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Vitamin A supplementation during pregnancy for maternal and newborn outcomes (Review)

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Van Den Broek, Nynke ORCID: https://orcid.org/0000-0001-8523-2684, Dou, Lixia, Othman, Mohammad, Neilson, James P, Gülmezoglu, A Metin and Gates, Simon (2010) 'Vitamin A supplementation during pregnancy for maternal and newborn outcomes (Review)'. Cochrane Database of Systematic Reviews, Issue 11, CD00866.

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Abstract

Background
The World Health Organization recommends routine vitamin A supplementation during pregnancy or lactation in areas with endemic vitamin A deficiency (where night blindness occurs), based on the expectation that supplementation will improve maternal and newborn outcomes including mortality, morbidity and prevention of anaemia or infection.

Objectives
To review the effects of supplementation of vitamin A, or one of its derivatives, during pregnancy, alone or in
combination with other vitamins and micronutrients, on maternal and newborn clinical outcomes. 0237 Vitamin A supplementation during pregnancy for maternal and newborn outcomes 2 / 78

Search strategy
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (15 July 2010). Selection criteria
All randomised or quasi-randomised trials, including cluster-randomised trials, evaluating the effect of vitamin A supplementation in pregnant women.

Data collection and analysis
Two review authors independently assessed all studies for inclusion and resolved any disagreement through
discussion with a third person. We used pre-prepared data extraction sheets.

Main results
We examined 88 reports of 31 trials, published between 1931 and 2010, for inclusion in this review. We included
16 trials, excluded 14, and one is awaiting assessment.
Overall when trial results are pooled, Vitamin A supplementation does not affect the risk of maternal mortality (risk ratio (RR) 0.78, 95% confidence interval (CI) 0.55 to 1.10, 3 studies, Nepal, Ghana,UK ), perinatal mortality, neonatal mortality, stillbirth, neonatal anaemia, preterm birth or the risk of having a low birthweight baby. Vitamin A supplementation reduces the risk of maternal night blindness (risk ratio (RR) 0.70, 95% CI 0.60 to 0.82, 1 trial Nepal). In vitamin A deficient populations and HIV-positive women, vitamin A supplementation reduces maternal anaemia (risk ratio (RR) 0.64, 95% confidence interval (CI) 0.43 to 0.94, 3 trials, Indonesia, Nepal,Tanzania ). There is evidence that vitamin A supplements may reduce maternal clinical infection (RR 0.37, 95% CI 0.18 to 0.77, 3 trials, South Africa, Nepal and UK). In HIV-positive women vitamin A supplementation given with other micronutrients was associated with fewer low birthweight babies (< 2.5 kg) in the supplemented group in one study (RR 0.67, CI 0.47 to 0.96).

Authors' conclusions
The pooled results of two large trials in Nepal and Ghana (with almost 95,000 women) do not currently suggest a
role for antenatal vitamin A supplementation to reduce maternal or perinatal mortality. However the populations
studied were probably different with regard to baseline vitamin A status and there were problems with follow-up
of women. There is good evidence that antenatal vitamin A supplementation reduces maternal anaemia for women who live in areas where vitamin A deficiency is common or who are HIV-positive. In addition the available evidence suggests a reduction in maternal infection, but these data are not of a high quality.

Item Type: Article
Additional Information: This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2010, Issue 11, CD008666. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review. There are two versions of this review. Both are attached to this record. Please make note of the dates at the top of each document.
Subjects: QU Biochemistry > Vitamins > QU 145 Nutrition. Nutritional requirements
WQ Obstetrics > Childbirth. Prenatal Care > WQ 175 Prenatal care
WQ Obstetrics > Pregnancy > WQ 200 General works
WS Pediatrics > Child Care. Nutrition. Physical Examination > WS 115 Nutritional requirements. Nutrition disorders
WS Pediatrics > WS 20 Research (General)
Faculty: Department: Groups (2002 - 2012) > Child & Reproductive Health Group
Digital Object Identifer (DOI): https://doi.org/10.1002/14651858.CD008666.pub2
Depositing User: Users 19 not found.
Date Deposited: 03 Nov 2011 15:26
Last Modified: 06 Feb 2018 13:04
URI: https://archive.lstmed.ac.uk/id/eprint/2382

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