Is vitamin E supplementation beneficial during pregnancy?

No, on the evidence from randomized trials. A 2015 Cochrane review of 21 trials, with more than 20,000 pregnant women in its main analyses, found that vitamin E, almost always given with vitamin C, did not lower pre-eclampsia (RR 0.91, 95% CI 0.79 to 1.06) or preterm birth (RR 0.98, 95% CI 0.88 to 1.09). It came with more term rupture of the membranes before labor. Whether vitamin E on its own does anything in pregnancy has barely been tested.

Myth. Vitamin E has been tested as a way to prevent pre-eclampsia, preterm birth, stillbirth and poor fetal growth, and it did not prevent any of them. The Cochrane authors concluded that the data do not support routine supplementation in combination with other supplements for any of these outcomes.

What the trials found

The main outcomes did not change

In the 2015 Cochrane review there was no clear difference for stillbirth (RR 1.17, 95% CI 0.88 to 1.56, moderate quality evidence), neonatal death (RR 0.81, 95% CI 0.58 to 1.13) or growth restriction (RR 0.98, 95% CI 0.91 to 1.06, high quality evidence). A 2011 meta-analysis of 9 trials with 19,810 women gives the plainest absolute figure. Pre-eclampsia affected 9.6 percent of women on vitamins C and E and 9.6 percent on placebo (RR 1.00, 95% CI 0.92 to 1.09), and that held in women at high risk and in women at low risk.

Two later syntheses landed in the same place. A 2018 meta-analysis of 19 prevention trials of oral antioxidants, vitamins C and E among them, found no clear fall in pre-eclampsia (RR 0.89, 95% CI 0.79 to 1.02). A 2026 network meta-analysis of 22 trials found that vitamins C and E did not prevent gestational hypertension. For women who took vitamins C and E before or early in pregnancy, a 2016 Cochrane review found no change in total fetal loss (RR 1.14, 95% CI 0.92 to 1.40, high quality evidence) or miscarriage (RR 0.90, 95% CI 0.65 to 1.26).

One outcome went down

Women given vitamin E with other supplements had fewer placental abruptions, in 7 trials with 14,922 women (RR 0.64, 95% CI 0.44 to 0.93, high quality evidence). That is a relative figure from trials of combined supplements, and the same review still concluded that the data do not support routine supplementation. It is not a reason to take vitamin E in pregnancy.

Unsettled. Two smaller studies point in a positive direction, and neither changes the answer. In a secondary analysis of a large US trial in first-time mothers, vitamins C and E went with fewer abruptions (RR 0.09, 95% CI 0.00 to 0.87) and fewer preterm births (RR 0.76, 95% CI 0.58 to 0.99), but only in smokers. That is a subgroup result and a hypothesis. A 2020 Iranian trial in 160 first-time mothers reported pre-eclampsia in 5 percent with 400 IU of vitamin E plus 1,000 mg of vitamin C, against 17.5 percent with iron alone. It had no placebo and it is small, and it runs against the large trials.

For children, observational data linked the highest maternal intake of vitamin E with 36 percent lower odds of wheeze at 2 years (aOR 0.64, 95% CI 0.47 to 0.87). That comes from two observational studies rated very low certainty, and it does not show that a supplement prevents wheeze.

Who should be careful

The randomized trials themselves found harms. In the 2015 Cochrane review, vitamin E with other supplements raised the risk of term prelabour rupture of membranes (RR 1.77, 95% CI 1.37 to 2.28, two trials, 2,504 women). Self-reported abdominal pain rose too (RR 1.66, 95% CI 1.16 to 2.37, one trial, 1,877 women). Preterm rupture of membranes did not rise significantly (RR 1.27, 95% CI 0.93 to 1.75, low quality evidence).

Not for everyone. Blood pressure is the signal that keeps coming back. In a 2010 meta-analysis of 9 trials, gestational hypertension affected 22.6 percent of women on vitamins C and E against 20.3 percent on placebo (RR 1.11, 95% CI 1.05 to 1.17). In women at risk of pre-eclampsia, a 2009 meta-analysis of 7 trials with 5,969 women found more gestational hypertension (RR 1.3, 95% CI 1.08 to 1.57) and more low birth weight (RR 1.13, 95% CI 1.004 to 1.27), an interval that almost touches 1. A 2008 Cochrane review found women on antioxidants, mostly vitamins C and E, more often needed blood pressure drugs (RR 1.77, 95% CI 1.22 to 2.57, two trials, 4,272 women).

NIH notes that large doses of vitamin E taken with warfarin or antiplatelet drugs can raise the risk of bleeding, especially with low vitamin K intake. That warning is general and was not written for pregnancy. If you take a blood thinner while pregnant, any vitamin E supplement is a question for the person treating you.

