human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: 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 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: 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 
    Output:
    