Our body needs many essential vitamins and minerals to function properly. B vitamins, for example, are particularly important for many of our daily functions including energy levels, cell health and nerve function.
These vitamins become even more important when a mother is pregnant, as low levels of some vitamins (such as folic acid, also known as vitamin B9) are associated with poor health outcomes during pregnancy and for baby after birth.
Because our bodies only produce many of these micronutrients in small amounts (if at all), we get most of them from our diet. But our recent study showed that most expectant mothers are missing out on many important vitamins that can have an impact on, not only their health, but also their babies.
We conducted a large study of over 1,700 women aged 18-38 in the UK, Singapore and New Zealand. We studied their health before, during and after pregnancy.
Before pregnancy, we found that nine out of ten women have low blood levels of several essential vitamins, including folic acid, riboflavin, vitamin B12 and vitamin D. These vitamins are needed to support the health of mother during pregnancy, and is important for the development of the unborn baby.
For the next part of the study, we randomly assigned the participants to two different groups. One group received a standard pregnancy vitamin supplement, containing folic acid. The other group received an improved supplement, which contained folic acid, as well as riboflavin, vitamins B6, B12 and D. The amount of vitamins in the improved supplement was similar to what you can buy from pharmacies and supermarket without a prescription.
Both groups took these supplements every day starting when they were trying to conceive and throughout their pregnancy. They stopped taking it after the baby was born.
We found that improved supplementation helped improve blood vitamin levels and reduced the prevalence of vitamin deficiency during pregnancy especially when it came to riboflavin, vitamin B6 and vitamin D. The standard supplement increased levels of folic acid, but the levels of other vitamins worsen during pregnancy. Perhaps this is due to the increased demand at this time.
Riboflavin is important during pregnancy because low levels can mean a higher chance of low blood counts and anemia.
For vitamin B6, the group taking the standard supplement had lower levels in late pregnancy, meaning they may not have had enough of this vitamin. Previous research has suggested that vitamin B6 may provide some relief from nausea and vomiting associated with pregnancy.
In both groups we found a decrease in homocysteine levels, which was particularly marked in those taking the enhanced supplement. A lower level of homocysteine is actually a good thing because it indicates a lower likelihood of vitamin deficiency. High levels of homocysteine are associated with early pregnancy loss and a range of pregnancy complications, including preeclampsia.
The benefits of the supplement improved the participants’ vitamin B12 levels lasting six months after having a baby. This is probably important for the mother’s ability to supply her baby with vitamin B12 if she is breastfeeding. B12 helps children’s brain development and growth.
Although our study included women from three different countries and different ethnic backgrounds, there were few black and American Indian women included in the research. This means that the results may not represent the experiences of women from specific ethnic groups. It will be important for future studies to investigate vitamin levels in these groups.
The specific benefits of improved vitamin levels also need to be further investigated in future studies. But, we can imagine that the supplements will have additional benefits, based on what previous studies have shown.
For example, our previous research showed that women taking the same enhanced supplement had a lower rate of pre-term delivery, and also a lower risk of major hemorrhage after delivering the baby.
It is also known that folic acid is important during pregnancy, as it can help prevent major defects in the development of the baby’s brain and spine. Taking folic acid supplements before conception and in early pregnancy is regularly recommended.
But many pregnancies are unplanned and a large number of women do not take folic acid supplements in early pregnancy. This is why around 80 countries have introduced mandatory fortification of staple foods. But many experts feel that the level of fortification in foods may not be sufficient for pregnant women, so a supplement would still be important.
Taking vitamin D supplements before and during pregnancy may also have benefits, including reducing the chances of infantile atopic eczema (a condition that causes patches of itchy, cracked and sore skin) and improving bone health in children.
Overall, our study showed that most women living in high-income countries do not get enough essential vitamins in their diet even before they become pregnant. Some of these vitamins are essential for the development of babies in the womb.
Although some of these vitamins are found in meat and dairy products, it is clear that most women still do not get enough of them regardless of the type of diet they follow. As more people choose to eat more plant-based foods, better advice about vitamin-rich foods will be needed. Many women may need to start taking supplements to make sure they are getting the vitamins they and their baby need.
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