Prenatal multivitamin with folic acid
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The Benefits of Prenatal Multivitamin with Folic Acid
Introduction to Prenatal Multivitamins with Folic Acid
Prenatal multivitamins containing folic acid are widely recommended for women of reproductive age to prevent various congenital anomalies and support overall pregnancy health. These supplements are particularly crucial for reducing the risk of neural tube defects (NTDs) and other folic acid-sensitive congenital anomalies1 2.
Prevention of Neural Tube Defects and Congenital Anomalies
Neural Tube Defects (NTDs)
Folic acid is essential for the proper closure of the neural tube during early fetal development. Supplementation with folic acid, especially when combined with a multivitamin, has been shown to significantly reduce the incidence of NTDs1 2. Women are advised to start taking these supplements at least three months before conception and continue through the first trimester to maximize protection against NTDs1 2.
Other Congenital Anomalies
In addition to NTDs, prenatal multivitamins with folic acid have been associated with a decreased risk of other congenital anomalies, such as congenital heart defects, limb defects, and urinary tract anomalies2. This protective effect underscores the importance of these supplements in prenatal care.
Impact on Pediatric Health
Pediatric Cancers
Recent studies suggest that prenatal multivitamin supplementation may also reduce the risk of certain pediatric cancers. A meta-analysis found that maternal ingestion of prenatal multivitamins is associated with a decreased risk of pediatric brain tumors, neuroblastoma, and leukemia3. This potential protective effect highlights another significant benefit of prenatal multivitamin use.
Behavioral and Hyperkinetic Disorders
There is evidence to suggest that early multivitamin use during pregnancy may reduce the risk of hyperkinetic disorders (HKD) and attention deficit hyperactivity disorder (ADHD) in children. A study based on the Danish National Birth Cohort found that early multivitamin use was associated with a reduced risk of HKD diagnosis and ADHD medication use8.
Maternal Health Benefits
Preeclampsia and Gestational Hypertension
Supplementation with multivitamins containing folic acid has been linked to a reduced risk of preeclampsia and gestational hypertension. Studies have shown that these supplements can lower plasma homocysteine levels and increase serum folate, which are associated with a decreased risk of these conditions6 7.
Preterm Birth
Folic acid supplementation during pregnancy has also been associated with a reduction in the rate of preterm births. A population-based study found that folic acid supplementation in the third trimester was linked to a longer gestational age and a significant reduction in preterm births10.
Considerations and Recommendations
Dosage and Timing
The recommended dosage of folic acid varies based on individual risk factors. For women at low risk of NTDs, a daily multivitamin containing 0.4 to 1.0 mg of folic acid is recommended, starting at least two to three months before conception and continuing throughout pregnancy and postpartum1 2. Women at higher risk may require higher doses, up to 5 mg of folic acid, to achieve the desired protective effect1 2.
Potential Risks
While the benefits of folic acid supplementation are well-documented, there are some potential risks to consider. High doses of folic acid have been associated with an increased likelihood of twin pregnancies and possible fetal epigenetic modifications1 5. These risks should be weighed against the benefits when considering supplementation.
Conclusion
Prenatal multivitamins with folic acid play a crucial role in preventing neural tube defects and other congenital anomalies, reducing the risk of certain pediatric cancers, and improving maternal health outcomes. Proper dosage and timing of supplementation are essential to maximize these benefits while minimizing potential risks. Health care providers should continue to educate women of reproductive age about the importance of these supplements for optimal pregnancy outcomes.
Sources and full results
Most relevant research papers on this topic
Pre-conception Folic Acid and Multivitamin Supplementation for the Primary and Secondary Prevention of Neural Tube Defects and Other Folic Acid-Sensitive Congenital Anomalies.
Pre- and post-conception oral folic acid and multivitamin supplementation can help prevent neural tube defects and other congenital anomalies, with benefits outweighing the risks.
Systematic Review
Highly CitedPre-conceptional vitamin/folic acid supplementation 2007: the use of folic acid in combination with a multivitamin supplement for the prevention of neural tube defects and other congenital anomalies.
Folic acid and multivitamin supplementation before pregnancy can help prevent neural tube defects and other congenital anomalies.
Systematic ReviewHighly CitedPrenatal Multivitamin Supplementation and Rates of Pediatric Cancers: A Meta‐Analysis
Prenatal multivitamin supplementation is associated with a decreased risk of pediatric brain tumors, neuroblastoma, and leukemia.
Meta-AnalysisHighly CitedJoint Effects of Prenatal Folic Acid Supplement with Prenatal Multivitamin and Iron Supplement on Obesity in Preschoolers Born SGA: Sex Specific Difference
Prenatal folic acid supplementation may decrease the risk of obesity in preschool girls born small for gestational age, with this effect potentially modified by prenatal multivitamin or iron supplementation.
Observational StudyPericonceptional folic acid/multivitamin supplementation and twin pregnancy.
Pre- and postconceptional supplementation with high doses of folic acid and multivitamins is associated with a slight increase in the incidence of twin pregnancies.
RCT
Large Human TrialHighly CitedFolic acid supplementation in early second trimester and the risk of preeclampsia.
Folic acid supplementation in the second trimester is associated with a reduced risk of preeclampsia.
Observational StudyHighly CitedPericonceptional folic acid fortification for the risk of gestational hypertension and pre-eclampsia: a meta-analysis of prospective studies.
Periconceptional multivitamin supplementation with appropriate dose, not folic acid alone, can prevent gestational hypertension and pre-eclampsia in pregnant women.
Meta-AnalysisPre-conceptual and prenatal supplementary folic acid and multivitamin intake, behavioral problems, and hyperkinetic disorders: A study based on the Danish National Birth Cohort (DNBC)
Early multivitamin use during pregnancy may reduce the risk of hyperkinetic disorder diagnosis and ADHD medication use in offspring.
Observational StudyPericonceptional intake of folic acid among low-risk women in Canada: summary of a workshop aiming to align prenatal folic acid supplement composition with current expert guidelines
Aligning prenatal folic acid supplement composition with current expert guidelines can help prevent neural tube defects in low-risk women.
Very Rigorous JournalPossible association of folic acid supplementation during pregnancy with reduction of preterm birth: a population-based study.
High dose folic acid supplementation during pregnancy significantly reduces preterm birth rates, with minor increase in mean birth weight but significant public health benefit.
Observational StudyVery Rigorous JournalHighly Cited