0.03 ) in the zinc group ( x + /- SD : 11.5 + /- 17.9 g/L ) than in the placebo group ( 15.2 + /- 18.6 g/L ) . Similarly , the changes in red blood cell count and in packed cell volume over the same period were significantly lower in the zinc group ( P < 0.01 and P = 0.01 , respectively ) . Zinc had no effect on CD4(+ ) , CD8(+ ) , or CD3(+ ) cell counts during the follow-up period . CONCLUSION Because of the lack of beneficial effects of zinc on adverse pregnancy outcomes and the likelihood of negative effects on hemoglobin concentrations , no compelling evidence exists to support the addition of zinc to prenatal supplements intended for pregnant HIV-infected women Iron deficiency is one of the main causes of anemia during pregnancy , although other micronutrient deficiencies may play a role . We examined the effects of daily antenatal and postnatal supplementation with four combinations of micronutrients on  maternal hematologic indicators  in a double-masked r and omized controlled community trial . Communities , called sectors , were r and omly assigned to supplementation with folic acid ( 400 microg ) , folic acid plus iron ( 60 mg ) , folic acid plus iron and zinc ( 30 mg ) and folic acid plus iron , zinc and 11 other micronutrients , each at the approximate recommended daily allowance for pregnancy all given with vitamin A as retinol acetate ( 1000 microg retinol equivalent ) , or vitamin A alone as the control group .  Hemoglobin ( Hb ) and indicators of iron status were assessed at baseline and at 32 wk of gestation . At 6-wk postpartum , Hb assessment was repeated using a finger stick . Severely anemic women ( Hb < 70 g/L ) were treated according to WHO recommendations . Folic acid alone had no effect on maternal anemia or iron status . Hb concentrations were 14 g/L , [ 95 % confidence limits ( CL ) , 8.3 - 19.2 ] , 10.0 g/L ( CL , 5.2 - 14.8 ) and 9.4 g/L ( CL , 4.7 - 14.1 ) higher in the groups receiving folic acid plus iron , folic acid plus iron and zinc and folic acid plus iron , zinc and multiple micronutrients , respectively , relative to the control . Anemia in the third trimester was reduced by 54 % with folic acid plus iron , by 48 % with folic acid plus iron and zinc and by 36 % with folic acid plus iron , zinc and multiple micronutrients supplementation , relative to the control ( P < 0.05 ) . Thus , the combinations of folic acid plus iron and zinc and folic acid plus iron , zinc and multiple micronutrients provided no additional benefit in improving maternal hematologic status during pregnancy compared with folic acid plus iron . The level of compliance and baseline Hb concentrations modified the effect of iron BACKGROUND Zinc deficiency may result in abnormal dark adaptation or night blindness , a symptom primarily of vitamin A deficiency . During a placebo-controlled trial in Nepal , weekly vitamin A supplementation of women reduced but failed to eliminate the incidence of night blindness during pregnancy , suggesting a role for zinc . OBJECTIVE The study examined the efficacy of daily zinc supplementation in restoring night vision of pregnant women who developed night blindness while routinely receiving either vitamin A , beta-carotene , or placebo in a field trial . DESIGN Women ( n = 202 ) who reported to be night blind during pregnancy were r and omly assigned in a double-blind manner , stratified on vitamin A , beta-carotene , or placebo receipt , to receive 25 mg Zn or placebo daily for 3 wk . Thus , the 6 groups studied were as follows : beta-carotene + zinc , beta-carotene alone , vitamin A + zinc , vitamin A alone ( vitamin A + placebo ) , zinc alone ( zinc + placebo ) , and placebo ( 2 placebos : one for the vitamin A or beta-carotene study and one for the zinc study ) . Women underwent a clinic-based assessment that included pupillary threshold testing and phlebotomy before and after supplementation . Supplement use and daily history of night blindness were obtained at home twice every week . RESULTS Zinc treatment increased serum zinc concentrations , but alone ( zinc alone group ) , failed to restore night vision or to improve dark adaptation . However , women in the vitamin A + zinc group who had baseline serum zinc concentrations < 9.9 micromol/L were 4 times more likely to have their night vision restored ( 95 % CI : 1.1 , 17.3 ) than were women in the placebo group and tended to have a small improvement in pupillary threshold scores ( by 0.21 log c and ela/m2 ; P = 0.09 ) . CONCLUSION These data suggest that zinc potentiated the effect of vitamin A in restoring night vision among night-blind pregnant women with low initial serum zinc concentrations Prenatal iron supplements may adversely influence zinc absorption during pregnancy . To examine the impact of prenatal iron supplements on supplemental zinc absorption , fractional zinc absorption was measured in 47 pregnant Peruvian women during the third trimester of pregnancy ( 33 + /- 1 wk gestation ) . Of these 47 women , 30 received daily prenatal supplements  from wk 10 - 24 of pregnancy until delivery . Supplements contained 60 mg of Fe and 250 microg of folate without [ iron group ( Fe ) , n = 16 ] or with [ iron and zinc supplemented group ( Fe + Zn ) , n = 14 ] 15 mg of Zn . The remaining 17 women [ unsupplemented control group ( C ) ] received no prenatal supplementation .  Zinc concentrations were measured in plasma , urine and cord blood and percentage zinc absorption was determined following dosing with oral ( (67)Zn ) and intravenous ( (70)Zn ) stable zinc isotopes . Percentage zinc absorption was significantly lower than controls in fasting women receiving iron- containing prenatal supplements ( 20.5 + /- 6.4 vs. 20.2 + /- 4.6 vs. 47.0 + /- 12.6 % , Fe , Fe + Zn and C groups , respectively , P : < 0.0001 , n = 40 ) . Plasma zinc concentrations were also significantly lower in the Fe group compared to the C group ( 8.2 + /- 2.2 vs. 9.2 + /- 2.2 vs. 10.9 + /- 1 . 8 micromol/L , Fe , Fe + Zn and C groups , respectively , P : = 0.002 ) , and cord zinc concentrations were significantly related to maternal plasma Zn levels ( y = 6.383 + 0.555x , r = 0.486 , P : = 0.002 ) . The inclusion of zinc in prenatal supplements may reduce the potential for iron supplements to adversely influence zinc status in population s at risk for deficiency of both these nutrients Maternal malnutrition continues to be a major contributor to adverse reproductive outcomes in developing countries , despite longst and ing efforts to fortify foods or to distribute medicinal supplements to pregnant women . The objective of this study was to test the effect of a micronutrient-fortified beverage containing 11 micronutrients ( iron , iodine , zinc , vitamin A , vitamin C , niacin , riboflavin , folate , vitamin B-12 , vitamin B-6 and vitamin E ) on the hemoglobin , iron and vitamin A status of pregnant women in Tanzania . A group of 259 pregnant women with gestational ages of 8 to 34 wk were enrolled in a r and omized double-blind controlled trial in which study women received 8 wk of supplementation .  Hemoglobin , ferritin and dried blood spot retinol were measured at baseline and at the end of the supplementation period . The supplement result ed in a 4.16 g/L increase in hemoglobin concentration and a 3 micro g/L increase in ferritin and reduced the risk of anemia and iron deficiency anemia by 51 and 56 % , respectively . The risk of iron deficiency was reduced by 70 % among those who had iron deficiency at baseline and by 92 % among those who had adequate stores . The micronutrient-fortified beverage may be a useful and convenient preventative measure , one that could help improve the nutritional status of women both before and during pregnancy and thereby help avoid some of the potential maternal and fetal consequences of micronutrient deficiencies To estimate the effect of maternal zinc deficiency on pregnancy outcomes , we conducted a zinc supplementation trial in an urban shantytown in Lima , Peru , a population with habitual low zinc intakes . Beginning at 10 - 24 wk gestation , 1295 mothers were r and omly assigned to receive prenatal supplements containing 60 mg iron and 250 ( g folate , with or without 15 mg zinc . Women were followed up monthly during pregnancy . At birth , newborn weight was recorded , and crownheel length , head circumference and other circumferences and skinfold thicknesses were assessed on d 1 . At delivery , 1016 remained in the study ;  duration of pregnancy  was known for all women , and birth weight information was available for 957 newborns . No differences were noted in duration of pregnancy ( 39.4 + /- 2.2 vs. 39 . 