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MAY 16, 2016 by MAE CHAN
Prenatal Supplements Reduce The Risk of Losing a Baby by 55 Percent

Couples' preconception lifestyle factors are often associated with pregnancy loss, although women's multivitamin adherence dramatically can reduce that risk by 55 percent compared to not taking the vitamins. In addition to serving as a back-up for any nutritional gaps in diet, prenatal supplements help reduce the risk for many serious birth defects.

According to most of the world's top experts in prenatal care, a healthy, well-balanced diet can provide all that is necessary for a single human being without the need for multivitamins, that is provided that diet is pesticide free with a high nutrient density. Unfortunately, it is very difficult for any human being on the planet to obtain such foods in this era of genetic modfication and crop poisons which have made their way to 95% of the food supply. This has deteriorated the nutritional content of most foods around the world.

Avoiding smoking (or second hand smoke) and reducing exposure to household items and toxins are strategies we know lead to healthier babies, but diet and supplements have always been a grey area.

For women who hope to become pregnant soon, prenatal vitamins help prepare a healthy environment for a baby. Continuing to take prenatal vitamins while breastfeeding is also good idea to make sure you're getting essential nutrient baby needs.

Miscarriage is a common complication of pregnancy that can be caused by a wide range of factors. Poor dietary intake of vitamins has been associated with an increased risk of miscarriage, therefore supplementing women with vitamins either prior to or in early pregnancy may help prevent miscarriage.

Data from the Longitudinal Investigation of Fertility and the Environment (LIFE) Study, a prospective cohort that enrolled couples prior to conception, indicated that this risk reduction increased to 79% for adherence during early pregnancy.

"This strong protective effect for preconception multivitamin usage is somewhat consistent with findings from a preconception cohort of female Chinese textile workers, where women in the highest versus lowest quartile of vitamin B6 had a lower odds of pregnancy loss," wrote the researchers, led by Germaine Buck Louis, PhD, from the National Institute of Child Health and Human Development, in Fertility and Sterility .

"Related support stems from previous studies that involved self-reported vitamin or folate usage and pregnancy loss. In a cohort of women with prospectively collected folate intake and self-reported pregnancy loss, women in the highest versus lowest quintile of folate intake had a 19% reduction in risk of loss.

"Collectively, these data are supportive of a beneficial association between vitamin usage and pregnancy loss."

No differentiation was made between over-the-counter multivitamins and prescription prenatal vitamins, noted the researchers.

No Surprises

Commenting independently on the study's findings, Marlene Goldman, ScD, Professor and Director of the Division of Clinical Research in the Dept. of Obstetrics and Gynecology at Dartmouth-Hitchcock Medical Center, told us: "It would be reassuring if the data were supported by others but it certainly reinforces preconception recommendations ."

Dr Goldman added that, for her, there were no real surprises in the study's findings, but she did point out some of the limitations, notably that this study relied on self-reported data, and that the link to vitamin use could be a marker for something else.

"Women who take vitamins are generally more health conscious," said Dr Goldman. "They may be more rigorous with timing intercourse with ovulation, or they may be more likely to take pregnancy tests, and so on."

Prenatal Support

According to SPINS, US sales of vitamins, supplements, herbs & homeopathic products positioned for prenatal support across natural, specialty gourmet and conventional multi outlet channels grew 10.0% to $108 million for the 52 weeks ending April 17, 2016, up from $98.3 million for the 52 weeks ending April 19, 2015.

Dr Buck Louis and her co-workers recruited 344 couples in 16 counties in Michigan and Texas to participate in their study, reflecting the societal shift from "I am pregnant" to "we are pregnant". The women were aged between 18 and 40, and the men over 18. The couples were followed while they were trying to conceive and then for seven weeks post-conception.

The incidence of pregnancy loss among couples who achieved a recognized pregnancy during the LIFE Study was 28%, reported the researchers.

Age was a significant risk factor, with a great risk of pregnancy loss in women over 35. Caffeine consumption was also associated with pregnancy loss, particularly when more than two caffeinated beverages were consumed per day. On the other hand, the researchers did not observed an association between alcohol consumption and pregnancy loss after adjusting for other factors. This result was in contrast to those reported in other studies.

"Our data suggest that couples' lifestyles are associated with the risk of pregnancy loss, including during the preconception period, emphasizing the need for continued efforts to promote healthy lifestyles before pregnancy begins, that is, preconception guidance," wrote Dr Buck Louis and her co-workers.

"Couples might continue to be advised that advanced age increases the risk of pregnancy loss and to limit caffeinated intake to fewer than 3 daily beverages irrespective of source and that women should continue to take daily multivitamins before and during pregnancy consistent with clinical guidance. Our findings are not intended to suggest substituting decaffeinated or caffeine-free beverages as a safer alternative, as we did not query couples on these products.

"Collectively, our findings are supportive of the need for ongoing efforts to ensure couples receive preconception guidance, and our findings await corroboration from other preconception couples-based cohorts to ensure that preconception guidance issued for the US population is responsive to discoveries to the extent possible."

Cochrane Review

A new review from the Cochrane Collaboration has examined the roll of vitamin supplements prior to pregnancy or in early pregnancy on the risk of miscarriage. Data from 40 trials involving 276,820 women (and 278,413 pregnancies) did not indicate a reduction in the risk of miscarriage.

"However, evidence showed that women receiving multivitamins plus iron and folic acid had reduced risk for stillbirth," wrote the reviewers in the Cochrane Database of Systematic Reviews.

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