e-Library of Evidence for Nutrition Actions (eLENA)

Vitamin A supplementation during pregnancy

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.

WHO recommendations

Vitamin A supplementation is only recommended for pregnant women in areas where vitamin A deficiency is a severe public health problem*, to prevent night blindness.**

* Vitamin A deficiency is a severe public health problem if ≥ 5% of women in a population have a history of night blindness in their most recent pregnancy in the previous 3 – 5 years that ended in a live birth, or if ≥ 20% of pregnant women have a serum retinol level < 0.70 µmol/L. 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.
** This recommendation supercedes the previous recommendation found in the WHO guideline ‘Vitamin A supplementation in pregnant women (2011).


Additional information for this recommendation can be found in the guidance summary and in the guideline, under 'WHO documents' below.

This is one of several WHO recommendations on vitamin A supplementation. The full set of recommendations can be found in 'Full set of recommendations'.

WHO documents

WHO documents

GRC-approved guidelines
Other guidance documents


Systematic reviews used to develop the guidelines
Related Cochrane reviews
Other related systematic reviews
Clinical trials

Last update:

15 June 2017 14:51 CEST

Category 1 intervention

Guidelines have been recently approved by the WHO Guidelines Review Committee

Essential Nutrition Actions

This intervention is an Essential Nutrition Action targeting the first 1000 days of life.