5 + /- 2.0 wk ) or birth weight ( 3267 + /- 461 vs. 3300 + /- 498 g ) by prenatal supplement type ( iron + folate + zinc vs. iron + folate ; P > 0.05 ) , and there were no differences in the rates of preterm ( < 37 wk ) or post-term ( > 42 wk ) delivery , low birth weight ( < 2500 g ) or high birth weight ( > 4000 g ) . Finally , there were no differences by prenatal supplement type in newborn head circumference , crownheel length , chest circumference , mid-upper arm circumference , calf circumference or skinfold thickness at any of three sites . Adjustment for covariates and confounding factors did not alter these results . Adding zinc to prenatal iron and folate tablets did not affect duration of pregnancy or size at birth in this population BACKGROUND Maternal zinc deficiency during pregnancy may be widespread among women in developing countries , but few data are available on whether prenatal zinc supplementation improves maternal and neonatal zinc status . OBJECTIVE We studied whether maternal zinc supplementation improved the zinc status of mothers and neonates participating in a supplementation trial in a shantytown in Lima , Peru . DESIGN Beginning at gestation week 10 - 24 , 1295 mothers were r and omly assigned to receive prenatal supplements containing 60 mg Fe and 250 microg folate , with or without 15 mg Zn .  Venous blood and urine sample s were collected at enrollment , at gestation week 28 - 30 , and at gestation week 37 - 38 . At birth , a sample of cord vein blood was collected . We measured serum zinc concentrations in 538 women , urinary zinc concentrations in 521 women , and cord zinc concentrations in 252 neonates . RESULTS At 28 - 30 and 37 - 38 wk , mothers receiving zinc supplements had higher serum zinc concentrations than mothers who did not receive zinc ( 8.8 + /- 1.9 compared with 8.4 + /- 1.5 micromol/L and 8.6 + /- 1.5 compared with 8.3 + /- 1.4 micromol/L , respectively ) . Urinary zinc concentrations were also higher in mothers who received supplemental zinc ( P < 0.05 ) . After adjustment for covariates and confounding factors , neonates of mothers receiving zinc supplements had higher cord zinc concentrations than neonates of mothers who did not receive zinc ( 12.7 + /- 2.3 compared with 12.1 + /- 2.1 micromol/L ) . Despite supplementation , maternal and neonatal zinc concentrations remained lower than values reported for well-nourished population s. CONCLUSION Adding zinc to prenatal iron and folate tablets improved maternal and neonatal zinc status , but higher doses of zinc are likely needed to further improve maternal and neonatal zinc status in this population BACKGROUND We previously reported that maternal micronutrient supplementation in rural Nepal decreased low birth weight by approximately 15 % . OBJECTIVE We examined the effect of daily maternal micronutrient supplementation on  fetal loss and infant mortality .  DESIGN The study was a double-blind , cluster-r and omized , controlled trial among 4926 pregnant women and their 4130 infants in rural Nepal . In addition to vitamin A ( 1000 microg retinol equivalents ) , the intervention groups received either folic acid ( FA ; 400 microg ) , FA + iron ( 60 mg ) , FA + iron + zinc ( 30 mg ) , or multiple micronutrients ( MNs ; the foregoing plus 10 microg vitamin D , 10 mg vitamin E , 1.6 mg thiamine , 1.8 mg riboflavin , 2.2 mg vitamin B-6 , 2.6 microg vitamin B-12 , 100 mg vitamin C , 64 microg vitamin K , 20 mg niacin , 2 mg Cu , and 100 mg Mg ) . The control group received vitamin A only . RESULTS None of the supplements reduced fetal loss . Compared with control infants , infants whose mothers received FA alone or with iron or iron + zinc had a consistent pattern of 15 - 20 % lower 3-mo mortality ; this pattern was not observed with MNs . The effect on mortality was restricted to preterm infants , among whom the relative risks ( RRs ) were 0.36 ( 95 % CI : 0.18 , 0.75 ) for FA , 0.53 ( 0.30 , 0.92 ) for FA + iron , 0.77 ( 0.45 , 1.32 ) for FA + iron + zinc , and 0.70 ( 0.41 , 1.17 ) for MNs . Among term infants , the RR for mortality was close to 1 for all supplements except MNs ( RR : 1.74 ; 95 % CI : 1.00 , 3.04 ) . CONCLUSIONS Maternal micronutrient supplementation failed to reduce overall fetal loss or early infant mortality .  Among preterm infants , FA alone or with iron reduced mortality in the first 3 mo of life . MNs may increase mortality risk among term infants , but this effect needs further evaluation BACKGROUND Maternal zinc supplementation has been suggested as a potential intervention to reduce the incidence of low birth weight in developing countries . To date , placebo-controlled trials have all been performed in industrialized countries and the results are inconsistent . OBJECTIVE The objective of this study was to evaluate whether zinc supplementation in Bangladeshi urban poor during the last 2 trimesters of pregnancy was associated with pregnancy outcome . DESIGN We conducted a double-blind , placebo-controlled trial in which 559 women from Dhaka slums , stratified by parity between 12 and 16 wk of gestation , were r and omly assigned to receive 30 mg elemental Zn/d ( n = 269 ) or placebo ( n = 290 ) . Supplementation continued until delivery .  Serum zinc was estimated at baseline and at 7 mo of gestation . Dietary intake was assessed at baseline and anthropometric measurements were made monthly . Weight , length , and gestational ages of 410 singleton newborns were measured within 72 h of birth . RESULTS At 7 mo of gestation , serum zinc concentrations tended to be higher in the zinc-supplemented group than in the placebo group ( 15.9 + /- 4.4 compared with 15.2 + /- 4.3 micromol/L ) . No significant effect of treatment was observed on infant birth weight ( 2513 + /- 390 compared with 2554 + /- 393 g ; NS ) or on gestational age , infant length , or head , chest , or midupper arm circumference . The incidence and distribution of low birth weight , prematurity , and smallness for gestational age also did not differ significantly after zinc supplementation . CONCLUSIONS Supplementation with 30 mg elemental Zn during the last 2 trimesters of pregnancy did not improve birth outcome in Bangladeshi urban poor . These results indicate that interventions with zinc supplementation alone are unlikely to reduce the incidence of low birth weight in Bangladesh BACKGROUND It is estimated that 60 % of pregnant women worldwide are anemic . OBJECTIVE We aim ed to examine the influence of iron status on iron absorption during pregnancy by measuring supplemental iron absorption , red blood cell iron incorporation , and iron status in pregnant women .  DESIGN Subjects were 45 pregnant Peruvian women ( 33+/-1 wk gestation ) , of whom 28 received  daily prenatal supplements containing 60 mg Fe and 250 microg folate without ( Fe group , n = 14 ) or with ( Fe+Zn group , n = 14 ) 15 mg Zn , which were were consumed from week 10 to 24 of gestation until delivery . The remaining 17 women ( control ) received no prenatal supplementation .  Iron status indicators and isotopes were measured in maternal blood collected 2 wk postdosing with oral ( 57Fe ) and intravenous ( 58Fe ) stable iron isotopes . RESULTS Maternal serum ferritin and folate concentrations were significantly influenced by supplementation ( P < 0.05 ) . Serum iron was also significantly higher in the Fe than in the Fe+Zn ( P < 0.03 ) or control ( P < 0.001 ) groups . However , the supplemented groups had significantly lower serum zinc concentrations than the control group ( 8.4+/-2.3 and 10.9+/-1.8 micromol/L , respectively , P < 0.01 ) . Although percentage iron absorption was inversely related to maternal serum ferritin concentrations ( P = 0.036 ) , this effect was limited and percentage iron absorption did not differ significantly between groups . CONCLUSIONS Because absorption of nonheme iron was not substantially greater in pregnant women with depleted iron reserves , prenatal iron supplementation is important for meeting iron requirements during pregnancy BACKGROUND Little is known about how maternal zinc intake influences growth in utero and in postnatal life in humans . OBJECTIVE We aim ed to assess the effect of maternal zinc supplementation during pregnancy on infant growth through age 1 y. DESIGN A double-blind , r and omized controlled trial of prenatal zinc supplementation was conducted from 1995 to 1997 in Lima , Peru . Women ( n = 1295 ) were enrolled at 15.6 + /- 4.6 wk gestation and assigned to receive daily supplements with zinc ( 15 mg Zn + 60 mg Fe + 250 microg folic acid ) or without zinc ( 60 Fe + 250 microg folic acid ) through pregnancy to 1 mo after delivery . At birth , 546 infants were followed for 12 mo to assess growth . Anthropometric measures of body size and composition were collected monthly , and morbidity and dietary intake surveillance was carried out weekly . RESULTS No differences in maternal socioeconomic characteristics by treatment group or follow-up period were found . Infants born to mothers prenatally supplemented with zinc had significantly ( P < 0.05 ) larger average growth measures beginning in month 4 and continuing through month 12 . In longitudinal regression modeling , prenatal zinc was associated with greater weight ( by 0.58 + /- 0.12 kg ; P < 0.001 ) , calf circumference ( by 1.01 + /- 0.21 cm ; P < 0.001 ) , chest circumference ( by 0.60 + /- 0.20 cm ; P = 0.002 ) , and calf muscle area ( by 35.78 + /- 14.75 mm(2 ) ; P = 0.01 ) after adjustment for a range of covariates . No effect was observed for linear growth . CONCLUSION Maternal zinc supplementation in this