Prenatal vitamins are recommended by healthcare providers to optimize maternal as well as fetal health during pregnancy. Antenatal supplements include micro-nutrients like Vitamin D, C, B-Complex (especially Vitamin B6, B12, B9) and Vitamin E along with minerals such as zinc, iron, calcium and copper in recommended doses.
However, many women commit the mistake of not taking extra efforts in maintaining their health by avoiding prenatal supplements. But the question is why these supplements are so important before and during pregnancy?
Why Prenatal Supplements Are Needed?
In order to understand why prenatal supplements are important for expecting moms, it is important to know what happens in a normal pregnancy.
Pregnancy is a phase that allows expecting mothers to nourish and protect their fetus in womb until the baby is fully prepared to survive in the outside world. To supply steady nourishment, to the fetus, maternal body undergoes several changes:
- Parallel system of blood circulation is established that maintains fetal circulation fairly independent of maternal circulation.
- In order to maintain two systems of circulation while still maintaining optimal blood pressure, the kidneys absorb significant amounts of water in an attempt to increase plasma volume.
- The extra fluidity of blood causes a relative deficiency of hemoglobin and other micronutrients like vitamins and minerals due to dilution factor.
- Moreover, the requirements of these nutrients also increase due to high rate of utilization. Maternal body utilizes micronutrients like vitamins and minerals for the growth and development of female reproductive tissues like uterus, breasts, placenta; while fetus requires these nutrients for fetal tissues and organs.
So, it is pretty evident the quantity of micronutrients demanded by the pregnant mothers increase significantly. But the question persists; why mothers require supplements and why can’t they consume extra food to meet the demand for extra nutrition?
Prenatal supplements are needed for a number of reasons:
- Women with professional careers are unable to give a lot of time to their health and diet. Obviously, these individuals can consume concentrated formulations to obtain important nutrients in the recommended dosage for the maintenance of steady health during pregnancy.
- A lot of pregnant mothers develop food aversions during first and second trimesters of pregnancy. Additionally some women are not fond of consuming animal products due to personal, religious or medical reasons. Animal products are considered as the richest sources of Vitamin B12, Vitamin D, Zinc and Iron. To supply these nutrients to the mother and the baby, prenatal supplements are needed.
- Regular intake of prenatal vitamins is known to prevent pre-mature births, low-birth weight babies and growth restricted babies.
- Some women are bound to consume a certain type of diet due to conditions like gluten sensitive enteropathy, crohn’s disease, diabetes, celiac disease and others. All such women can get highly benefitted from prenatal supplements to ensure there is no gap in their nutritional status and the baby get optimal quantities of all essential micronutrients (vitamins and minerals).
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Benefits And Importance Of Prenatal Vitamins
Vitamins and minerals are nutritional elements that are needed in very small quantities to steer major metabolic and biological activities. The benefits of prenatal vitamins can be categorized as:
Benefits Before Conception
To prevent any aberrations or abnormalities, it is recommended to consume prenatal vitamins before getting pregnant (ideally when you start planning your family) in order to supply essential nutrients to fuel rapid metabolism in the baby.
- Certain vitamins increases the chances of conception by correcting hormonal imbalance (like vitamin C play a very important role in the production of vital reproductive hormone- progesterone).
- Prenatal supplements like Vitamin C and E are considered powerful antioxidants that ward off free radicals and toxins. Research published in The New England Journal of Medicine suggested that Vitamin C and E during pregnancy can minimize the risk of gestational hypertension and associated complications like pre-eclampsia and low-birth weight babies.
In most situations, the mothers don’t even realize they are pregnant until at least a few weeks in their pregnancy. Soon after the conception, the zygote (product of fertilization of egg with sperm) undergoes rapid divisions. Optimal nutritional status increases the fertility and raises the chances of successful pregnancy.
Research report Fertility Effect of Multivitamin Supplementation suggested that the chances of conception increases when women consume prenatal multivitamin supplements.
A research study conducted on 5502 women by Czeizel and associates suggested that supplementation of 0.8 mg of folic acid in pregnant mothers increase fertility (by increasing the total number of live births and multiple gestations). The report also suggested that mothers who consumed multivitamin supplements and folic acid throughout first semester and mid-second trimester delivered more healthy babies than control group.
Benefits During Pregnancy
Pregnancy is a physiological state of hormonal, nutritional and immunological imbalance. Consumption of certain vitamins and minerals in recommended dosage helps in preventing aberrations in the health of both baby and the mommy.
