If you're thinking about getting pregnant or you are already pregnant, you need to ensure you're taking a daily multivitamin. Even if you have no plans to conceive, a one-a-day supplement should be part of your nutritional regimen.
Taking folic acid, a B vitamin needed for healthy cell division, before and during the early weeks of pregnancy, is vital to preventing neural tube defects in the developing fetus.
NTDs are serious birth defects caused by the incomplete development of the brain, spinal cord and/or their protective coverings that occurs around the fourth week of pregnancy.
But taking a multivitamin before and during pregnancy may do more than guard against NTDs. A report published in yesterday's issue of the Canadian Association Medical Journal revealed that taking a multivitamin during pregnancy - versus only folic acid and iron - offered significant protection from delivering a low birth-weight infant.
This finding was based on a review of 13 studies conducted in 30,000 women from a variety of populations: women who were well nourished and undernourished, as well as HIV-positive women.
Babies born under 5.5 pounds (2.5 kilograms) are considered low birth-weight babies. Low birth weight can result when babies are born early (before 37 weeks gestation), are small for their gestational age, or both.
Low birth weight is the main reason babies die in their first year of life. It also increases the risk a child will have learning and vision difficulties and grow up to develop heart disease, type 2 diabetes, stroke and high blood pressure.
To reduce the risk of NTDs, the Society of Obstetricians and Gynecologists of Canada advises healthy women to take a multivitamin with 0.4 to 1 milligrams of folic acid for at least two to three months before becoming pregnant and throughout pregnancy and breastfeeding.
Women at high risk for NTDs - including women with epilepsy, type 1 diabetes, a family history of NTDs and those who are obese - should take a supplement with 5 milligrams of folic acid a few months prior to pregnancy and continue until 12 weeks of her pregnancy. After 12 weeks, a multivitamin with 0.4 to 1 milligram of folic acid can be taken.
Mounting evidence also suggests that women who are not overweight and who are regular users of multivitamins before and during pregnancy have a lower risk of preeclampsia, a pregnancy disorder characterized by high blood pressure, fluid retention and protein in the urine. If left untreated, it can lead to eclampsia, a toxic and life-threatening condition.
Folic acid is needed for the development and function of blood vessels, a process thought to be disrupted in women with preeclampsia.
The bottom line: All women who could become pregnant, who are pregnant, and who are breastfeeding should take a daily multivitamin with folic acid. Do not take more than one daily dose to prevent getting too much vitamin A (retinol). During pregnancy, women should not consume more than 10,000 IU of vitamin A per day; doing so increases the risk of birth defects.
While taking a multivitamin helps ensure a healthy pregnancy, it's not your only safeguard. In addition to avoiding alcohol and limiting caffeine, the following nutrition strategies are important to protect the health of both moms-to-be and developing babies:
Don't eat for two During pregnancy, you need extra calories to support the growth of your baby, the placenta, as well the expansion of your own body's tissues. But it doesn't take a lot of food: calorie needs increase by 300 in the second and third trimesters. (Since energy expenditure changes only slightly and weight gain is minor during the first trimester, calorie needs don't change until trimester two.)
