Document Detail


WITHDRAWN: Vitamin A supplementation during pregnancy.
MedLine Citation:
PMID:  21069669     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Vitamin A supplements have been recommended in pregnancy to improve outcomes that include maternal mortality and morbidity.
OBJECTIVES: To review the effectiveness of vitamin A supplementation during pregnancy, alone or in combination with other supplements, on maternal and newborn clinical and laboratory outcomes.
SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group's specialised register of controlled trials (April 2002) and the Cochrane Controlled Trials Register (The Cochrane Library Issue 1, 2002).
SELECTION CRITERIA: All randomised or quasi-randomised trials evaluating the effect of vitamin A supplementation in pregnant women. The types of intervention included vitamin A supplementation alone or in combination with other micro-nutrients.
DATA COLLECTION AND ANALYSIS: We assessed trials for methodological quality using the standard Cochrane criteria of adequacy of concealment. At least two review authors independently assessed the trials for inclusion and extracted data. We collected information on blinding, loss to follow-up, setting, number of women, exclusion after randomisation and follow-up as well as supplementation type, dose and frequency. The outcomes we sought included maternal and neonatal clinical and laboratory outcomes.
MAIN RESULTS: Five trials involving 23,426 women were included. Because the trials were heterogeneous with regard to type of supplement given, duration of supplement use and outcomes measured, pooled results using meta analysis could not be performed. One large population based trial in Nepal showed a possible beneficial effect on maternal mortality after weekly vitamin A supplements. In this study a reduction was noted in all cause maternal mortality up to 12 weeks postpartum with Vitamin A supplementation (RR 0.60, 95% CI 0.37-0.97). Night-blindness was assessed in a nested case-control study within this trial and found to be reduced but not eliminated. Three trials examined the effect of vitamin A supplementation on haemoglobin levels. The trial from Indonesia showed a beneficial effect in women who were anaemic ([Hb] <11.0 g/dl). After supplementation, the proportion of women who became non-anaemic was 35% in the Vitamin A supplemented group, 68% in the iron-supplemented group, 97% in the group supplemented with both Vitamin A and iron and 16% in the placebo group. The two trials from Malawi did not corroborate these positive findings.
AUTHORS' CONCLUSIONS: Although the two trials from Nepal and Indonesia suggested beneficial effects of vitamin A supplementation, further trials are needed to determine whether vitamin A supplements can reduce maternal mortality and morbidity and by what mechanism.
Authors:
Nynke van den Broek; Regina Kulier; A Metin Gülmezoglu; José Villar
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Publication Detail:
Type:  Journal Article; Review     Date:  2010-11-10
Journal Detail:
Title:  The Cochrane database of systematic reviews     Volume:  -     ISSN:  1469-493X     ISO Abbreviation:  Cochrane Database Syst Rev     Publication Date:  2010  
Date Detail:
Created Date:  2010-11-11     Completed Date:  2010-12-06     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  100909747     Medline TA:  Cochrane Database Syst Rev     Country:  England    
Other Details:
Languages:  eng     Pagination:  CD001996     Citation Subset:  IM    
Affiliation:
Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK, L3 5QA.
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MeSH Terms
Descriptor/Qualifier:
Dietary Supplements*
Female
Humans
Pregnancy
Pregnancy Outcome*
Randomized Controlled Trials as Topic
Vitamin A / administration & dosage*
Chemical
Reg. No./Substance:
11103-57-4/Vitamin A
Comments/Corrections
Update Of:
Cochrane Database Syst Rev. 2002;(4):CD001996   [PMID:  12519564 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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