For example, calcium and vitamin D requirements increase during pregnancy. In order to prevent osteoporosis (poorly mineralized bones) that increases the risk of fractures, bone pain, bowing of legs and other bone related issues. Calcium and vitamin D supplements also promote bone and teeth health of babies.
Besides an increase in the body demands, most expecting mothers are unable to consume the nutrients in recommended doses because of nausea, vomiting, food aversions, dizziness, indigestion, heart-burn, unhealthy cravings, constipation and other physiological symptoms of pregnancy. Poor intake of essential nutrients via oral intake may culminate in health issues like anemia, weakness, poor resistance to infections, headaches and shortness of breath.
The need of consuming antenatal vitamins further increase in these situations:
- If you are pregnant with multiple fetuses (twins, triplets etc)
- If you have a prior history of low-birth weight babies, birth defects or miscarriage
- History of previous pregnancy (including full term childbirth or miscarriage) in the past two years.
Commonly Asked Questions About Prenatal Vitamins
- Prenatal vitamins vs. multivitamins – what’s the difference?
- Do prenatal vitamins increase fertility and pregnancy chances?
- What to look for in prenatal vitamins?
- How important is DHA in prenatal vitamins?
- Recommendations for over-the-counter prenatal vitamins?
- When is the best time to start taking prenatal vitamins?
- How not taking prenatal vitamins affect your unborn child?
- What to do if your prenatal vitamins makes you nauseous?
- How long should I take prenatal vitamins?
- Is it alright to take expired prenatal vitamins?
1. Prenatal vitamins vs. multivitamins – what’s the difference?
Most women confuse multi-vitamins to prenatal vitamins that are fairly different entities.
The dosage of multi-vitamin formulation is designed according to the daily recommended dose of an adult woman. However, the body requirements of different nutrients increases during pregnancy, which is why prenatal vitamins should be consumed to obtain all necessary vitamins according to higher requirements. Below are some key differences between multi-vitamins and prenatal vitamins:
- The dose of Iron in prenatal vitamins is higher than (up to 3 times) than that of most multi-vitamins
- The dose of folic acid is higher in prenatal vitamins
- Most multi-vitamins supply a very high dose of Vitamin A (up to 5000 IU) that may lead to birth defects in babies. The dose of Vitamin A is small in prenatal vitamins.
2. Do prenatal vitamins increase fertility and pregnancy chances?
Prenatal vitamins and supplements increase fertility and support an uneventful pregnancy. Research and data suggests that certain vital vitamins and minerals are needed for the development of reproductive system and optimal maturity/ survival of egg in the genital tract. Vitamins like ascorbic acid (Vitamin C) directly increase the serum levels of progesterone (an important hormone needed for the maintenance of pregnancy). Likewise, deficiency of folic acid is a leading cause of neural tube defects (malformation of brain and spinal cord that may be incompatible with life in severe cases).
3. What to look for in prenatal vitamins?
Experts suggest that a dose of 200 mg of DHA per day is highly recommended for an uneventful pregnancy. Unfortunately, most women consume only 70 – 80 mg of DHA per day. Study published in the peer-reviewed journal Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy suggested that DHA supplementation during pregnancy is helpful in the prevention or management of perinatal depression in mothers.
According to the recommendations of The American Congress of Obstetricians and Gynecologists, a dose of 400 – 800 mcg per day of Folic acid is needed throughout pregnancy to reduce the risk of neural tube defects, cleft lip and palate. A higher dose is needed in women who have a prior history of giving birth to baby/babies with birth defects.
Similarly iron supplements are helpful in hemoglobin synthesis that is needed to transport oxygen to the developing baby. During pregnancy the demand of iron increases 3-folds to non-pregnant state. Most antenatal supplements usually supply iron in a dose of 27 – 30 milligrams.
- Calcium can be consumed in a dose of 250 milligrams and vitamin D in the dose of 400 IU/ day
- Vitamin C is a powerful antioxidant that serve many other functions and choose a supplement that provides at least 50 milligrams of vitamin C
- Zinc is another micro-nutrient that support fetal growth and development and can be consumed in a dose of 15 milligrams/ day
- 2 milligrams of Copper are sufficient for the hair, nail and skin development and health of mother and the baby
- Vitamin B-6 can be consumed in the form of B-Complex. A dose of 2 milligrams is generally safe and effective during pregnancy.
4. How important is DHA in prenatal vitamins?
DHA (abbreviation of omega-3 fat docosahexaenoic acid) are highly recommended during pregnancy for a number of reasons. DHA is required for the brain development of babies. Other benefits include development of vision and strong bones.