population was associated with offspring growth , which is suggestive of lean tissue mass accretion The effects of zinc supplementation on levels of various blood constituents and the outcome of pregnancy  in 213 Hispanic women attending a prenatal clinic in Los Angeles was assessed in this double-blind study . The women were r and omized into either a control ( C ) or a zinc-supplemented ( Z ) group and received similar vitamin and mineral supplements except that 20 mg zinc was added to the Z group 's capsules . At the final interview , women ( C + Z ) with low serum Zn levels ( less than or equal to 53 micrograms/dl ) had higher ( p less than 0.01 ) mean ribonuclease activity and lower ( p less than 0.01 ) mean delta-aminolevulinic acid dehydratase activity than women with acceptable serum zinc levels . The incidence of pregnancy-induced hypertension was higher ( p less than 0.003 ) in the C than in the Z group , but pregnancy-induced hypertension was not associated with low serum zinc levels at either the initial or final interview . The expected increase in serum copper levels was greater ( less than 0.001 ) in women with pregnancy-induced hypertension ( C + Z ) than in normotensives . Except for pregnancy-induced hypertension , there was a higher incidence of abnormal outcomes of pregnancy in the noncompliers than in the compliers ( C + Z ) BACKGROUND Maternal zinc deficiency is relatively common in developing countries , but its consequences for fetal growth are not established . OBJECTIVE The goal was to examine whether improvement in maternal gestational zinc status is positively associated with fetal growth as assessed by ultrasonography . DESIGN We conducted a double-masked , r and omized trial among 242 pregnant Peruvian women in an impoverished shantytown in Lima , Peru . At 10 - 16 wk of gestation , the women were r and omly assigned to receive daily supplements containing 60 mg Fe and 250 microg folic acid , with or without 25 mg Zn . We measured fetal head circumference , biparietal diameter , abdominal circumference , and femur diaphysis length at 20 , 24 , 28 , 32 , 36 , and 38 wk of gestation . Fetal measures were analyzed longitudinally to evaluate differences in trends of fetal growth by supplement type , and within-subject correlations were taken into account . RESULTS Femur diaphysis length was greater in fetuses whose mothers received zinc supplements ( P < 0.05 ) , and the difference tended to increase with gestational age . No significant differences by supplement type were observed for the other anatomical sites measured . CONCLUSIONS The observed positive effect of prenatal zinc on fetal femur diaphysis length is consistent with the results of experimental studies in animals and in vitro . The supplementation effect represents an upward shift in mean femur diaphysis length at term of about one-quarter of the reference SD . These findings suggest the potential importance of maternal zinc status for fetal bone growth in humans and illustrate the value of ultrasonography for evaluating the effect of prenatal nutritional interventions on components of fetal growth Dietary zinc ( Zn ) intake and selected biochemical indices of Zn status were studied longitudinally at monthly intervals in 46 pregnant middle-income women , 10 of whom received a daily supplement of 15 mg Zn .  Mean dietary Zn intake for the nonsupplemented subjects ( group A ) was 11.3 + /- 4.1 mg/day ( 56 % of the Recommended Dietary Allowances ) , and for the Zn-supplemented subjects ( group B ) was 21.7 mg/day ( 109 % of the Recommended Dietary Allowance ) , including an average intake of 11.1 mg/day as supplemental Zn . The mean plasma Zn concentration of group A at 2 months gestation , 71.4 + /- 9.8 micrograms/dl , was 17 % lower than that of nonpregnant control women , and continued to decline significantly ( p less than 0.01 ) between 2 and 10 months gestation . Plasma Zn of group B did not differ significantly from group A at any stage of gestation . Mean serum alkaline phosphatase activity of group B was higher than that of group A at 7 of 8 months studied ( p less than 0.05 ) . The level of prenatal iron supplementation  in group A was negatively correlated with alkaline phosphatase activity and plasma Zn in the 2nd and 3rd trimesters , respectively . It is concluded that an early and progressive decline in plasma Zn which is not influenced by Zn intake occurs during gestation . Tentative st and ards for lower limits of normal at monthly intervals have been suggested . The higher alkaline phosphatase activity of group B compared with group A suggested that the dietary Zn intake of the latter was suboptimal . Prenatal supplemental iron may adversely affect maternal Zn status BACKGROUND A negative effect of prenatal zinc deficiency on brain function has been well established in experimental animals , but this association in humans is controversial . OBJECTIVE We evaluated the effect of prenatal zinc supplementation on the mental and psychomotor development of 355 children whose mothers participated in a double-blind trial of zinc supplementation that result ed in increased head circumference and birth weight .  DESIGN The children took 6 tests-the Differential Ability Scales , Visual Sequential Memory , Auditory Sequential Memory , Knox Cube , Gross Motor Scale , and Grooved Pegboard tests-at a mean age of 5.3 y. The scores were compared between the children of women who received a daily oral dose of 25 mg Zn during the second half of pregnancy and the children of women who received placebo . RESULTS There were no differences in the test scores of neurologic development between the 2 groups . We analyzed the scores in 4 subgroups on the basis of maternal body mass index , because the increases in birth weight and head circumference due to the supplementation occurred only in the children of women with a body mass index ( in kg/m(2 ) ) < 26.0 in the original trial . No differences in the scores were found between these subgroups . CONCLUSIONS Zinc supplementation of women in the latter half of pregnancy had no effect on the neurologic development of their children at age 5 y. It is not known whether our findings of no positive effect in the population with apparently inadequate zinc nutriture can be readily extrapolated to other population BACKGROUND Previously we showed that women in rural Nepal experience multiple micronutrient deficiencies in early pregnancy . OBJECTIVE This study examined the effects of daily antenatal micronutrient supplementation on changes in the biochemical status of several micronutrients during pregnancy . DESIGN In Nepal , we conducted a r and omized controlled trial in which 4 combinations of micronutrients ( folic acid , folic acid + iron , folic acid + iron + zinc , and a multiple micronutrient supplement containing folic acid , iron , zinc , and 11 other nutrients ) plus vitamin A , or vitamin A alone as a control , were given daily during pregnancy . In a sub sample of subjects ( n = 740 ) , blood was collected both before supplementation and at approximately 32 wk of gestation . RESULTS In the control group , serum concentrations of zinc , riboflavin , and vitamins B-12 and B-6 decreased , whereas those of copper and alpha-tocopherol increased , from the first to the third trimester . Concentrations of serum folate , 25-hydroxyvitamin D , and undercarboxylated prothrombin remained unchanged . Supplementation with folic acid alone or folic acid + iron decreased folate deficiency . However , the addition of zinc failed to increase serum folate , which suggests a negative inhibition ; multiple micronutrient supplementation increased serum folate .  Folic acid + iron + zinc failed to improve zinc status but reduced sub clinical infection .  Multiple micronutrient supplementation decreased the prevalence of serum riboflavin , vitamin B-6 , vitamin B-12 , folate , and vitamin D deficiencies but had no effect on infection . CONCLUSIONS In rural Nepal , antenatal supplementation with multiple micronutrients can ameliorate , to some extent , the burden of deficiency . The implication s of such biochemical improvements in the absence of functional and health benefits remain unclear BACKGROUND Iron deficiency anemia is the most prevalent nutrient deficiency during pregnancy , yet there are few data on the effect of prenatal iron supplementation in women in developing countries . OBJECTIVE Our objective was to describe the effect of iron supplementation on hematologic changes during pregnancy , and the effect on those changes of adding zinc to the supplements . DESIGN Pregnant women were enrolled in a r and omized , double-masked study conducted at a hospital in a shantytown in Lima , Peru . Women were supplemented daily from 10 - 24 wk gestation to 4 wk postpartum with 60 mg Fe and 250 microg folic acid with or without 15 mg Zn .  