Pharmaceutical companies are often seen promoting multivitamin and mineral supplements to pregnant women as a means of giving their child the best possible start in life. However, a review of the available evidence published recently in an issue of the ‘Drug and Therapeutics’ concludes that they are unlikely to be needed by most mums-to-be and are an unnecessary expense.
The report says it will be in the best interest of the pregnant women and her baby to steer clear of such claims as such pills don’t do any good to the mother or the baby. Focus should be on improving the overall diet and in taking folic acid and vitamin D supplements. These are available at a reasonably low cost. Nourishment before and during pregnancy is utmost important for the wellbeing of the mother and her unborn child good. If there is deficiency of any key nutrients, there is an increased chance of complications of pregnancy and birth such as pre-eclampsia, restricted fetal growth, neural tube defects, skeletal deformities and low birthweight.
It is common to see that a number of such multi-vitamin and mineral supplements are promoted to women for all stages of pregnancy to keep all such problems at bay. Typically, such supplements contain 20+ vitamins and minerals, such as vitamins B1, B2, B3, B6, B12, C, D, E, K, folic acid, iodine, magnesium, iron, copper, zinc and selenium, at a cost of around £15/month.
In order to critically examine the current UK guidance for vitamin supplements recommended for pregnant women, and the evidence behind it, the published research on folic acid, vitamin D, iron, vitamins C, E, and A, and multivitamin supplements was reviewed by the dtb. Their review revealed that folic acid had the strongest evidence to support national UK guidance. It is recommended that women take 400 ug of folic acid daily from before, until 12 weeks of, pregnancy. In case a woman is at a greater risk of having a child with neural tube defects because of a family history of the condition, or because of diabetes, a daily dose of 5 mg is recommended. The data on vitamin D supplementation was also studied – the evidence were not strong enough to support the claim that it reduces the risk of complications of pregnancy or birth. Still, a daily dose of 10 ug is recommended throughout pregnancy and breastfeeding.
The review found that if a woman is well nourished, there was no evidence of any clinical benefit from any other supplements. On the contrary, high doses of vitamin A may harm the developing fetus. The available data don’t support the use of multi-vitamin supplements in most pregnant women either, says dtb.
The report says that the researchers found no reason to recommend all pregnant women to take prenatal multi-nutrient supplements beyond the nationally advised folic acid and vitamin D supplements. The dtb also points out that much of the evidence which forms the basis of marketing claims for multi-vitamin supplements are studies carried out in low income countries, where women are more likely to be undernourished or malnourished than women in the UK.
The dtb finally concludes their report by aging that most women who are planning to become pregnant or who are pregnant, complex multivitamin and mineral preparations promoted for use during pregnancy are unlikely to be needed and are an unnecessary expense. Pregnant women are typically vulnerable to messages about giving their baby the best start in life, regardless of cost. However, the marketing of such supplements does not seem to be supported by evidence of improvement in child or maternal outcomes. The only supplements recommended for all pregnant women are folic acid and vitamin D and they would do well by just taking them.
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