What expert bodies say

The WHO e-Library of Evidence for Nutrition Actions states that current evidence does not support the routine use of vitamin E supplementation during pregnancy. WHO also notes that few trials were done in women known to have inadequate vitamin E intake, so the findings may not apply to every population.

EFSA reviewed the evidence in 2024. It noted that of the 21 trials in the Cochrane review only three gave vitamin E alone against placebo, and it kept the upper limit at 300 mg a day, applying also during pregnancy and breastfeeding. The US upper limit for adults is 1,000 mg of supplemental alpha-tocopherol a day, and NIH says the data behind it are limited and come from small groups followed for weeks or months. The European limit is less than a third of the American one.

How we searched

What would change this answer

• Trials of vitamin E alone in pregnancy. EFSA counted three, two of them conference abstracts without the dose.
• Trials in women whose vitamin E intake or status is known to be low. WHO notes there are few, so a benefit in that group is untested.
• A dedicated trial of the placental abruption result, which the Cochrane authors flag for research.
• A check of the 2026 meta-analysis on vitamin E status, gestational age and birth weight, which we read only in outline and did not card.

Sources

1. ev-vepr-01 · Meta-analysis or systematic review · Cochrane systematic review and meta-analysis of RCTs · n = 20878
   No clear difference was found between women supplemented with vitamin E in combination with other supplements during pregnancy compared with placebo for the risk of stillbirth (risk ratio (RR) 1.17, 95% confidence interval (CI) 0.88 to 1.56, nine studies, 19,023 participants, I² = 0%; moderate quality evidence), neonatal death (RR 0.81, 95% CI 0.58 to 1.13, nine trials, 18,617 participants, I² = 0%), pre-eclampsia (average RR 0.91, 95% CI 0.79 to 1.06; 14 trials, 20,878 participants; I² = 48%; moderate quality evidence), preterm birth (average RR 0.98, 95% CI 0.88 to 1.09, 11 trials, 20,565 participants, I² = 52%; high quality evidence) or intrauterine growth restriction (RR 0.98, 95% CI 0.91 to 1.06, 11 trials, 20,202 participants, I² = 17%; high quality evidence).
   
   Who: pregnant women in randomized or quasi-randomized trials; all contributing trials gave vitamin E with vitamin C and/or other agents
   Effect: pre-eclampsia RR 0.91 (95% CI 0.79 to 1.06; 14 trials, 20,878); preterm birth RR 0.98 (0.88 to 1.09; 11 trials, 20,565); stillbirth RR 1.17 (0.88 to 1.56); neonatal death RR 0.81 (0.58 to 1.13); growth restriction RR 0.98 (0.91 to 1.06)
   Certainty: GRADE high for preterm birth and growth restriction, moderate for stillbirth and pre-eclampsia. The effect of vitamin E separately from C cannot be isolated.
   Cochrane Database Syst Rev, 2015 · checked 2026-10-07 · we read the abstract
2. ev-vepr-02 · Meta-analysis or systematic review · Cochrane systematic review and meta-analysis of RCTs · n = 14922
   Women supplemented with vitamin E in combination with other supplements compared with placebo were at decreased risk of having a placental abruption (RR 0.64, 95% CI 0.44 to 0.93, seven trials, 14,922 participants, I² = 0%; high quality evidence).
   
   Who: pregnant women in 7 RCTs of vitamin E combined with other supplements
   Effect: placental abruption RR 0.64 (95% CI 0.44 to 0.93); high quality evidence
   Certainty: Relative risk; the quote does not give absolute proportions. The review's conclusion (ev-vepr-04): the data do not support routine supplementation.
   Cochrane Database Syst Rev, 2015 · checked 2026-10-07 · we read the abstract
3. ev-vepr-03 · Meta-analysis or systematic review · Cochrane systematic review and meta-analysis of RCTs · n = 2504
   Conversely, supplementation with vitamin E was associated with an increased risk of self-reported abdominal pain (RR 1.66, 95% CI 1.16 to 2.37, one trial, 1877 participants) and term prelabour rupture of membranes (PROM) (average RR 1.77, 95% CI 1.37 to 2.28, two trials, 2504 participants, I² = 0%); however, there was no corresponding increased risk for preterm PROM (average RR 1.27, 95% CI 0.93 to 1.75, five trials, 1999 participants, I² = 66%; low quality evidence).
   
