Vitamin E in Pregnancy

Patricia Van Leer

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Apr 1, 2017 Issue

Medicine by the Numbers

A Collaboration of TheNNT.com and AFP

Vitamin E in Pregnancy

PATRICIA VAN LEER, MD

Am Fam Physician. 2017 Apr 1;95(7):online.

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VITAMIN E IN PREGNANCY

Benefits	Harms
1 in 333 avoided a placental abruption	1 in 19 developed term premature rupture of membranes
	No change in neonatal death, infant death, or preterm birth rates

VITAMIN E IN PREGNANCY

Benefits	Harms
1 in 333 avoided a placental abruption	1 in 19 developed term premature rupture of membranes
	No change in neonatal death, infant death, or preterm birth rates

Details for This Review

Study Population: Pregnant women

Efficacy End Points: Placental abruption avoided

Harm End Points: Stillbirth, neonatal death, perinatal infant death, preterm birth, preeclampsia, intrauterine growth restriction, premature rupture of membranes (PROM), placental abruption

Narrative: Vitamin E has antioxidant properties that decrease oxidative stress within the body. During pregnancy, increased oxidative stress has been linked to pre-eclampsia, intrauterine growth restriction, and PROM. This review evaluates the effectiveness of vitamin E supplementation in pregnancy.1

Approximately 22,000 women from 17 trials were included in the analysis. The review reports no clear difference in stillbirth or neonatal death. There was also no difference noted for perinatal death, preterm birth, preeclampsia, or intrauterine growth restriction, although the authors note substantial heterogeneity for these specific outcomes.

PROM and placental abruption were considered secondary outcomes. Heterogeneity is a limiting factor for analysis of preterm PROM; however, the authors reported no difference using advanced data analysis. There is a statistically significant increase in the risk of term PROM in patients taking vitamin E supplements vs. the control groups (number needed to harm = 19; P < .001). Patients who received vitamin E had a decreased risk of placental abruption (number needed to treat = 333; P = .02).

Among the most patient-important outcomes, such as infant death, vitamin E does

Author disclosure: No relevant financial affiliations.

REFERENCES

1. Rumbold A, Ota E, Hori H, Miyazaki C, Crowther CA. Vitamin E supplementation in pregnancy. Cochrane Database Syst Rev. 2015(9):CD004069.

2. Johnson L, Bowen FW Jr, Abbasi S, et al. Relationship of prolonged pharmacologic serum levels of vitamin E to incidence of sepsis and necrotizing enterocolitis in infants with birth weight 1,500 grams or less. Pediatrics. 1985;75(4):619–638.

This series is coordinated by Dean A. Seehusen, MD, MPH, AFP Contributing Editor, and Daniel Runde, MD, from the NNT Group.

A collection of Medicine by the Numbers published in AFP is available at http://www.aafp.org/afp/mbtn.

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