5. Recommendations for over-the-counter prenatal vitamins?
If you are not using prescription prenatal supplements and using over-the-counter formulations, it is recommended to follow these guidelines:
- Always check the labels to make sure it has all the necessary nutrients (vitamins and minerals) that you need
- If you are not sure about the brand or type of formulation, feel free to consult with your doctor or pharmacist for assistance
- Maintain a healthy diet (as supplements are not the replacement of dietary nutrition)
- Make sure your supplement is free from herbs and herb like ingredients (that may not be safe in pregnancy)
- Choose a supplement that has an absorption rate of 90 to 100% in 30 minutes (you can check the solubility in water by filling a glass with water and 2 pills and observing how much the pill has dissolved after 30 minutes). This strategy is especially helpful in women who are suffering from a severe variety of morning sickness.
6. When is the best time to start taking prenatal vitamins?
Ideally it is recommended to initiate the supplementation before getting pregnant especially folic acid and B vitamins; however, you can always initiate the prenatal supplementation as soon as your pregnancy is confirmed.
According to the recommendations of American Pregnancy Association, every woman of child-bearing age (15 to 44 years) should consume at least 0.4 mg of Folic acid daily. In women with a personal or family history of neural tube defects, antenatal vitamins and folic acid can be initiated at a dose 10 times higher than normal recommended dosage (i.e. 4 mg)
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7. How not taking prenatal vitamins affect your unborn child?
Prenatal vitamin supplements are highly recommended by doctors and healthcare providers to maintain maternal health during the course of pregnancy, at the time of labor and after childbirth. Most importantly, during pregnancy, your baby is dependent on you for his nutritional needs and requirements. Here are a few consequences of not taking necessary vitamins from your diet or via antenatal supplements.
Deficiency of B- Complex (especially B-9 or folate) is associated with miscarriage, pre-term labor, fetal cardiac defects, facial anomalies (like cleft lip and palate) in addition to neural tube defects.
A research published in the scientific journal Current Osteoporosis Reports suggested that the babies exposed to low calcium levels during pregnancy develop osteoporosis and weak bones growing up.
Deficiency of B12 and Iron can lead to anemia that can significantly impair fetal weight gain and circulatory functioning. In severe cases, mental retardation or fetal brain damage may also occur due to low oxygen concentration in the fetal blood (as a complication of anemia).
Most importantly, any nutritional deficiency that affects maternal health ultimately takes its toll on fetal health (before or after childbirth).
- Weak mothers are at higher risk of developing complications in the third trimester or at the time of delivery.
- Moreover, healthy mothers are better able to take care of their newborn babies and transfer healthy antibodies and nutrients via breast milk.
8. What to do if your prenatal vitamins makes you nauseous?
Of course nausea and vomiting makes it very hard for some women to swallow anything during first and early second trimester. There are some tips that may help in decreasing nausea associated with pill intake:
- Try taking your pills at night time
- Consume supplements in divided doses (or take some in the morning and some at night)
- Taking pills with a small snack
- Make sure to maintain healthy nutritious diet throughout pregnancy
If nothing works, contact your healthcare provider to seek assistance regarding a different form/ brand of prenatal vitamins. Liquid or chewable forms are generally well-tolerable. In situations where women develop indigestion, constipation or allergy to oral/ liquid formulations of iron, injectibles are advised if hemoglobin concentration is below 10 g/dL.
9. How long should I take prenatal vitamins?
For optimal health and wellness, initiate supplementation before getting pregnant and continue the prenatal vitamins for at least 6 months after childbirth. If you are breastfeeding your baby, vitamin D and calcium supplementation can be continued for another 1- 1.5 years after delivery. Nursing mothers need at least 1000 mg of calcium per day that corresponds to 3 glasses of milk. It is always a good idea to consult your healthcare provider regarding the dose, duration and nature of vitamin supplements after childbirth.
10. Is it alright to take expired prenatal vitamins?
Generally the expiry date of supplements suggests that the efficacy of contents is decreasing and the formulation is less potent than what is suggested by the label. Vitamins and minerals are subject to environmental and moisture related damage. Although, consumption of expired supplements is not harmful or life threatening for you or the baby, but healthcare providers suggests that intake of such formulation does not benefit you. It is better to get a re-fill.
To conclude, although most women are well-aware of the importance of healthy nutrition during pregnancy, only few are actually successful in obtaining all required nutrients from their diet. In order to optimize your health and wellness of your baby, speak to your healthcare provider to start antenatal vitamin supplements as soon as you get pregnant.