Pregnancy: Prenatal Vitamins

Prenatal Vitamins
By: Dr. Obikoya

Pregnancy is a special event in a woman’s life. The intensity of the anticipation and joy of bringing a new life to the world can best be imagined except you are actually the person involved. Yet, pregnancy and the life of the unborn child can be very precarious for a number of reasons not least of which is a pregnant woman lacking vitamins.

Fifty percent of birth defects can be prevented by pregnant women taking prenatal vitamins before pregnancy. The quantity of folic acid required by the fetus cannot be obtained by diet alone. By taking vitamins as early as three months prior to becoming pregnant, you are ensuring the health and well being of your future baby.

The idea that prenatal vitamins help prevent certain birth defects and of continuing them during pregnancy and breastfeeding for continued protection from nutrition deficiencies is important, not new, and stands to reason. A pregnant woman is actually feeding two persons, herself and the unborn child. This clearly places the onus on her to increase her nutritional intake and that of vitamins to keep both of them well and healthy. The increased nutritional requirements actually include before, during, and after pregnancy. She needs to take multivitamin supplements particularly Iron, Vitamin C, Vitamin A (as 100% beta-carotene), and Folic Acid during these periods.

Folic Acid (part of the vitamin B family) is critical for a strong pregnancy and healthy fetal development. Folic acid is known to reduce the risk of birth defects like spina bifida, other neural tube defects and other birth defects like congenital heart conditions. Neural Tube Defects are some of the most serious, yet relatively common birth defects. They occur when the neural tube of a fetus does not grow properly early in pregnancy and the baby is born with a serious birth defect. Spina bifida is the most common neural tube defect. These congenital abnormalities can be a major source of sorrow for the family and a threat to the very existence of the child. Women, therefore, need to take an abundant quantity of folic acid even before getting pregnant and certainly start very early on in pregnancy.

In a study by MRC Vitamin Study Research Group (1991), deficiencies of folic acid during pregnancy were associated with low birth weight and an increased incidence of neural tube defects. Results of the Czeizel Study (1996) showed that folic acid significantly helps prevent neural-tube defects, urinary tract and cardiovascular defects, in addition to a decrease in the rate of limb deficiencies and congenital hypertrophic pyloric stenosis.

Being water-soluble, folic acid is washed out of the system and excreted in the urine not long after taking it. This calls for a regular and daily intake of this all-important vitamin. And because the body's requirement for this vitamin increases during pregnancy, it is necessary to ensure a pregnant woman takes folic acid once a day. Folic acid can reduce the risk of neural tube defects by as much as 80%.

Iron is another important prenatal nutritional supplement. It is necessary for a healthy and uneventful pregnancy. Iron is the main component of hemoglobin, the part of the blood that carries oxygen, hence important in the transportation of oxygen around the body of the pregnant woman and that of her unborn child. This mineral enhances the baby’s enhances healthy growth, and helps the mother maintain a healthy body crucial to be able to take care of the child. Vitamin A is important for healthy embryonic development, cellular and tissue growth. It also helps with the development of our eyes, hearts, ears, skin and the integrity of our mucous membranes. It helps us fight infections and repair damaged tissue. Vitamin A intake helps with lactation to replace that lost in breastfeeding.

The goal of taking prenatal vitamins, however, is to supplement your diet not to replace it. Indeed, prenatal vitamins work better when you are eating a healthy diet that includes a variety of foods. Besides, you need to take a look at the components of the prenatal vitamins you want to buy to make sure it has Calcium in it. The calcium level in the average prenatal vitamin is 250 mg. A pregnant woman needs about 1,200 - 1,500 mg of calcium daily to help her and the baby.
You should also note the amount of folic acid in the supplement. This is because many supplements have less than the required amounts of folic acid. Every year, approximately 2,500 babies are born with neural tube defects in the US, and many additional neural tube defect-affected pregnancies end in miscarriage or stillbirth.

Neural tube defects occur in the first three to four weeks following ovulation/fertilization. It is, therefore, important for women to make prenatal multivitamins (containing folic-acid) a daily, dietary cornerstone well before getting pregnant. To achieve a satisfactory folic acid level it is suggested to begin folic acid supplementation at least 1-2 months before pregnancy. Because many pregnancies are not planned, all women of childbearing age ought to regularly take increased amounts of folic acid on a daily basis.

Many vitamins are available by prescription and others over the counter. It does not really matter how you get the vitamins. It is more important for you to note it contains enough of what you need and how well they absorb into your body.

When trying to decide which prenatal vitamin is right for you, seek your doctor or midwife’s opinion and look out for the amount of calcium it has, as well as the amount of folic acid and other vitamins it contains.

Remember that too much vitamin A can cause birth defects. Ensure you are taking a prenatal vitamin or a multi-vitamin with under 10,000 IU of vitamin A. Also too much iron in a prenatal vitamin will be poorly absorbed. So, check on its amount in the supplement you plan to buy too.

References:
Czeizel AE, Toth M, Rockenbauer M. Population-based case control study of folic acid supplementation during pregnancy. Teratology 1996; 53:345–51.

MRC Vitamin Study Research Group. Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. Lancet 1991;338(8760):131–7.