Hemoglobin and ferritin concentrations were measured in 645 and 613 women , respectively , at enrollment , at 28 - 30 and 37 - 38 wk gestation , and in the cord blood of 545 neonates . RESULTS No differences in iron status were detected by supplement type , but hematologic changes were related to initial hemoglobin status . Women with anemia ( hemoglobin < 110 g/L ) showed steady increases in hemoglobin concentration throughout pregnancy whereas women with relatively higher initial hemoglobin concentrations had declining values during mid pregnancy , then rising values by 37 - 38 wk gestation . Women with an initial hemoglobin concentration > 95 g/L showed increases in serum ferritin by the end of the pregnancy . Despite supplementation , women with poorer hematologic status ; who were younger , single , and multiparous ; and who consumed fewer supplements were more likely to have anemia at the end of pregnancy . CONCLUSIONS These hematologic changes are congruent with the effects of iron supplementation reported in placebo-controlled trials and the addition of zinc did not significantly affect them The effect of zinc supplementation on concentrations of zinc in hair and serum of 213 pregnant Hispanic women attending a clinic in Los Angeles was assessed using a r and om , double-blind experiment . Both the treatment ( T ) and control ( C ) groups received similar vitamin and mineral supplements except that 20 mg zinc was added to the supplements for the treatment group . Nutrient intakes were calculated from 24-h recalls . The initial mean dietary  zinc intake of both groups was about 50 % of the Recommended Dietary Allowance ( 9 + /- 5 mg ) . Initially there were no significant differences between the two groups in mean zinc levels in serum ( 66 + /- 11 micrograms/dl , C , and 65 + /- 12 micrograms/dl , T ) or in hair ( 184 + /- 41 micrograms/g , C , and 175 + /- 38 micrograms/g , T ) . Zinc supplementation did not alter mean zinc levels in serum or hair but significantly ( p less than 0.05 ) reduced the number of low serum zinc values ( less than or equal to 53.3 micrograms/dl ) toward the end of pregnancy . Although serum zinc levels do decline in pregnancy , our results suggest that severely depressed levels ( less than or equal to 50 to 55 micrograms/dl ) indicate inadequate zinc status Although iron and zinc deficiencies are known to occur together and also appear to be high in Ghana , a few supplementation studies addressed this concurrently in pregnancy . In a double-blind , r and omized controlled trial , 600 pregnant women in Ghana were r and omly assigned to receive either a combined supplement of 40 mg of zinc as zinc gluconate and 40 mg of iron as ferrous sulphate or 40 mg of elemental iron as ferrous sulphate . Overall , there was no detectable difference in the mean birthweight between the study groups , although the effect of  iron-zinc supplementation on the mean birthweight was masked by a strong interaction between the type of supplement and the iron status of participants [ F (1,179)=5.614 , p=0.019 ] . Prenatal iron-zinc supplementation was effective in increasing the mean birthweight among anaemic and iron-deficient women but not among women with elevated iron stores in early pregnancy BACKGROUND Prenatal supplementation with micronutrients may increase birth weight and thus improve infant health and survival in setting s where infants and children are at risk of micronutrient deficiencies . OBJECTIVE To assess whether vitamin A and /or zinc supplementation given during pregnancy can improve birth weight , birth length , neonatal morbidity , or infant mortality . METHODS A double-blind , r and omized controlled trial supplementing women ( n = 2173 ) in Central Java , Indonesia throughout pregnancy with vitamin A , zinc , combined vitamin A+zinc , or placebo . RESULTS Out of 2173 supplemented pregnant women , 1956 neonates could be evaluated . Overall , zinc supplementation improved birth length compared to placebo or combined vitamin A+zinc ( 48.8 vs. 48.5 cm , p = 0.04 ) ; vitamin A supplementation improved birth length compared to placebo or combined vitamin A+zinc ( 48.7 vs. 48.2 cm , p = 0.04 ) . These effects remained after adjusting for maternal height , pre-pregnancy weight , and parity . There was no effect of supplementation on birth weight , the proportion of low birth weight , neonatal morbidity , or mortality . CONCLUSIONS Prenatal zinc or vitamin A supplementation demonstrates a small but significant effect on birth length , but supplementation with zinc , vitamin A or a combination of zinc and vitamin A , have no effect on birth weight , neonatal morbidity , or mortality OBJECTIVE In spite of interventions being put in place to reduce the burden of maternal anaemia and malaria in Ghana , they continue to impact negatively on pregnancy outcomes . It is unclear whether there are some other factors that limit the effectiveness of these interventions . The aim of this study was to explore whether there are benefits associated with the addition of zinc to the routine malaria chemoprophylaxis , iron and folic acid intervention package for pregnant women in Ghana . DESIGN A double-blind , r and omised controlled trial ( RCT ) conducted in the Upper West Region of Ghana . RESULTS Iron-zinc supplementation reduced the risk of increased malaria parasitaemia associated with high maternal serum ferritin and Hb concentrations . Iron-zinc supplementation was associated with reduced malaria parasite densities , F ( 1 , 20 ) = 4.744 , p = 0.042 . Iron and zinc provided in the ratio of 1:1 prevented a significant decline in maternal iron stores of pregnant women . Adjusted geometric mean serum ferritin concentration in the Iron-zinc Group was significantly higher than in the Control Group ( 22.9 microg/L versus 16.9 microg/L ) , F ( 1 , 156)= 6.336 , p = 0.013 CONCLUSIONS Joint iron and zinc supplementation appears to be a better option than iron-only supplementation in malaria-endemic areas We hypothesized that plasma extracellular superoxide dismutase ( EC-SOD ) activity reflects the zinc nutriture of healthy pregnant women . Sixty-three women were selected from 580 African-American women who participated in a clinical trial to evaluate the effect of prenatal zinc supplementation on pregnancy outcome . Half of the women received zinc ( 25 mg/d ) and the other half was given a placebo from about 19 wk gestation to delivery . In the trial , a positive effect of zinc supplementation on birthweight was observed , indicating that the population as a whole had suboptimal zinc nutriture . Using plasma sample s obtained during the trial , EC-SOD activities were measured and the values were compared with plasma zinc concentrations and plasma alkaline phosphatase activities . Plasma EC-SOD activities in our subjects were lower than previously published values for healthy adults in Korea . Although plasma EC-SOD activity may reflect severe zinc deficiency , it is not a sensitive marker for marginal deficiency status . Plasma EC-SOD activities did not prove to be a better indicator of zinc nutriture of pregnant women than either plasma zinc or plasma alkaline phosphatase activities In the present study , pregnant women in different trimesters of pregnancy were r and omly allocated to  untreated control group ( Gp A ; n = 58 ) , and  zinc treated group ( Gp B ; n = 104 ) . Both groups were administered ferrous sulphate 60 mg , and folic acid 5 mg , twice daily throughout the period of study . Gp B subjects were also administered 45 mg elemental zinc , in a single daily post lunch dose . Maternal blood and urine sample s collected in each trimester , and at the time of delivery , and blood taken from the umbilical cord were tested for Cu levels . Maternal Hb was also estimated . In Gp A , mean serum Cu increased significantly from 117.15 + /- 2.12 micrograms/dl in I trimester to 138.57 + /- 0.92 micrograms/dl in III trimester ( P < 0.001 ) . In Gp B , serum Cu declined significantly from 115.64 + /- 1.12 micrograms/dl in I trimester to 111.10 + /- 0.99 micrograms/dl in III trimester ( P < 0.001 ) . Urinary Cu declined significantly from 47.24 + /- 2.31 micrograms/24 hrs in I trimester to 37.43 + /- 2.06 micrograms/24 hrs in III trimester ( P < 0.01 ) . Zn treatment did not alter differentially the serum Cu levels in anaemic and normohaemic subjects . Gp B cord blood serum Cu was significantly lower as compared to respective controls , significance being proportional to duration of zinc administration . Hb levels increased significantly in all subjects . Increase in Hb in Gp B was significantly higher in comparison to that in Gp A ( P < 0.05 ) . Elemental zinc when administered to pregnant women in a dose of 20 - 45 mg/day , causes improvement in Hb level , without leading to hypocupremia Background / Objectives : Micronutrient deficiencies are prevalent worldwide , and a major cause of infant death . Supplementation with multiple micronutrients during pregnancy might improve micronutrient status of the newborn , thereby reducing morbidity and death . Moreover , maternal supplementation might affect the newborn 's immune development . Therefore , this study investigated the effects of maternal zinc and β-carotene supplementation on the  infant  's morbidity and immune function during the first 6 months of life . Subjects/ Methods : Mothers were