Objective To investigate the effectiveness of antioxidants for preventing preeclampsia and other maternal and fetal complications among pregnant women with low, moderate or high risk of preeclampsia.
Methods We searched Medline, Embase, Cochrane Central, mRCT, CRD, ISI Web of Science, Lilacs, Scielo and Scopus databases, without language restriction or limits on date of publication. Randomised controlled clinical trials evaluating the use of antioxidants vs placebo or a group without antioxidants were considered eligible.
Results A total of 1120 articles were located, and 16 randomised clinical trials were analysed (20 808 women). A meta-analysis did not show any statistically significant difference between women who received an antioxidant (vitamin C, vitamin E, lycopene, selenium, red palm oil) and women who received placebo, for the outcomes of preeclampsia (RR=0.92; 95% CI 0.80 to 1.06), severe preeclampsia (RR=1.03; 95% CI 0.87 to 1.22), preterm birth (RR=1.03; 95% CI 0.95 to 1.11), small-for-gestational-age infants (RR=0.95; 95% CI 0.86 to 1.05) and any baby death (RR=1.02; 95% CI 0.87 to 1.20). Side-effects (abdominal pain, itching, eczema, vomiting, diarrhoea, headache, constipation, malaise, decreased vision, skin rash and chest pain) occurred more frequently among the women who took antioxidants than among those who took placebo (RR=1.58; 95% CI 1.11 to 2.24).
Conclusion The evidence does not support the use of antioxidants during pregnancy. Not only are its benefits unclear, but also adverse effects occurred more frequently with its use.
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Funding MS/SCTIE/DECIT, via CNPq (Edital 67/2009).
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