Suplementação com vitamina A no puerpério: revisão sistemática

Abstract

A systematic review on studies evaluating the effect of applying megadoses of vitamin A on the retinol concentrations in maternal milk and blood, as a short-term measure for preventing hypovitaminosis A, was conducted. Based on the strategy of the Brazilian Cochrane Center for randomized trials, 115 published papers were identified in PubMed. From these, through a set of inclusion/exclusion criteria, 14 articles published between 1993 and 2007 were selected. The effects of interventions with three posological regimens (200,000, 300,000 and 400,000 IU) of vitamin A were analyzed. Out of 11 experiments conducted on maternal milk, nine presented elevation of the retinol levels in comparison with the control group; out of nine that evaluated maternal blood, four showed elevation at varying times after applying megadoses of vitamin A. It was concluded that the results from administration of vitamin A at high doses were positive in 82% of the trials on maternal milk, but less notable in relation to maternal blood. No significant differences regarding the posological regimens applied were observed.

Effect of vitamin A, calcium and vitamin D fortification and supplementation on nutritional status of women: an overview of systematic reviews

“…Hence, we decided to include only De-Regil et al [ 17 ] considering it being the most comprehensive and had scored high on R-AMSTAR. Arthur et al [ 18 ] included one RCT, i.e., Tchum 2006 (list of included RCTs are provided in Additional File 6 ), for assessing effect of vitamin A supplementation on the serum retinol levels among postpartum women, because it had already been included by Caminha et al [ 19 ]; therefore, Arthur et al [ 18 ] was not included for data synthesis of serum retinol levels. Similarly, one RCT (Martins et al 2010) of Neves et al [ 20 ] was included by Oliveira et al [ 21 ]; hence, Neves et al [ 20 ] was not considered for synthesis of effect of vitamin A on the serum retinol levels in women.…”

“…low-income settings in India, Bangladesh, Indonesia, Tanzania, Gambia, Zimbabwe, Kenya, Ghana, Peru, and Brazil (Oliveira et al [ 21 ]) Pregnant and puerperal women (Neves et al [ 20 ]) Lactating women (Caminha et al [ 19 ]) Pregnant women (Thorne-Lyman and Fawzi [ 25 ]; McCauley et al [ 24 ]) Pregnant women (Christesen et al [ 22 ]; De-Regil et al [ 17 ]; Roth et al [ 9 ]) Adult women of age > 18 years (Reid et al [ 27 ]) Pregnant women, children, and adolescents (Chakhtoura et al [ 26 ]) Children, adolescents, pre-pregnant women, women of reproductive age group, and post-menopausal women (Das et al [ 28 ]) Adult women of age > 18 years (Trowman et al [ 29 ]; Cumming [ 30 ]) Pregnant women (Buppasiri et al [ 31 ]). Obese/ overweight participants (Onakpoya et al [ 32 ]) Pregnant and puerperal women (Arthur et al [ 18 ]) Pre-pregnant women, women of reproductive age group, and post-menopausal women (Das et al [ 28 ]) included Intervention Supplementation of vitamin A alone or in combination with other micronutrients (Oliveira et al [ 21 ]; McCauley et al [ 24 ]; Neves et al [ 20 ]) Supplementation of vitamin A/beta carotene (Thorne-Lyman and Fawzi [ 25 ]; Caminha et al [ 19 ]) Supplementation of vitamin D (Chakhtoura et al [ 26 ]; Christesen et al [ 22 ]; Reid et al [ 27 ]; De-Regil et al [ 17 ]; Roth et al [ 9 ]) Fortified food with vitamin D along with other micronutrients (Das et al [ 28 ]) Calcium supplementation with or without dairy products or combined calcium supplementation (Trowman et al [ 29 ]; Cumming [31]; Buppasiri et al [ 31 ]; Onakpoya et al [ 32 ]; Arthur et al [ 18 ]) Alkaline phosphatase and s...…”

“…Five SRs [ 19 – 21 , 24 , 25 ] provided information on the effect of vitamin A supplementation on nutritional outcomes. Summary of the synthesis is given below, and detailed synthesis is provided in Additional file 5 under table 1.…”

“…However, there is no additional effect on the serum retinol levels by 400,000 IU vitamin A, assessed at 2–6 months, when compared to a standard dose of 200,000 IU. Dosage of 200,000–300,000 IU of vitamin A given to postpartum women increases the serum retinol levels till 6 to 6.5 months postpartum, but the effect was lost when assessed at 9 months postpartum [ 19 , 21 ].…”

Práticas baseadas em evidências publicadas no Brasil: identificação e reflexão na área da prevenção em saúde humana

“…Thus, there were studies that only focused on the prevalence or incidence of health problem events (I) (12)(13)27,32,45,(47)(48)67,81,(83)(84)(85)(86)90,92) ; others to iden fy and/or associate risk factors (II) ( ; and s ll others to correlate interven ons with preven on, prophylaxis or reduc on of events (III) (14)(15)(17)(18)20,23,33,46,(50)(51)(53)(54)(55)58,62,(64)(65)(68)(69)(70)(71)(72)(73)(74)(75)(76)(79)(80)82,89,91,(93)(94) .…”