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.
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'.
Other guidance documents
Global prevalence of vitamin A deficiency in populations at risk 1995–2005: WHO Global Database on Vitamin A Deficiency