supplemented during pregnancy  with β-carotene and /or zinc , in addition to iron and folic acid , in a r and omized , double-blind controlled trial . Newborn infants ( n=136 ) were followed up for 6 months . Results : Infants born from mothers receiving zinc during pregnancy had significantly fewer episodes of diarrhoea than infants born from mothers not receiving zinc ( 0.2 and 0.4 , respectively ) , but more episodes of cough ( 1.3 and 0.9 respectively ) during the first 6 months . Maternal β-carotene supplementation had no effect on infants ’ morbidity . Cytokine production in the newborns was affected by maternal zinc and β-carotene supplementation , with zinc supplementation giving higher interleukin-6 production ( 16 % higher ) , and β-carotene supplementation leading to lower interferon-γ production ( 36 % lower ) . Conclusions : This study shows that maternal supplementation with zinc and β-carotene affected the newborn 's immune development in specific ways , but only maternal zinc supplementation significantly affected morbidity in the infants . Addition of zinc to routine iron and folic acid supplements for pregnant women could be an effective way to reduce diarrhoeal disease during the first 6 months of life , albeit at the expense of more episodes of cough OBJECTIVE To evaluate the effects of usual dietary intake of zinc and of zinc supplementation during pregnancy on plasma and erythrocyte zinc concentrations . DESIGN A r and omized , double-blind , placebo-controlled trial . SUBJECTS Low-income African-American women ( n = 580 ) assigned r and omly to groups at 19 weeks of gestation . INTERVENTION A daily dose of zinc ( 25 mg ) or a placebo until delivery . MAIN OUTCOME MEASURES Plasma , erythrocyte , and dietary zinc levels . STATISTICAL ANALYSES Multiple regression and repeated measures analysis of variance . RESULTS In both the placebo and the supplemented groups , when all subjects were grouped by usual dietary zinc intake above or below the median ( 12 mg/day ) , results were the same : Women with high dietary zinc intake had higher erythrocyte zinc levels at the time of r and omization and at all subsequent measurements during pregnancy than those who had low dietary zinc intake ( P < or = .06 ; difference not significant for zinc-supplemented group ) ; no difference was observed for plasma zinc levels . On the other h and , when the subjects were stratified at the median by total daily zinc intake ( usual dietary zinc + 25 mg zinc supplement ) during pregnancy , a significant difference in plasma zinc levels ( P < .005 ) was found between women with high total zinc intake ( mean = 38 mg/day ) and low total intake ( mean = 13 mg/day ) at 26 , 32 , and 38 weeks of gestation ; however , no such differences were found in erythrocyte zinc levels . APPLICATIONS These results should help dietitians and other health professionals better underst and the expected changes in plasma and erythrocyte zinc levels during pregnancy , and the relationship between dietary and supplemental zinc and zinc nutriture The effect of diet supplementation throughout pregnancy on third-trimester amniotic fluid growth-supporting activity ( GSP ) was studied in 100 African women ; 32 were given zinc supplementation ,  22  each animal and vegetable supplements , respectively  , and 24 served as  control subjects .  No difference in GSP was noted in any of the four groups , the majority of fluids ( 65 % ) being noninhibitory . Zinc levels in fluids from African women were much lower than those described for other population groups at corresponding periods of gestation . Although zinc levels in liquor rose following dietary zinc supplementation , these remained lower than values described in white patients . In vitro addition of zinc ( up to 153 mu moles per liter final concentration ) to 17 noninhibitory African liquors result ed in these fluids becoming inhibitory OBJECTIVE The purpose of this study was to determine whether second-trimester plasma homocysteine levels are elevated among women whose pregnancies are subsequently complicated by pregnancy-induced hypertension , preeclampsia , or intrauterine growth restriction . STUDY DESIGN Women with normal but relatively low plasma zinc levels were r and omly assigned to receive zinc supplementation or placebo from 19 weeks ' gestation until delivery . Plasma homocysteine concentration and plasma and erythrocyte folate levels were determined for all available stored sample s ( zinc group , 231/294 ; placebo group , 206/286 ) at 26 and 37 weeks ' gestation . Among all women with available sample s , pregnancy-induced hypertension ( n = 12 ) or preeclampsia ( n = 4 ) developed in 16 women , and 22 pregnancies were complicated by intrauterine growth restriction . RESULTS Mean homocysteine levels in women with pregnancy-induced hypertension and preeclampsia  were similar to those of control subjects at 26 weeks ' gestation but were significantly higher at 37 weeks ' gestation . Homocysteine levels were similar between women with pregnancies complicated by intrauterine growth restriction and control subjects at both time points . CONCLUSION Second-trimester plasma homocysteine concentrations do not predict the subsequent development of pregnancy-induced hypertension , preeclampsia , and intrauterine growth restriction As part of a double-blind r and omised controlled trial to test the efficacy of 20 mg of zinc supplementation during pregnancy , 494 mothers were enrolled at booking . After giving informed consent they were asked to taste a dilute solution of zinc sulphate . Of the 489 mothers who were given the solution , 44 ( 9 % ) were unable to taste it . Mothers who failed this test did not differ significantly from the rest of the population in background factors such as social class , ethnic group , maternal age or parity . Significantly more non-tasting mothers had had a previous growth-retarded infant . Their diets did not differ in any way from those of the tasters . Zinc supplementation did not affect their taste as assessed at the end of pregnancy . Of the possible outcome measures considered , the zinc taste test did predict whether the mother was to develop diastolic hypertension ( 23 % of non-tasters , 8 % of tasters ) , but the mean birthweight , preterm delivery rate and other outcomes were identical OBJECTIVES This study was undertaken to evaluate whether prenatal zinc supplementation affects maturation of fetal cardiac patterns . STUDY DESIGN A r and omized double-blind controlled trial among 242 low-income Peruvian women was performed . Beginning at 10 to 16 weeks ' gestation , women received supplements containing 60 mg iron , 250 microg folic acid with or without 25 mg zinc .  Fetal heart rate ( mean FHR , variability [ HRV ] , number of accelerations ) and movements ( number and amplitude of movement bouts , time spent moving ) were electronically monitored monthly from 20 weeks ' gestation . Developmental trends were evaluated by supplement type among 195 women who completed the trial and had no serious complications of pregnancy . RESULTS Zinc supplementation was associated with lower FHR , greater number of accelerations , and greater HRV . Supplementation effects on HRV and accelerations were more pronounced after 28 weeks ' gestation . No differences in motor activity were observed . CONCLUSION Prenatal supplementation of zinc-deficient mothers may be beneficial to fetal neurobehavioral development OBJECTIVE To evaluate the effects of oral zinc supplementation on the serum zinc levels of pregnant women . DESIGN Experimental ( double blinded r and omized controlled trial ) . PLACE AND DURATION OF STUDY PIMS and KRL Hospital , Islamabad , and community in tehsil Kahuta from April 2003 to April 2004 . PATIENTS AND METHODS Pregnant women of 10 to 16 weeks gestation were invited to enter the study on their booking visit . A sample size of 125 in each group was calculated . After taking an informed consent , they were assigned to control or test group by simple r and om sampling technique . A detailed question naire was filled-up by trained staff and initial evaluation along with serum zinc sample s was collected . The subjects were given either zinc sulphate powder , equivalent to 20 mg elemental zinc , or were given placebo treatment along with routine supplements . These patients were followed up throughout the pregnancy by health care providers and their compliance was monitored . At delivery , serum sample s were again collected for zinc estimation . The data was entered on computer , cleaned and analyzed . Paired t-test was used for comparison of means . RESULTS The data of 242 subjects was analyzed at the end of the study . The mean age of the study participants was 25.7 + /- 4.8 years ( range 16 to 40 ) . Both the groups were similar in other demographic variables as socioeconomic status , education , BMI , height and weight .  