Vitamin A supplementation in pregnant women
Vitamin A is important for visual health, immune function and fetal growth and development. Vitamin A deficiency is a public health problem in many parts of the world, particularly Africa and South-East Asia. It can cause visual impairment in the form of night blindness and, in children, may increase the risk of illness and death from childhood infections, including measles and those causing diarrhoea.
Although pregnant women are susceptible to vitamin A deficiency throughout gestation, susceptibility is at its highest during the third trimester of pregnancy due to accelerated fetal development and the physiological increase in blood volume during this period.
While there is some indication that low doses of vitamin A supplements given to pregnant women on a daily or weekly basis, starting in the second or third trimester, can reduce the severity of decline in maternal serum retinol levels during late pregnancy and the symptoms of night blindness, current evidence indicates that vitamin A supplementation during pregnancy does not reduce the risk of illness or death in mothers or their infants.
Pregnant women should be encouraged to receive adequate nutrition, which is best achieved through consumption of a healthy balanced diet.
Vitamin A supplementation during pregnancy as part of routine antenatal care for the prevention of maternal and infant morbidity and mortality is not recommended.
In settings where there is a severe public health problem related to vitamin A deficiency (prevalence of night blindness is 5% or higher in pregnant women or 5% or higher in children 24–59 months of age), vitamin A supplementation during pregnancy is recommended for the prevention of night blindness.
Determination of vitamin A deficiency as a public health problem involves estimating the prevalence of deficiency in a population by using specific biochemical and clinical indicators of vitamin A status. Classification of countries based on the most recent estimates is available in the guidance document, Global prevalence of vitamin A deficiency in populations at risk 1995–2005, under 'WHO documents' below.
A suggested scheme for vitamin A supplementation in pregnant women, where there is a severe public health problem related to vitamin A deficiency, can be found in the WHO guideline, Vitamin A supplementation in pregnant women, under 'WHO documents' below.
Other guidance documents
Global prevalence of vitamin A deficiency in populations at risk 1995–2005: WHO Global Database on Vitamin A Deficiency
Systematic reviews used to develop the guidelines
- Vitamin A supplementation during pregnancy for maternal and newborn outcomes
- Vitamin supplementation for preventing miscarriage