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Effect of Antenatal Zinc Supplementation on Impetigo in Infants in Bangladesh

Darmstadt, Gary L. MD, MS*; Osendarp, Saskia J. M. PhD†,‡; Ahmed, Saifuddin PhD§; Feldman, Candace MD, MPH*; Van Raaij, Joop M. A. PhD; Baqui, Abdullah H. MB BP, DRPH*; Hautvast, J.G.A.J. MD, PhD; Fuchs, George J. MD†,¶

The Pediatric Infectious Disease Journal: April 2012 - Volume 31 - Issue 4 - p 407–409
doi: 10.1097/INF.0b013e318243e232
Brief Reports

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, randomized 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).

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*International Center for Advancing Neonatal Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD

International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Centre for Health and Population Research, Dhaka, Bangladesh

Division of Human Nutrition and Epidemiology, Wageningen University, Wageningen, The Netherlands

§Department of Population and Family Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD

Arkansas Children’s Hospital, Little Rock, AR

Accepted for publication November 26, 2011.

The authors have no funding or conflicts of interest to disclose.

Gary L. Darmstadt is currently at Family Health Division, Global Health Program, Bill & Melinda Gates Foundation, Seattle, WA.

Saskia J. M. Osendarp is currently at Unilever R&D, Vlaardingen, The Netherlands.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

Address for correspondence: Gary L. Darmstadt, MD, MS, Family Health Division, Global Health Program, Bill and Melinda Gates Foundation, PO Box 23350, Seattle, WA 98102. E-mail:

© 2012 Lippincott Williams & Wilkins, Inc.