One-third of the patients had serum zinc levels below 64 microg/dl at the start of the study . A 128 pairs of pre and post-serum zinc levels were analyzed in the two groups ( 64 pairs in each group ) to compare the means . The zinc supplemented women showed a mean increase of 14.7 microg/dl ( 95 % CI 5 - 23 ) ( P = 0.002 ) . On the other h and the non-supplemented group showed an actual decrease in the serum zinc level which , however , did not reach statistical significance ( P = 0.47 ) . CONCLUSION Oral zinc supplementation of pregnant women with 20 mg elemental zinc was effective in raising the serum levels of zinc . It is suggested that supplementation trials with larger dose of zinc should be carried out OBJECTIVE To evaluate whether zinc supplementation during pregnancy is associated with an increase in birth weight . DESIGN A r and omized double-blind placebo-controlled trial . SETTING Outpatient clinic and delivery service at the University of Alabama at Birmingham . PATIENTS Five hundred eighty medically indigent but otherwise healthy African-American pregnant women with plasma zinc levels below the median at enrollment in prenatal care , r and omized at 19 weeks ' gestational age . Women were subdivided by the population median body mass index of 26 kg/m2 into two groups for additional analyses . INTERVENTION Women who were taking a non-zinc-containing prenatal multivitamin/mineral tablet  were r and omized to receive either a daily dose of 25 mg of zinc or a placebo until delivery . MAIN OUTCOME MEASURES Birth weight , gestational age at birth , and head circumference at birth . RESULTS In all women , infants in the zinc supplement group had a significantly greater birth weight ( 126 g , P = .03 ) and head circumference ( 0.4 cm , P = .02 ) than infants in the placebo group . In women with a body mass index less than 26 kg/m2 , zinc supplementation was associated with a 248-g higher infant birth weight ( P = .005 ) and a 0.7-cm larger infant head circumference ( P = .007 ) . Plasma zinc concentrations were significantly higher in the zinc supplement group . CONCLUSIONS Daily zinc supplementation in women with relatively low plasma zinc concentrations in early pregnancy is associated with greater infant birth weights and head circumferences , with the effect occurring predominantly in women with a body mass index less than 26 kg/m2 BACKGROUND Zinc deficiency is widely prevalent in developing countries . Zinc supplements given to Bangladeshi pregnant women have been shown to reduce infants ' infectious disease morbidity . We assessed these infants at age 13 months to establish the effect of antenatal zinc supplementation on infant development and behaviour . METHODS The study originally consisted of 559 pregnant women who were r and omly allocated to zinc ( 30 mg daily ) or placebo ( cellulose ) from 4 months ' gestation to delivery . The effect of zinc supplementation on pregnancy outcome and on infant growth and morbidity in the first 6 months was assessed . We then r and omly selected a sub sample of 168 infants from 383 who completed the study at 6 months . When babies in this sub sample reached age 13 months , we assessed mental development with Bayley scales of infant development-II , rated behaviour on a modified version of Wolke 's scales , and measured weight and height . FINDINGS When we controlled for differences between tested and non-tested participants , infants in the placebo group had higher scores on mental development index ( regression coefficient=3.3 , SE 1.6 , 95 % CI 0.2 - 6.5 , p=0.04 ) and psychomotor development index ( 5.1 , 2.4 , 0.2 - 9.9 , p=0.04 ) than those in the zinc-supplemented group . Zinc supplementation had no significant effect on behaviour or growth . The children 's nutritional status was poor , and weight-for-age at testing was strongly related to developmental levels , which accounted for some of the treatment effect . INTERPRETATION Prenatal supplementation with zinc alone in poor women from Bangladesh does not seem to confer benefit on infants ' mental development . Such treatment should be considered with caution BACKGROUND Though pregnant women in Ghana routinely receive iron and folic acid supplements , the prevalence of anaemia continues to be as high as 70 % . OBJECTIVE To determine the impact of zinc deficiency on iron status indicators in pregnant women . DESIGN A double-blind , r and omized controlled trial ( RCT ) of joint iron and zinc supplementation . SETTING The study was conducted in the Upper West Region of Ghana , where the prevalence of anaemia is high . PARTICIPANTS The study population comprised pregnant women who presented themselves for antenatal care ( ANC ) in the Wa Regional Hospital of the Upper West Region in Ghana . INTERVENTIONS The intervention group received a combined supplement of 40 mg zinc as zinc gluconate and 40 mg iron as ferrous sulphate . The control group received 40 mg elemental iron as ferrous sulphate . MAIN OUTCOME MEASURES The primary outcome measures were mean and percentage changes in Hb . Serum ferritin and zinc concentrations serve as secondary outcomes . RESULTS Adjusted mean Hb increase was 0.6g/dl higher among women who were not iron replete ( SF ferritin ≤ 20 µg/L ) and received the iron-zinc supplement , compared to women who received iron-only supplement , F ( 1 , 99 ) = 4.356 , p = 0.039 . Women who had low plasma zinc levels were 3-fold increased odds of developing iron deficiency at recruitment , ( OR 3.41 , 95 % CI : 1.19 - 9.76 ) . CONCLUSIONS Iron-zinc supplementation was effective in raising Hb and serum ferritin values among women who were iron deficient in early pregnancy but not among iron sufficient women We sought to determine the effects of maternal zinc supplementation on  skin infections among infants in poor urban areas of Dhaka , Bangladesh . A double-blind , placebo-controlled , r and omized trial was conducted among 199 and 221 Bangladeshi infants whose mothers were administered 30 mg daily of zinc or placebo , respectively . The mothers received zinc supplementation from 12–16 weeks ’ gestation until delivery , and the infants were followed up until 6 months of age . Among the infants of mothers who received zinc supplementation during the antenatal period , 10.6 % had at least 1 episode of impetigo compared with 19.6 % of the infants of mothers in the placebo group ( P = 0.01 ) . Infants in the treatment group had a 54 % reduction in incidence rate of episodes of impetigo when compared with infants in the placebo group ( P = 0.01 ) . The effect of zinc supplementation was more pronounced among male infants ( 64 % reduction ) and intrauterine growth restricted and low birth weight infants ( 73 % reduction ) and among infants of mothers with increased parity ( 60 % reduction ) or decreased socioeconomic status ( 71 % reduction ) Objective : To investigate the possible beneficial effects of a micronutrient supplementation to apparently healthy pregnant women on maternal biological status and new born anthropometric characteristics . Setting : Departments of Obstetric of the University Hospital of Grenoble ( France ) and Lyon ( France ) , Laboratoire of Biology of Oxidative Stress , UFR de Pharmacie . Grenoble ( France ) . Study design : Double-blind , r and omized placebo-controlled intervention trial . Subjects : A total of 100 apparently healthy pregnant women were recruited at 14±2 weeks of gestation to delivery . At the end , they were 65 women to follow out the study . Interventions : Daily consumption over gestation of a miconutrients supplement or placebo . Main outcome measures : Plasma micronutrient levels and oxidative stress parameters were measured in mothers at 14 and 38 weeks of gestation . New born 's anthropometric characteristics were measured at delivery . Results : In the supplemented group , folic acid , vitamin C , E , B2 , B6 and β-carotene levels were higher than in the placebo group . Oxidative stress parameters were not different between the groups . Birth weights were increased by 10 % and the number of low newborn weights ( < 2700 g ) decreased significantly when the mother received the supplementation . Maternal plasma Zn levels were positively correlated to the newborn heights . Conclusion : A regular intake of a micronutrient supplement at nutritional dose may be sufficient to improve micronutrient status of apparently healthy pregnant women and could prevent low birth weight of newborn . Sponsorship : The supplement and placebo were supplied and the study was partially funded by BOIRON Pharmaceutical Company Women in different trimesters of pregnancy ( Group B ; n = 106 ) were administered 200 mg zinc sulphate ( elemental Zn 45 mg ) orally/day from the day of reporting till delivery . Untreated group of 62 served as control . Levels of zinc in maternal serum , umbilical cord blood serum , and urine were estimated . Pregnancy outcome was assessed in terms of incidence of prematurity , IUGR , birth weight ; apgar score and gestational age . Serum zinc levels in Gp . A declined significantly from 113.00 + /- 2.80 ug/dl in I trimester to 83.78 + /- 2.20 ug/dl in III ( P < 0.001 ) . Following zinc supplementation ( Gp . B ) serum zinc levels increased significantly from 109.70 + 3.23 micrograms/dl to 205.40 + /- 4.47 micrograms/dl ( P < 0.001 ) . Urinary excretion