   Who: pregnant women in RCTs of vitamin E combined with other supplements
   Effect: term PROM RR 1.77 (95% CI 1.37 to 2.28; 2 trials, 2,504 women); abdominal pain RR 1.66 (1.16 to 2.37; 1 trial, 1,877); preterm PROM RR 1.27 (0.93 to 1.75, NS)
   Certainty: Harm signal from two RCTs; for preterm PROM the quality is low.
   Cochrane Database Syst Rev, 2015 · checked 2026-10-07 · we read the abstract
4. ev-vepr-04 · Meta-analysis or systematic review · Cochrane systematic review and meta-analysis of RCTs · n = —
   The data do not support routine vitamin E supplementation in combination with other supplements for the prevention of stillbirth, neonatal death, preterm birth, pre-eclampsia, preterm or term PROM or poor fetal growth.
   
   Who: pregnant women in randomized trials of vitamin E combined with other supplements
   Effect: no supported benefit for stillbirth, neonatal death, preterm birth, pre-eclampsia, PROM or fetal growth
   Certainty: A review conclusion, not a separate number.
   Cochrane Database Syst Rev, 2015 · checked 2026-10-07 · we read the abstract
5. ev-vepr-05 · Meta-analysis or systematic review · systematic review and meta-analysis of RCTs · n = 19810
   Overall, there were no significant differences between the vitamin and placebo groups in the risk of preeclampsia (9.6% vs 9.6%; relative risk, 1.00, 95% confidence interval, 0.92-1.09).
   
   Who: pregnant women in RCTs of vitamins C and E, subgroups at high and at low or moderate risk of pre-eclampsia
   Effect: pre-eclampsia 9.6% vs 9.6%, RR 1.00 (95% CI 0.92 to 1.09); more gestational hypertension and PROM, fewer abruptions
   Certainty: Overlaps with the Cochrane review; confirms the null separately for risk groups.
   Am J Obstet Gynecol, 2011 · checked 2026-10-07 · we read the abstract
6. ev-vepr-06 · Meta-analysis or systematic review · systematic review and random-effects meta-analysis of RCTs · n = 19675
   The incidence of gestational hypertension was 22.6% (1915 of 8491) in the vitCE group and 20.3% (1728 of 8500) in the placebo group (RR: 1.11, 95% CI: 1.05-1.17).
   
   Who: pregnant women in 9 RCTs of combined vitamin C and E
   Effect: gestational hypertension RR 1.11 (95% CI 1.05 to 1.17); pre-eclampsia RR 0.98 (0.87 to 1.10); abruption RR 0.67 (0.46 to 0.98)
   Certainty: The authors caution: the links with hypertension and abruption may be chance because of multiple comparisons. n = 9833 + 9842.
   Obstet Gynecol Surv, 2010 · checked 2026-10-07 · we read the abstract
7. ev-vepr-07 · Meta-analysis or systematic review · meta-analysis of randomized trials · n = 5969
   The RRs are 1.3 (95% CI of 1.08-1.57, p = 0.0066) for gestational hypertension, 0.7 (95% CI of 0.58-1.08, P = 0.1653) for preeclampsia, 1.12 (95% CI of 0.96-1.32, p = 0.141) for preterm delivery, 1.04 (95% CI of 0.94-1.15, p = 0.4789) for small for gestational age, and 1.13 (95% CI of 1.004-1.27, p = 0.0429) for low birth weight.
   
   Who: pregnant women at risk of preeclampsia
   Effect: gestational hypertension RR 1.3 (95% CI 1.08 to 1.57); low birth weight RR 1.13 (1.004 to 1.27); pre-eclampsia RR 0.7 (0.58 to 1.08, NS)
   Certainty: Small old MA; the CI bound for low birth weight is almost 1.
   Hypertens Pregnancy, 2009 · checked 2026-10-07 · we read the abstract
8. ev-vepr-08 · Meta-analysis or systematic review · Cochrane systematic review and meta-analysis of RCTs · n = 6533
   Women allocated antioxidants were more likely to self-report abdominal pain late in pregnancy (RR 1.61, 95% CI 1.11 to 2.34; one trial, 1745 women), require antihypertensive therapy (RR 1.77, 95% CI 1.22 to 2.57; two trials, 4272 women) and require an antenatal hospital admission for hypertension (RR 1.54, 95% CI 1.00 to 2.39; one trial, 1877 women).
   
