article · BMJ Open
Infants born to mothers living with HIV face higher risks of illness, mortality, and developmental delays compared to unexposed infants. A secondary analysis of a randomised, triple-blind, placebo-controlled clinical trial conducted between 2015 and 2019 assessed whether maternal vitamin D supplementation during pregnancy and lactation improves early childhood development. The study followed women attending antenatal clinics in Dar es Salaam, Tanzania, evaluating 1,312 infants at one year of age using caregiver-reported instruments. Researchers measured development across overall, language, motor, and cognitive domains. The trial found that vitamin D supplementation produced no significant difference in overall development scores or any individual domain when compared with a placebo. The results show that maternal vitamin D supplementation during pregnancy and lactation does not enhance developmental outcomes in infants born to women living with HIV.
Children born to mothers living with HIV often face heightened health challenges, prompting interest in maternal nutritional interventions to support child health. These findings demonstrate that maternal vitamin D supplementation does not improve infant motor, cognitive, or language outcomes at one year, offering valuable clarity for maternal health guidelines and the allocation of healthcare resources.
The abstract does not indicate an application pathway for commercial product development. Rather than supporting a new supplement product or commercial intervention, these applied clinical trial findings inform public health organisations, antenatal care providers, and policymakers that maternal vitamin D supplements do not provide a developmental benefit for this target group.
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BACKGROUND: Infants born to pregnant women living with HIV (WLHIV) are at greater risk for morbidity and mortality and may also have poorer developmental outcomes as compared with infants who are not exposed to HIV. Nutrition interventions in pregnancy may affect developmental outcomes. OBJECTIVES: This study evaluated the effect of maternal vitamin D supplementation on infant development outcomes. DESIGN: We conducted a secondary analysis of a randomised, triple-blind, placebo-controlled trial of maternal vitamin D supplementation from June 2015 to October 2019. SETTING: Antenatal care clinics in Dar es Salaam, Tanzania. PARTICIPANTS: Pregnant WLHIV and their offspring. INTERVENTIONS: or placebo supplements taken during pregnancy and lactation. OUTCOME MEASURES: Infants were assessed for cognitive, language and motor development at 1 year of age with the Caregiver Reported Early Development Instruments (CREDI). RESULTS: A total of 2167 infants were eligible, and 1312 of them completed CREDI assessments at 1 year of age. Vitamin D supplementation had no effect on overall CREDI z-scores (standardised mean difference (SMD) 0.03, 95% CI -0.09, 0.15, p value 0.66). There was also no evidence of a difference between vitamin D and placebo groups in language (SMD 0.06, 95% CI -0.08, 0.21, p value 0.40), motor (SMD 0.02, 95% CI -0.09, 0.14, p value 0.69) or cognitive domain z-scores (SMD 0.05, 95% CI -0.08, 0.17, p 0.48). CONCLUSIONS: Maternal vitamin D supplementation during pregnancy and lactation did not affect infant development outcomes. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov identifier: NCT02305927.
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DOI: 10.1136/bmjopen-2024-098723
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