of zinc in Gp . A declined significantly with increase in the period of gestation . However in Gp . B , elimination of Zn increased significantly in proportion with the serum levels ( P < 0.001 ) cord blood serum zinc level was normal irrespective of maternal serum Zn levels . Following oral Zn supplementation , levels increased significantly from below 127.0 micrograms/dl to above 158.0 micrograms/dl in Gp . B ( P < 0.001 ) . Maternal serum and cord blood serum zinc ratios were fairly constant in Gp . A as well as in Gp . B. Birth weight of babies born with Zn supplementation was significantly higher than control and was related to duration of oral zinc supplementation ( P < 0.001 ) . Gestational age of babies in Gp . B was significantly higher than respective controls when Zn supplementation was given for more than 3 months ( P < 0.01 ) , and was related to duration of zinc therapy ( P < 0.05 ) . ( ABSTRACT TRUNCATED AT 250 WORDS Objective : To examine the effect of zinc supplementation to HIV-1-infected pregnant women on viral load , early mother-to-child transmission of HIV ( MTCT ) , and wasting . Design : Double-blind placebo-controlled r and omized clinical trial . Setting : Antenatal clinic in Dar es Salaam , Tanzania . Subjects : Four hundred HIV-1-infected pregnant women . Methods : Women 12–27 weeks of gestation were r and omly assigned to receive a daily oral dose of 25 mg zinc or placebo from the day of the first prenatal visit until 6 weeks postdelivery . Weight and mid-upper arm circumference ( MUAC ) were measured monthly . HIV status of the babies was assessed at birth and at 6 weeks postpartum . Viral load was assessed in a r and om sample of 100 women at baseline and at the end of the study . Results : Zinc had no effects on maternal viral load or early MTCT . Supplementation was related to a significant threefold increase in the risk of wasting ( reaching a MUAC value < 22 cm ) during an average 22 weeks of observation ( RR=2.7 , 95%CI=1.1 , 6.4 , P=0.03 ) , and to a 4 mm decline in MUAC during the second trimester ( P=0.02 ) . Conclusions : Zinc supplementation to HIV-infected pregnant women offers no benefits on viral load or MTCT . The clinical relevance of an apparent decrease in MUAC associated with zinc supplementation is yet to be ascertained . These findings together with the lack of effect on fetal outcomes ( reported previously ) do not provide support for the addition of zinc supplements to the st and ard of prenatal care among HIV-infected women . Sponsorship : The US National Institute of Child Health and Human Development ( NICHD R01 32257 ) The present study was conducted in the Department of Obstetrics & Gynaecology , Mymensingh Medical College Hospital , Mymensingh and Molecular Microbiology & Central Laboratory of Bangladesh Institute of Nuclear Agriculture ( BINA ) from 15th November 2007 to 31st May 2009 to find out the relation between maternal serum zinc level with neonatal birth weight . Hundred pregnant women who were advised to take 61.8 mg zinc daily throughout pregnancy were assigned to study group while the pregnant woman did not take zinc orally were allocated into control group .  Serum zinc levels were measured between 37 - 42 weeks gestation and birth weight were measured just after delivery . Data were processed and analyzed using SPSS version 11.5 . The test used to analyze the data was descriptive statistics , Chi-square probability test , Pearson correlation , unpaired t-test and odds ratio . A probability value of < 0.05 was considered significant . Majority ( 97 % ) of the cases who received zinc during their antenatal period had normal serum zinc ( ≥ 700μg/L ) level compared to only 22 % of the control group woman who did not receive zinc . Normal birth weight of babies in pregnant woman who received zinc is 5.7 times higher than the pregnant woman who did not receive zinc . As the present study was a cross-sectional one , further study with large sample size and prospect i ve design is recommended Pregnant women in different trimesters of pregnancy were divided into control ( n = 58 ) and study ( n = 104 ) groups . Study group subjects were given 45 mg zinc/p.o./day as 200 mg ' zinc sulphate tablets from the day of reporting till term . Body zinc status was clinical ly assessed by ' zinc taste test ' . Blood sample s were drawn at the same time and serum zinc levels measured . Zinc taste test scores decreased with advancement of pregnancy ( P < 0.05 ) and increased significantly following zinc administration ( P < 0.05 ) . Serum zinc level declined significantly with advancement of pregnancy ( P < 0.001 ) . Following zinc administration , serum zinc level increased significantly ( P < 0.001 ) . Accuracy of zinc taste test in individual cases ranged between 70 and 100 percent . On the whole , zinc taste test was well correlated with serum zinc level , and provides a fair idea of zinc deficiency OBJECTIVE The objective of our study was to investigate zinc ( Zn ) status and effects of Zn supplementation in relation to insulin-like growth factor-I ( IGF-I ) and iron deficiency anemia in pregnant women . The role of Zn and IGF-I in hematologic abnormalities has remained unclear . METHODS Thirty-eight Japanese women , when examined at the second trimester of pregnancy , had hemoglobin concentrations below 11.0 g/dL and 32 of 38 had normocytic erythrocytes . These 38 women were divided into three groups , and we compared the hematological status and serum IGF-I levels before and after iron ( Group A ) or Zn ( Group B ) or iron plus Zn ( Group C ) supplementation . RESULTS The concentrations of hemoglobin ( Hb ) did not change in groups A and B. In group C , Hb levels were significantly increased from 10.3+/-0.3 to 11.0+/-0.6 g/dL. Furthermore , numbers of RBC and reticulocytes also increased significantly . Concentrations of iron , IGF-I and total iron binding capacity ( TIBC ) were increased , and concentrations of erythropoietin were decreased , but not statistically . There were significant positive correlations between increases in IGF-I and increases in Hb and RBC in the Zn administered groups . CONCLUSION Zn status to some extent can account for hematological abnormalities in pregnant women . Zn derived IGF-I has a role in the regulation of hematopoiesis in pregnant women BACKGROUND AND OBJECTIVES Deficiencies of protein , energy , and micronutrients are highly prevalent in developing countries and have major effects on pregnancy outcome . Low dietary intake is the most common reason for zinc deficiency . The present research is part of a larger double-blind r and omized-controlled trial to evaluate the effect of zinc supplementation on the pregnancy outcome . The aim of the present study was to assess the  zinc status and dietary intake of zinc and other macronutrients and micronutrients among pregnant women in Alex and ria , Egypt . PARTICIPANTS AND METHODS Participants were pregnant women attending two antenatal care centers that serve low-income and middle-income pregnant population s. A total of 1055 healthy pregnant women aged 20 - 45 years were assessed for eligibility . Of these , only 675 had serum zinc level below the median for the gestational age . They were assigned r and omly to one of three parallel groups . Zinc supplements were provided from 16 weeks until delivery . A sub sample of 100 women was assessed for their dietary intake . A question naire interview was used to collect basic socioeconomic and data on current pregnancy and labor . Dietary data were collected using the 24-h recall method and a food frequency question naire . The nutritive value of the daily diet was computed using the Egyptian food composition tables . The blood hemoglobin level , serum zinc level , and fasting blood sugar were determined . RESULTS Zinc deficiency was detected among 53.5 % of the sample . Dietary intake of zinc was low , representing 59.4 , 59.4 , and 62 % of the recommended dietary allowance ( RDA ) for the zinc group , zinc plus multivitamins , and the placebo group , respectively . The iron intake was below 50 % of the RDA . Protein intake was less than 70 % of the RDA . The mean intakes of fat were 191.97 , 211.8 , and 196.3 g/day for the three groups . The mean energy intake represented 51.1 , 53.5 , and 49.8 % of the RDA . CONCLUSION AND RECOMMENDATIONS Except for carbohydrate intake , the dietary intake of all macronutrients and micronutrients was low . The lowest intake was of iron ( below 50 % of the RDA ) . Zinc and protein intake represented less than 70 % of the RDA . The overall energy intake was around 50 % of the RDA . Nutritional health education should be used as a preventive approach to allow the large sector of the low-income population to maximize the use of the limited re sources in the best way . In women at high risk of zinc deficiency , zinc supplementation should be added to the routine supplements OBJECTIVE To test whether zinc supplementation during pregnancy would reduce  infant morbidity rates .  