Supplements during pregnancy: are there any benefits?

  • Oh C & al.
  • Nutrients
  • 14 Feb 2020

  • curated by Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
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Takeaway

  • Single micronutrient supplementation during pregnancy has few effects on maternal and neonatal outcomes.

Why this matters

  • Almost 2 billion people around the world have vitamin and mineral deficiencies that adversely affect pregnancy and offspring.

Key results

  • Compared with placebo:
    • Vitamin A: no effect on maternal mortality, stillbirths.
    • Zinc: no effect on risk for low birth weight (LBW), preeclampsia, preterm birth.
    • Iron: reduced risk for maternal anemia by 47% (risk ratio [RR], 0.53; 95% CI, 0.43-0.65); no effect on perinatal mortality.
    • Vitamin D: no effect on risk for small for gestational age or cesarean delivery (CD).
    • Calcium: no effect on risk for LBW, stillbirths, preterm birth, CD. Calcium was tied to reduced risk for preeclampsia (RR, 0.45; 95% CI, 0.19-1.06).
  • Multiple micronutrients: no effect on maternal mortality or perinatal mortality and decreased risk for LBW (RR, 0.85; 95% CI, 0.77-0.93) vs iron with or without folic acid.
  • Lipid-based nutrient supplementation vs multiple micronutrients: no effect on risk for LBW, miscarriage, neonatal mortality.

Study design

  • Systematic review, meta-analysis.
  • Studies after 1995 on vitamin/mineral supplementation during pregnancy in healthy mothers of any age and parity in low- and middle-income countries (72 studies, 314 associated articles).
  • Funding: Bill and Melinda Gates Foundation.

Limitations

  • Heterogeneity among studies.