   Who: pregnant women in 10 RCTs of antioxidants, mostly combined vitamin C and E
   Effect: pre-eclampsia RR 0.73 (95% CI 0.51 to 1.06, NS); antihypertensive therapy RR 1.77 (1.22 to 2.57; 2 trials, 4,272); abdominal pain RR 1.61
   Certainty: An outdated review, replaced by the 2015 Cochrane; valuable as a signal about hypertension.
   Cochrane Database Syst Rev, 2008 · checked 2026-10-07 · we read the abstract
9. ev-vepr-09 · Meta-analysis or systematic review · Cochrane systematic review and meta-analysis of RCTs · n = 18949
   There was no difference in the risk of total fetal loss (risk ratio (RR) 1.14, 95% confidence interval (CI) 0.92 to 1.40, seven trials, 18,949 women; high-quality evidence); early or late miscarriage (RR 0.90, 95% CI 0.65 to 1.26, four trials, 13,346 women; moderate-quality evidence); stillbirth (RR 1.31, 95% CI 0.97 to 1.76, seven trials, 21,442 women; moderate-quality evidence) or adverse effects of vitamin supplementation (RR 1.16, 95% CI 0.39 to 3.41, one trial, 739 women; moderate-quality evidence) between women receiving vitamin C with vitamin E compared with placebo or no vitamin C groups.
   
   Who: women supplemented before or in early pregnancy (under 20 weeks)
   Effect: total fetal loss RR 1.14 (95% CI 0.92 to 1.40); early or late miscarriage RR 0.90 (0.65 to 1.26); stillbirth RR 1.31 (0.97 to 1.76)
   Certainty: GRADE high for fetal loss, moderate for miscarriage and stillbirth.
   Cochrane Database Syst Rev, 2016 · checked 2026-10-07 · we read the abstract
10. ev-vepr-10 · Meta-analysis or systematic review · systematic review and meta-analysis of RCTs · n = 19 prevention trials
    The antioxidants used in these studies were vitamins C and E, selenium, l-arginine, allicin, lycopene and coenzyme Q10, none of which showed beneficial effects on the prevention of preeclampsia (RR: 0.89, CI 95%: [0.79-1.02], P = 0.09; I2 = 39%, P = 0.04) and other outcomes.
    
    Who: pregnant women in randomized trials of oral antioxidant supplementation
    Effect: pre-eclampsia RR 0.89 (95% CI 0.79 to 1.02)
    Certainty: Mixes different antioxidants.
    Nutr Metab Cardiovasc Dis, 2018 · checked 2026-10-07 · we read the abstract
11. ev-vepr-11 · Meta-analysis or systematic review · network meta-analysis of RCTs · n = 36104
    None of the four nutritional supplements (calcium, phytonutrient, VC, and VC-VE) were effective in preventing gestational hypertension.
    
    Who: pregnant women in 22 RCTs of oral nutritional supplements; 18,133 intervention and 17,971 placebo
    Effect: calcium, phytonutrient, vitamin C and vitamin C-E: none effective in preventing gestational hypertension
    Certainty: The combination with L-arginine cannot be attributed to vitamin E; indirect comparisons.
    Indian J Med Res, 2026 · checked 2026-10-07 · we read the abstract
12. ev-vepr-12 · Randomized controlled trial(s) · secondary subgroup analysis of a multicentre double-blind RCT · n = —
    Vitamin C/E was protective for placental abruption in smokers (relative risk [RR] 0.09; 95% CI 0.00-0.87], but not in nonsmokers (RR 0.92; 95% CI 0.52-1.62) (P = 0.01), and for preterm birth in smokers (RR 0.76; 95% CI 0.58-0.99) but not in nonsmokers (RR 1.03; 95% CI 0.90-1.17) (P = 0.046).
    
    Who: low-risk nulliparous women with singleton pregnancies, supplementation from 9 to 16 weeks, by smoking status
    Effect: smokers: abruption RR 0.09 (95% CI 0.00 to 0.87), preterm birth RR 0.76 (0.58 to 0.99); non-smokers: abruption RR 0.92, preterm birth RR 1.03
    Certainty: Subgroup, hypothesis, not evidence; smoking did not affect preeclampsia.
    BJOG, 2015 · checked 2026-10-07 · we read the abstract
13. ev-vepr-13 · Randomized controlled trial(s) · open clinical trial versus iron-only control, no placebo · n = 160
    The incidence of preeclampsia in the control group was 17.5% and in the intervention group was 5%, which was significantly different.
    
    Who: nulliparous women aged 18-38 years without risk factors for preeclampsia, from 20-24 weeks
    Effect: pre-eclampsia 5% vs 17.5%
    Certainty: Small, no placebo, weak report; contradicts large RCTs and meta-analyses, so it carries little weight.
    J Perinat Med, 2020 · checked 2026-10-07 · we read the abstract
14. ev-vepr-14 · Observational data · systematic review and meta-analysis mostly of observational studies · n = 2 observational studies
    In meta-analyses, maternal intake in the highest vitamin E quartile versus lowest reduced the odds of wheeze at 2 years by 36% (aOR: 0.64, 95% CI: 0.47-0.87, n = 2 observational studies, very low certainty); this was not true for vitamin C intake (aOR: 0.85, 95% CI: 0.63-1.16, n = 2 observational studies, very low certainty).
    
