Vitamin supplementation before and during pregnancy

Background Having a poor diet quality is one the top five predictors of mortality in pregnant and postpartum women. Micronutrient deficiency, one form of malnutrition, has a direct impact on pregnancy and can have adverse... [ view full abstract ]

Background
Having a poor diet quality is one the top five predictors of mortality in pregnant and postpartum women. Micronutrient deficiency, one form of malnutrition, has a direct impact on pregnancy and can have adverse neonatal outcomes such as neural tube defects. Research indicates wide variations in the use of vitamin supplementation by pregnant women despite the existence of recommendations on folic acid supplementation preconception and vitamin D supplementation during pregnancy.

Aim
To determine nulliparous women’s use of, and sources of advice on, vitamin supplementation before and during pregnancy.

Methodology
The Diet and Physical Activity survey, as one part of a longitudinal, cohort study on maternal health and morbidities during and after pregnancy, was administered to 600 nulliparous women at 36 weeks’ gestation. Dietary intake, vitamin supplementation use and physical activity levels are being assessed using a self-completed validated survey. Ethical approval was granted by the university and site hospital, and all participants give written consent. Early findings from 162 nulliparous women are presented.

Results

Before pregnancy, 57% (n=93) of women used vitamin supplements. This proportion increased to 93% (n=151) during pregnancy. Folic acid was the main vitamin supplement used before and during pregnancy. Almost one-quarter of women, 23% (n=37) did not receive any advice on vitamin supplementation use, including folic acid, during pregnancy.



Conclusion and implications

Nutrition is one of the most powerful adaptable environmental factors and, if well understood, can be used to break cycles of maternal malnutrition and impact directly on neonatal outcomes. Seventy percent of neural tube defects could be prevented through adequate intake of folic acid in the peri-conception period, yet two out of five of the women surveyed did not take folic acid and one in four women were not advised about vitamin supplementation. These gaps in women’s knowledge and the information women planning conception and becoming pregnant receive should be addressed by maternity care professionals.