VMS may need to include iron and folic acid to help reduce some birth risks
May 11 2016
Vitamin and mineral supplements (VMS) taken before a woman becomes pregnant or during early pregnancy may not prevent a woman experiencing miscarriage. However, there is evidence to show that “women receiving multivitamins plus iron and folic acid had reduced risk for stillbirth,” Cochrane researchers have concluded.
The researchers reviewed 40 randomised controlled trials involving over 276,000 women and more than 278,000 pregnancies. Suitable studies for inclusion were those looking at single or multiple vitamin supplementation during pregnancy and compared to placebo, other vitamins, no vitamins or other interventions. The researchers included studies where supplementation had commenced prior to the pregnancy, around conception and through the first 20 weeks of the pregnancy.
For vitamin C, alone or in combination, the researchers found no difference to the risk of miscarriage or stillbirth. There was a similar conclusion for vitamin A supplementation.
The researchers also found no difference in miscarriage rates between women receiving multivitamins plus iron and folic acid compared with iron and folate only groups. In addition: “There was no evidence of any difference in the risk of total foetal loss, early or late miscarriage, stillbirth or congenital malformations between women supplemented with folic acid with or without multivitamins and/or iron compared with no folic acid groups.”
However, “there was evidence of a decrease in the risk for stillbirth among women receiving multivitamins plus iron and folic acid compared iron and folate only groups,” said the researchers. They noted that foetal loss was lower in women taking multivitamins without folic acid, and multivitamins with or without vitamin A, but the trial data was limited to a single studies with small numbers of women.
The researchers commented that vitamin supplementation is often recommended to women planning to become pregnant and during the pregnancy. They wanted to look at the relationship between vitamin supplementation and early pregnancy outcomes “particularly since the causes of miscarriage are unknown and the nutritional status of a mother can affect her baby’s development.”
They concluded: “Taking any vitamin supplements prior to pregnancy or in early pregnancy does not prevent women experiencing miscarriage. However, evidence showed that women receiving multivitamins plus iron and folic acid had reduced risk for stillbirth. There is insufficient evidence to examine the effects of different combinations of vitamins on miscarriage and miscarriage-related outcomes.”