Prenatal vitamins with folate
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The Importance of Prenatal Vitamins with Folate
Folate Bioavailability in Prenatal Supplements
Prenatal vitamins are essential for ensuring the health of both the mother and the developing fetus. A study comparing the bioavailability of folate and vitamin B12 from two prenatal multivitamin/multimineral supplements, Stuartnatal Plus and Materna, found that both vitamins were readily absorbed into the maternal hepatic portal circulation within three hours of ingestion. The absorption was significantly higher when the supplements were taken on an empty stomach compared to postprandial ingestion. Specifically, folate absorption was 117% greater for Stuartnatal Plus and 57% greater for Materna when taken fasting.
Prevention of Neural Tube Defects
Folic acid supplementation before and during pregnancy is crucial for the prevention of neural tube defects (NTDs) and other congenital anomalies. It is recommended that all women of reproductive age take a multivitamin containing folic acid, as many pregnancies are unplanned. The standard dosage for over-the-counter prenatal vitamins is 1.0 mg of folic acid, while prescription multivitamins can contain up to 5.0 mg. This supplementation is necessary to achieve the red blood cell folate levels associated with maximal protection against NTDs.
Folate and Vitamin B12 in Premature Infants
Premature infants often require additional supplementation of folate and vitamin B12 to reduce the severity of anemia of prematurity. A study involving 184 premature infants found that those treated with vitamin B12 alone or in combination with folate had higher hemoglobin values compared to untreated or solely folate-treated groups. This indicates the importance of both vitamins in managing anemia in premature infants.
Dietary and Supplemental Intakes
A study assessing the dietary and supplemental intakes of folate, vitamin B12, vitamin D, and choline in pregnant women found that many women rely on prenatal vitamins to meet their nutrient requirements. While 90% of women met the Estimated Average Requirement (EAR) for folate, 77% exceeded the Tolerable Upper Intake Level (UL). This highlights the need for reformulating prenatal multivitamin supplements to provide doses within recommended levels to complement a balanced diet.
Harmonizing Folate Recommendations
There is a need to harmonize the units of measure and forms of folate in prenatal supplements. Currently, more than 25% of prenatal supplements contain folate as synthetic salts of L-5-methyltetrahydrofolate (L-5-MTHF), but recommendations do not include this form. Addressing these inconsistencies would help provide clearer guidance on folate intake for reducing the risk of NTDs.
One-Carbon Nutrients and Pregnancy
Folate, vitamin B6, vitamin B12, and choline are critical for one-carbon metabolism and play essential roles in pregnancy, including the prevention of birth defects and promotion of neurodevelopment. A study found that without supplements, many pregnant women would not meet the recommended intakes for these nutrients. This underscores the importance of prenatal vitamins in ensuring adequate nutrient intake during pregnancy.
Efficacy of Different Micronutrient Supplements
A study in rural Bangladeshi women compared the efficacy of different micronutrient supplements. It found that multiple micronutrient supplements (MMNs) produced higher maternal vitamin B12 concentrations and similar folate concentrations compared to standard iron and folic acid supplements. This suggests that MMNs may be more effective in improving maternal micronutrient status.
Cognitive Performance in Offspring
Supplementation with vitamin B12, folate, and omega-3 fatty acids during pregnancy has been shown to improve cognitive performance in offspring. In a study involving a pregnancy-induced hypertension rat model, combined supplementation improved levels of neurotrophins and cognitive performance in adult offspring, indicating the potential benefits of these nutrients in reducing the risk of cognitive disorders.
Alternative Forms of Folate
Supplementation with (6S)-5-methyltetrahydrofolic acid ((6S)-5-MTHF) has been found to be as effective as folic acid in maintaining maternal folate status while reducing unmetabolized folic acid in maternal plasma. This suggests that (6S)-5-MTHF may be a viable alternative to folic acid in prenatal supplements.
Impact on Fetal Development
Maternal supplementation with folic acid and vitamin B12 during late pregnancy has been shown to promote fetal development by improving placental antioxidant capacity, angiogenesis, and amino acid transport. This supplementation reduced homocysteine levels in umbilical cord blood and increased placental vascular density, highlighting its positive impact on fetal development.
Conclusion
Prenatal vitamins with folate are essential for the health of both the mother and the developing fetus. They play a crucial role in preventing neural tube defects, managing anemia in premature infants, and ensuring adequate nutrient intake during pregnancy. Harmonizing the forms and units of folate in supplements and considering alternative forms like (6S)-5-MTHF can further enhance their efficacy.
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