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<strong>KCE</strong> reports vol. 6A Prenatale zorg 238 1.f. Fluoride Do prenatal fluoride supplements prevent dental caries? Study Ref Population Intervention Outcomes Results Comments Study Leverett et al., 1997 121 Pregnancy women and 798 children followed until age 5. Fluoride supplementation in pregnancy vs. placebo during last 6 months of pregnancy. (1 mg tablet daily,). Caries in children at 3 and 5 years old. Fluorosis at age 5. 92% of children remained caries-free in the treatment group and 91% remained caries-free in the placebo group. There were no statistically significant differences in the study groups with respect to caries and fluorosis in deciduous teeth. These findings do not support the hypothesis that prenatal fluoride has a strong caries-preventive effect. Does prenatal fluoride supplemented (PNF) teeth allow the fetus to grow and develop to its full potential? Study Ref Population Intervention Outcomes Results Comments Study Glenn et al., 1982 Glenn et al., 1997 122 492 children Sodium fluoride tablet supplementation during last two trimesters 123 Fluoride supplementation, 2 mg/day pulse dose Fetal teeth nutrition Pregnancy women produce children with superior teeth that are immune to decay Teeth development of fetuses PNF allows teeth to develop to their full potential Does sodium fluoride supplementation during pregnancy to the improved occlusal morphology of molar teeth? Study Ref Population Intervention Outcomes Results Comments Study Glenn et al., 1984 124 200 mothers Fluoride prenatal supplementation (PNF) regimen and 100 whose mothers were not Occlusal morphology of molar teeth A statistically significant differences in their occlusal molar morphology between two groups EL type DBRP 1b type Clinical study EL RV 2 2b EL Study type is not clear type CH? 2b?
<strong>KCE</strong> reports vol. 6A Prenatale zorg 239 2. Vitamins 2.a. Vitamin A Does vitamin A supplementation during pregnancy improve maternal and perinatal outcomes? Study Ref Population Intervention Outcomes Results Comments Study Van DE et al., 2004 Date of most recent substantive amendment: 22 August 2002 125 5 RCTs 23,426 women Varried between trials Maternal mortality Night blindness Anaemia 2. b. Vitamins C & E (the antioxidants) in pregnancy All 3 outcomes were significantly improved in the Nepal trial, but not in the others. Because this was by far the largest, the combined odds ratio was affected Differences between the trials with regard to the dose of vitamin A given, the combination with additional micronutrients (iron, folate, vitamin D) and the duration of supplementation. Does vitamin C & E supplementation during pregnancy improve maternal and perinatal outcomes? Study Ref Population Intervention Outcomes Results Comments Study Gulmezoglu et al, 1997 Chappell et al, 1999 Steyn et al, 2003 126 South Africa; Women with severe pre-eclampsia diagnosed between 24 and 32 weeks of gestation; total 56 women 127 London, 283 women identified as being at increased risk of preeclampsia by abnormal uterine- artery doppler 128 203 women with a history of PTB or 2nd trimester miscarriage recruited before 26 weeks Vitamin E (800 IU/day), vitamin C (1000 mg/day), and allopurinol (200 mg/day Vitamin C (1000 mg/day) and vitamin E (400 IU/day) or placebo at 16-22 weeksÊÊÊ gestation Vitamin C (250 mg/day) until 33 weeks Complications of pre-eclampsie NS decrease in preterm birth ( in the antioxidant group was 52% (14/27) compared with 76% (22/29) Insufficient power. EL type SR 1a EL type DBRP 1b Pre-eclampsie OR 0.39 [0.17-0.90] RCT 1b Preterm labour Birth prior to 37 weeks more likely in treated arm DBRP 1b
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