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Meta-Analysis
. 2022 Oct;101(10):1038-1047.
doi: 10.1111/aogs.14356. Epub 2022 Apr 7.

Multivitamin use and risk of preeclampsia: A systematic review and meta-analysis

Cecilie Holm Christiansen  1 , Stinne Høgh  1   2 , Line Rode  3   4 , Jeppe Bennekou Schroll  5   6 , Hanne Kristine Hegaard  2   6 , Hanne Trap Wolf  5
Affiliations
Meta-Analysis

Multivitamin use and risk of preeclampsia: A systematic review and meta-analysis

Cecilie Holm Christiansen et al. Acta Obstet Gynecol Scand. 2022 Oct.

Abstract

Introduction: Preeclampsia is associated with adverse maternal and neonatal outcomes. It is unclear whether multivitamin use reduces the risk of preeclampsia. This systematic review and meta-analysis aimed to evaluate the association between multivitamin use and the risk of preeclampsia.

Material and methods: We searched PubMed, Embase and the Cochrane Library from database inception to July 2021. Randomized controlled trials (RCTs), case-control and cohort studies assessing the association between multivitamin use and risk of preeclampsia were eligible. Studies of treatment with a single micronutrient were excluded. Relative risks and 95% confidence intervals (95% CI) were calculated using random-effects models. RoB2, the Newcastle Ottawa Scale and GRADE were used to assess risk of bias and quality of evidence. The protocol was registered in PROSPERO (no. CRD42021214153).

Results: Six studies were included (33 356 women). Only two RCTs were found, both showing a significantly decreased risk of preeclampsia in multivitamin users. These studies were not compatible for meta-analysis due to clinical heterogeneity. A meta-analysis of observational studies using a random-effects model showed an unchanged risk of preeclampsia following multivitamin use (relative risk 0.85, 95% CI 0.69-1.03). The quality of evidence according to GRADE was very low.

Conclusions: Very weak evidence suggests that multivitamin use might reduce the risk of preeclampsia; however, more research is needed. Large RCTs should be prioritized. The results of this review do not allow any final conclusions to be drawn regarding a preventive effect of multivitamin use in relation to preeclampsia.

Keywords: HELLP; eclampsia; micronutrients; multivitamin; preeclampsia; pregnancy; pregnant women.

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Conflict of interest statement

None to declare.

Figures

FIGURE 1
FIGURE 1
Flow chart of search results and process for selection and inclusion of references in systematic review
FIGURE 2
FIGURE 2
Meta‐analyses. Forest plots of effect estimates for preeclampsia
See this image and copyright information in PMC

Comment in

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