| Objectives To evaluated the effect of vitamin A (VA), riboflavin (VB2) or both on top of ironsupplementation and improve the immune status of anemia pregnant women.Methods This cohort study is designed for the supplemental trial. 369 pregnant women, gestation age 12 ~24 weeks, Hb concentrations between 80 and 105g/L, were recruited and randomly divided into 4 groups in the trial. Subjects were daily supplemented with different nutrients of iron (Fe), VA, VB2 and folk acid (FA) in capsules, which were: 60mg Fe (ferrous sulfate)+400 g FA for I group, 60mg Fe + 400 g FA+2000 g (RE) VAfor I+A group, 60mg Fe + 400 g FA+ 1.0mg VB2 for I+B group, 60mg Fe + 400 g FA+2000 g(RE) VA +1.0mg VB2 for I+A+B group. The capsules were dispersed to each of subjects by community's nurses and village doctors. All subjects were asked to make a note of capsule intake and handed it to investigators at the end of the supplementation. Moreover, the investigators had done a lot of home visits for capsule-intake supervision during the trial.24h diet recall for some of subjects was done to evaluate the intake of VA, Fe, VA, VB2, etc. Samples of 5-6ml fasting blood were collected twice before and at the end of intervention trial. Hemoglobin (Hb) was measured by the cyanmethemoglobin method, Plasma ferritin (SF) by radioimmunoassay; Plasma iron (SI) and total iron binding capacity (TIBC) by colorimetry methods; VA measured by fluorometry, folk acid by radioimmunoassay, BGRAC measured by DTNB colorimetry according to Yu Shouyang. The content of immunoglobulin A(IgA), immunoglobulin G(IgG) , immunoglobulin M(IgM) in the plasma by biochemical methods. The proliferation of Lymphocytes was detected by the method of MTT.Results The results showed that the incidence of anemia (80-105g/L) of country pregnancy women, gestation 12-24 weeks, was 47.46%. The average intake of energy and protein 91.84% and 73.95% of RNIs respectively, and daily intakes of VA, riboflavin and iron were lower than 50% of RNI.The biochemical results showed that average SI, TIBC, and SF were 46.65 g/dL, 312.42 g/dL and 28.42 g/dL before the trial, which were much lower than the normal values. The average VA and BGRAC were 29.85 g/dL (<30 g/dL is absence) and 1.87(<1.5 is absence). It indicated that most of subjects suffered fromiron deficiency and anemia, and VA and VB2 deficiencies as well.After the trial, the 87.39% of subjects with anemia recovered from anemia and iron deficiency. The average increase of Hb concentration reached to 32g/L. The SI concentration was 130.3 g/dL in I+A+B higher than those in I and I+ A groups respectively (P<0.05). SF levels could indicate the storage of iron. After 8week supplementation, the levels of SF in I+A and I+A+B groups 41.44p,g/dL and 39.41 g/dL respectively, which were higher than one in I group. In the meanwhile, nutritional statuses of plasma VA and VB2 have been improved agreat deal. The leveles of plasma VA in I+A and I+A+B groups were 2.13mg/L and 2.42mg/L, which were significantly higher than I group after the trial (P<0.05), and meanwhile, level of plasma VB2 in the groups supplemented with riboflavin (I+B and I+A+B groups) was higher than one in the groups without riboflavin supplementation.The contents of IgA, IgG, IgM increased after 8 weeks intervention, compared with the I group, the changes were significant (P<0.05). The significant increase of plasma IgA was found in I+A+B group and the significant decline in the I+B group, compared with I+A group. The activities of lymphocyte proliferation in four intervention groups were 0.23 in the I group, 0.26 in the I+A group, 0.2S in the I+B group, 0.33 in the I+A+B group respectively, Compared with the I group; there was significant changes in I+A group and I+A+B group. It was suggested that VA and riboflavin supplementation could improve the immune function of the body. Conclusion 1. The prevalence of anemia (85-105g/L) in pregnant women in the second trimester was 47.46%. The reason might be related to their unbalanced diet.2. Combination of i...
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