Vitamin E supplementation in pregnancy
Editorial Group: Cochrane Pregnancy and Childbirth Group
Published Online: 20 APR 2005
Assessed as up-to-date: 16 DEC 2004
Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
How to Cite
Rumbold A, Crowther CA. Vitamin E supplementation in pregnancy. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD004069. DOI: 10.1002/14651858.CD004069.pub2.
- Publication Status: Edited (no change to conclusions)
- Published Online: 20 APR 2005
Vitamin E supplementation may help reduce the risk of pregnancy complications involving oxidative stress, such as pre-eclampsia. There is a need to evaluate the efficacy and safety of vitamin E supplementation in pregnancy.
To assess the effects of vitamin E supplementation, alone or in combination with other separate supplements, on pregnancy outcomes, adverse events, side-effects and use of health services.
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (23 June 2004), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 2, 2004), MEDLINE (1966 to May 2004), Current Contents (1998 to May 2004) and EMBASE (1980 to May 2004). We updated the search of the Cochrane Pregnancy and Childbirth Group's Trials Register on 7 May 2010 and added the results to the awaiting classification section.
All randomised or quasi-randomised controlled trials evaluating vitamin E supplementation in pregnant women. We excluded interventions using a multivitamin supplement that contained vitamin E.
Data collection and analysis
Two authors independently assessed trials for inclusion, extracted data and assessed trial quality.
Four trials, involving 566 women either at high risk of pre-eclampsia or with established pre-eclampsia, were eligible for this review. All trials assessed vitamin E in combination with other supplements and two trials were published in abstract form only. No difference was found between women supplemented with vitamin E in combination with other supplements during pregnancy compared with placebo for the risk of stillbirth (relative risk (RR) was 0.77, 95% confidence intervals (CI) 0.35 to 1.71, two trials, 339 women), neonatal death (RR 5.00, 95% CI 0.64 to 39.06, one trial, 40 women), perinatal death (RR 1.29, 95% CI 0.67 to 2.48, one trial, 56 women), preterm birth (RR 1.29, 95% CI 0.78 to 2.15, two trials, 383 women), intrauterine growth restriction (RR 0.72, 95% CI 0.49 to 1.04, two trials, 383 women) or birthweight (weighted mean difference -139.00 g, 95% CI -517.68 to 239.68, one trial, 100 women), using fixed-effect models. Substantial heterogeneity was found for pre-eclampsia. Women supplemented with vitamin E in combination with other supplements compared with placebo were at decreased risk of developing clinical pre-eclampsia (RR 0.44, 95% CI 0.27 to 0.71, three trials, 510 women) using fixed-effect models; however, this difference could not be demonstrated when using random-effects models (RR 0.44, 95% CI 0.16 to 1.22, three trials, 510 women). There were no differences between women supplemented with vitamin E compared with placebo for any of the secondary outcomes.
The data are too few to say if vitamin E supplementation either alone or in combination with other supplements is beneficial during pregnancy.
[Note: The 24 citations in the awaiting classification section of the review may alter the conclusions of the review once assessed.]
Plain language summary
Vitamin E supplementation in pregnancy
Not enough evidence to determine if giving women vitamin E during pregnancy helps prevent their babies dying, being born small or too soon.
For pregnant women, insufficient dietary vitamin E (found in vegetable oils, nuts, cereals and some leafy green vegetables) may lead to complications like pre-eclampsia and the baby being born small. The review of trials found no studies on vitamin E supplementation alone, but studies included vitamin C, and additional supplements or drugs. There was not enough evidence to say if vitamin E in combination with other supplements during pregnancy improved outcomes for women and babies.
我們搜尋了Cochrane Pregnancy and Childbirth Group Trials Register(2004年6月23日)、Cochrane Central Register of Controlled Trials(The Cochrane Library， Issu ， 2004年)、MEDLINE(1966至2004年5月)、Current Contents(1998至2004年5月)以及EMBASE(1980至2004年5月)等資料庫
共計4個試驗566位婦女，不論是子癇前症高風險對象或已確診子癇前症，都合乎本文研究的條件。 所有的試驗都評估了維生素E與其它補充品的合併使用效果而其中兩個試驗是僅發表摘要而以。 若使用固定效應模式分析後發現，在與安慰劑相較之下，懷孕期間合併補充維生素E與其他補充品，對死產的風險(relative risk (RR) was 0.77， 95% confidence intervals (CI) 0.35 to 1.71，2個試驗，339位婦女)、新生兒死亡(R .00， 95% CI 0.64 to 39.06， 1個試驗，40位婦女)、產期死亡(R .29，95% CI 0.67 to 2.48，1個試驗，56位婦女)、早產(R .29，95% CI 0.78 to 2.15，2個試驗，383位婦女)、子宮內胎兒生長遲滯(R .72， 95% CI 0.49 to 1.04，2個試驗，383位婦女)、出生體重(加權平均差 139.00 g， 95% CI −517.68 to 239.68，1個試驗，100位婦女)等項目上都沒有統計學上的差異。 子癇前症的資料用不同的統計分析法,會出現相當大的差異性。 與安慰劑相較之下，婦女合併補充維生素E與其他補充品，若用固定效應模式來分析，對臨床子癇前症發生的風險會減低(R .44，95% CI 0.27 to 0.71，3個試驗，510位婦女)；但是若用隨機因子模式來分析，就無法呈現這個差異(R .44，95% CI 0.16 to 1.22，3個試驗，510位婦女)。 與安慰劑相較之下，婦女補充維生素E對任何次級預後都不會出現統計學上的差異
此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌
沒有足夠的證據可以確認懷孕期間補充維生素E能幫助婦女防止嬰兒死亡、早產或出生體重不足。 孕婦飲食缺乏維生素E(主要存在於植物油、堅果、穀類和某些帶葉的綠色蔬菜中)可能會導致併發症例如子癇前症以及生下體重不足的嬰兒。 本文發現沒有單獨只補充維生素E的研究，都是併用維生素C，和其他補充品或是藥物。 沒有足夠的證據可以斷定孕婦補充維生素E合併其他補充品能改善婦女及嬰兒的預後