    Who: mothers and offspring in observational studies
    Effect: highest vs lowest vitamin E quartile: wheeze at 2 years aOR 0.64 (95% CI 0.47 to 0.87; 2 observational studies, very low certainty)
    Certainty: Dietary intake, not supplements; very low certainty.
    J Hum Nutr Diet, 2025 · checked 2026-10-07 · we read the abstract
15. ev-vepr-15 · Position of an expert body · EFSA scientific opinion, hazard identification section · n = —
    A total of 21 trials were eligible for that review, of which only three trials administered supplemented ‘vitamin E’ alone versus placebo (Anthony et al., 1996; Sawhney et al., 2000; Shahraki, 2006).
    
    Who: pregnant women in RCTs of alpha-tocopherol supplementation
    Effect: vitamin E alone vs placebo: 3 trials in the Cochrane review plus 2 later RCTs; no adverse effects seen but data scarce; not usable for setting a UL
    Certainty: Almost the entire evidence base is the E+C combination; there are few data on vitamin E alone.
    EFSA NDA Panel, Scientific opinion on the tolerable upper intake level for vitamin E, EFSA Journal 2024 (CC BY-ND 4.0) · checked 2026-10-07 · we read the fulltext
16. ev-vepr-16 · Position of an expert body · EFSA scientific opinion on the tolerable upper intake level · n = —
    The UL applies also to women during pregnancy and lactation, as no new evidence was found regarding specific adverse effects or different susceptibility in these groups.
    
    Who: adults in the EU including pregnant and lactating women
    Effect: UL 300 mg alpha-tocopherol/day applies to pregnancy and lactation
    Certainty: The EU limit is three times lower than the American one.
    EFSA NDA Panel, Scientific opinion on the tolerable upper intake level for vitamin E, EFSA Journal 2024 (CC BY-ND 4.0) · checked 2026-10-07 · we read the fulltext
17. ev-vepr-17 · Position of an expert body · government fact sheet · n = —
    As a result, taking large doses with anticoagulant or antiplatelet medications, such as warfarin (Coumadin), can increase the risk of bleeding, especially in conjunction with low vitamin K intake.
    
    Who: people taking anticoagulant or antiplatelet medications
    Effect: bleeding risk with large doses plus anticoagulant or antiplatelet drugs, especially with low vitamin K intake
    Certainty: Relevant for pregnant women on anticoagulants (thrombophilia, valves).
    Vitamin E, Fact Sheet for Health Professionals, NIH Office of Dietary Supplements · checked 2026-10-07 · we read the section
18. ev-vepr-18 · Position of an expert body · government fact sheet reporting FNB ULs · n = —
    Doses of up to 1,000 mg/day (1,500 IU/day of the natural form or 1,100 IU/day of the synthetic form) in adults appear to be safe, although the data are limited and based on small groups of people taking up to 3,200 mg/day of alpha-tocopherol for only a few weeks or months.
    
    Who: adults
    Effect: doses up to 1,000 mg/day appear safe in adults, based on small groups over weeks or months
    Certainty: American limit; EFSA: 300 mg.
    Vitamin E, Fact Sheet for Health Professionals, NIH Office of Dietary Supplements · checked 2026-10-07 · we read the section
19. ev-vepr-19 · Position of an expert body · WHO eLENA evidence summary page · n = —
    Current evidence does not support the routine use of vitamin E supplementation during pregnancy
    
    Who: pregnant women
    Effect: routine use not supported; abruption reduced but term PROM increased
    Certainty: WHO ANC 2016 separately: E+C not recommended (row in the log; the ANC page via NCBI returned a captcha).
    WHO e-Library of Evidence for Nutrition Actions (eLENA), review summary: Vitamin E supplementation in pregnancy · checked 2026-10-07 · we read the section
20. ev-vepr-20 · Position of an expert body · WHO eLENA review summary · n = —
    Few trials were conducted in women known to have inadequate intakes of vitamin E, and thus the findings may not be generalizable to all populations.
    
    Who: pregnant women with inadequate vitamin E intake or status
    Effect: evidence gap for deficient populations
    Certainty: Gap: the benefit for women with deficiency has not been tested.
    WHO e-Library of Evidence for Nutrition Actions (eLENA), review summary: Vitamin E supplementation in pregnancy · checked 2026-10-07 · we read the section