STUDY DESIGN A double-blind , r and omized controlled trial of prenatal zinc supplementation was conducted from 1995 to 1997 in a periurban slum of Lima , Peru . Participants were r and omly assigned to receive daily supplementation with zinc ( 15 mg zinc + 60 mg iron + 250 microg folic acid ) or placebo ( 60 iron + 250 microg folic acid ) from 10 to 24 weeks gestation until 1 month postpartum . Anthropometry was measured monthly from birth through age 12 months , and morbidity and dietary intake were measured weekly from 6 to 12 months ( n = 421 ) . RESULTS The average percentage of observation days with diarrhea among infants prenatally treated with zinc ( 5.8 % ) was reduced compared with infants in the control group ( 7.7 % ) ( P = .01 ) . Prenatal zinc supplementation reduced the likelihood of an infant experiencing diarrheal episodes of acute diarrhea lasting longer than 7 days ( OR 0.66 , 95 % CI 0.43 , 0.99 , P = .04 ) and mucus in the stool ( OR 0.65 95 % CI 0.46 , 0.92 , P = .01 ) adjusting for infant age , breastfeeding , season , and hygiene and sanitation covariates . No treatment effects on respiratory illnesses , fever , or skin conditions were detected . CONCLUSIONS Improving prenatal zinc nutrition protected against diarrheal morbidity in infant offspring through 12 months of age Abstract Objective : To assess the impact on birth size and risk of low birth weight of alternative combinations of micronutrients given to pregnant women . Design : Double blind cluster r and omised controlled trial . Setting : Rural community in south eastern Nepal . Participants : 4926 pregnant women and 4130 live born infants . Interventions : 426 communities were r and omised to five regimens in which pregnant women received daily supplements of folic acid , folic acid-iron , folic acid-iron-zinc , or multiple micronutrients all given with vitamin A , or vitamin A alone ( control ) . Main outcome measures : Birth weight , length , and head and chest circumference assessed within 72 hours of birth . Low birth weight was defined < 2500 g. Results : Supplementation with maternal folic acid alone had no effect on birth size . Folic acid-iron  increased mean birth weight by 37 g ( 95 % confidence interval −16 g to 90 g ) and reduced the percentage of low birthweight babies ( < 2500 g ) from 43 % to 34 % ( 16 % ; relative risk=0.84 , 0.72 to 0.99 ) . Folic acid-iron-zinc had no effect on birth size compared with controls . Multiple micronutrient supplementation  increased birth weight by 64 g ( 12 g to 115 g ) and reduced the percentage of low birthweight babies by 14 % ( 0.86 , 0.74 to 0.99 ) . None of the supplement combinations reduced the incidence of preterm births . Folic acid-iron and multiple micronutrients increased head and chest circumference of babies , but not length . Conclusions : Antenatal folic acid-iron supplements modestly reduce the risk of low birth weight . Multiple micronutrients confer no additional benefit over folic acid-iron in reducing this risk . What is already known on this topic Deficiencies in micronutrients are common in women in developing countries and have been associated with low birth weight and preterm delivery What this study adds In rural Nepal maternal supplementation with folic acid-iron reduced the incidence of low birth weight by 16 % A multiple micronutrient supplement of 14 micronutrients , including folic acid , iron , and zinc , reduced low birth weight by 14 % , thus conferring no advantage over folic OBJECTIVE Our objective was to examine whether improvement in maternal zinc status during pregnancy is positively associated with fetal neurobehavioral development  in a Peruvian population . STUDY DESIGN We electronically monitored , at 32 and 36 weeks ' gestation , 55 fetuses whose mothers were r and omly assigned to receive , during pregnancy , a daily supplement containing 60 mg iron and 250 microg folate , with or without 15 mg zinc .  Fetal heart rate and movement patterns were quantified in 55 and 34 fetuses , respectively , as indexes of neurobehavioral development . RESULTS Fetuses of mothers who received zinc supplementation showed fewer episodes of minimal fetal heart rate variability , increased fetal heart rate range , an increased number of accelerations , an increased number of movement bouts , an increased amount of time spent moving , and an increased number of large movements . Differences by supplementation type increased with gestational age and were statistically significant at 36 weeks ' gestation ( P < .05 ) . CONCLUSION Improving maternal zinc status through prenatal supplementation may improve fetal neurobehavioral development BACKGROUND Infant malnutrition and mortality rates are high in less-developed countries especially in low-birthweight infants . Zinc deficiency is also widely prevalent in these circumstances . We aim ed to assess the effect of daily zinc supplements given to pregnant mothers on their infants ' growth and morbidity . METHODS We did a double-blind , placebo controlled , r and omised trial in 199 and 221 Bangladeshi infants whose mothers took 30 mg daily elemental zinc or placebo , respectively , from 12 to 16 weeks ' gestation until delivery . Infants were followed up until 6 months of age . We obtained data for morbidity every week by mothers ' recall . Infants ' anthropometric measurements were done every month , and their serum zinc was assessed at 1 and 6 months of age . FINDINGS Infants of mothers who received zinc during pregnancy had at age 6 months reduced risks compared with those in the placebo group for acute diarrhoea ( risk ratio 0.84 ; 95 % CI 0.72 - 0.98 ) , dysentery ( 0.36 ; 0.25 - 0.84 ) , and impetigo ( 0.53 ; 0.34 - 0.82 ) . These reductions were seen in low-birthweight infants but not in those with normal birthweight . There were no differences in infant growth or serum zinc concentrations between treatment groups . INTERPRETATION Maternal zinc supplementation during pregnancy result ed in a reduction of the health risks in Bangladeshi low-birthweight infants , although this intervention did not improve birthweight . Whether zinc should be added to usual antenatal supplements in regions with high rates of low birthweight should be review ed tional cardiac markers in the population studied . The fact that IL-6 and CRP values were not significantly different in the AMI and non-AMI groups could suggest both a lack of sensitivity of the acute-phase response at presentation and the presence of other inflammatory conditions in this population . This study population included patients with various elapsed times since the onset of symptoms and thus represents an actual emergency department experi- ence involving sequential patient evaluations . The rela- tive performance of the markers studied might be differ- ent in other population s. We emphasized , moreover , that this study evaluated initial presentation sampling and did not address serial sampling during the hours after The study attempted to determine if the bulk of dietary supplements given to pregnant women after midgestation affects fetal growth .  127 Zulu women were r and omly assigned to four groups , two of which received daily food supplements design ed to raise their energy , protein and vitamin intakes to levels recommended by the U.S. Food and Nutrition Board . One of these supplements had a high bulk , the other a low bulk . The third supplement contained only zinc and the fourth a placebo . Women in all four groups had a similar weight gain and length of gestation . Birth weights were from 6.5 to 9.5 % greater with the low bulk than with the other supplements In a double-blind zinc trial in low-income , pregnant adolescents thought to be at risk for poor zinc nutriture , subjects were r and omly assigned to receive 30 mg zinc ( gluconate ) or placebo . Response to zinc was related to maternal weight . Infants of normal-weight mothers given zinc had reduced rates of prematurity ( p = 0.05 ) and assisted respiration ( p = 0.006 ) . Underweight multiparas given zinc had longer gestational lengths ( p = 0.008 ) than did subjects given the placebo . Multiple stepwise regression analysis , used to identify predictors of infant size , revealed that 14 - 26 % more variance was accounted for in the zinc than in the placebo group . Except for gestational age , the predictors selected were entirely different in the two groups . The zinc group had a positive toxemia screen more often , which did not appear to affect outcome . Zinc supplementation improved pregnancy outcome in normal-weight women and in underweight multiparas . The nonresponse in underweight primiparas was perhaps due to multiple limiting factors Objective . To investigate whether zinc supplementation during pregnancy improves maternal and fetal outcome
BACKGROUND It has been suggested that low serum zinc levels may be associated with suboptimal outcomes of pregnancy such as prolonged labour , atonic postpartum haemorrhage , pregnancy-induced hypertension , preterm labour and post-term pregnancies , although many of these associations have not yet been established .
OBJECTIVES To assess the effects of zinc supplementation in pregnancy on maternal , fetal , neonatal and infant outcomes .