Prenatal Vitamins dosage, safety
July 1 2017 by
Ray Sahelian, M.D.

Prenatal vitamins are designed for women who are pregnant or who are planning to be pregnant. The prenatal supplements help ensure that the expectant mother and developing baby have the proper nutrients. Folic acid, calcium, and iron should be among the most important components of multi-vitamin prenatal supplements. These prenatal vitamins reduce the risk of birth defects, especially defects of the brain and spine known as neural tube defects. Because neural tube defects originate within the first 28 days of conception, and many pregnancies are unplanned, it is recommended that all women of child-bearing potential take prenatal vitamin supplements -- especially folic acid, the clinic advises.
   There is little risk in taking low dosages of supplements during pregnancy and the possibility that they could be beneficial. Prenatal vitamins may reduce the risk of brain tumors in children.

Prenatal Vitamins and supplements helpful during Pregnancy
Nearly all obstetricians routinely prescribe prenatal vitamins to their pregnant patients at the time of the first prenatal visit.

Biotin is one of the B vitamins.
Folic Acid is a B vitamin.
Choline - half of a 500 mg capsule a few times a week should be sufficient.
Fish Oils improve circulation
Vitamin E - Women who get enough vitamin E during pregnancy may help lower their child's future risk of asthma. Vitamin E may aid in lung and immune system development.

Nutrition Journal 2013. Micronutrients and pregnancy; effect of supplementation on pregnancy and pregnancy outcomes: a systematic review. Every year more than 20 million infants are born with low birth weight worldwide. About 3.6 million infants die during the neonatal period. More than one third of child deaths are thought to be attributable to maternal and child under nutrition. To systematically review the effect of supplementing various combinations and types of micronutrients on the course and outcomes of pregnancy. Electronic search of Medline, Pub Med, Health Internetwork access to Research Initiative, and Google Scholar databases was conducted. Outcomes of interest were birth weight, low birth weight, small size for gestational age, prenatal mortality and neonatal mortality. After exclusion of irrelevant /incomplete ones, 17 out of 115 articles were considered for the final analysis. Majority of the articles reviewed favored the supplementation of micronutrients to pregnant mother. Some studies suggested calcium supplementation is associated with a significant protective benefit in the prevention of pre-eclampsia. The remaining articles reviewed, showed significant benefit of Multiple Micronutrients supplementation during pregnancy in reducing low birth weight, small for Gestational Age births as compared to the usual iron-folate supplements. Supplying micronutrients, mainly multiple micronutrients have beneficial effect in reducing the risk of low birth weight and other complications.

Prenatal vitamins may reduce the risk of low birth-weight babies for certain women
Low birth weight, or infants weighing less than 2,500 grams (about 5.5 pounds) at birth, is a major predictor of death during infancy and is also associated with an increased risk of heart disease, diabetes, stroke and high blood pressure later in life. In a study published in the January 2007 issue of the Archives of Pediatrics & Adolescent Medicine, researchers from the University College of Medical Sciences in Delhi, India, followed a group of 200 women who were 24 to 32 weeks pregnant and lived within 5 kilometers of a hospital in East Delhi, India. The women either were underweight (with a body mass index less than 18.5) or had a low hemoglobin level (between 7 grams and 9 grams per deciliter), which can indicate malnourishment. About half of the women were randomly assigned to take a daily prenatal vitamin containing a mix of 29 micronutrients. The other half were assigned to take a placebo pill. Both groups of women were given iron and folic acid supplements and guidance on prenatal health. The women taking the prenatal vitamins gained an average of 9.2 kilograms (20.3 pounds), compared with 8.7 kilograms (19.2 pounds) for the women taking the placebo. The babies born to the women taking the prenatal vitamin also weighed an average of 98 grams (about 3.5 ounces) more than those born to the women taking the placebo. The rate of low birth weight in the vitamin group was 15.2 percent, compared with 43.1 percent in the placebo group.

Prenatal vitamins and risk for cancer
Prenatal Multivitamin Supplementation and Rates of Pediatric Cancers: A Meta-Analysis.
Clin Pharmacology Ther. 2007. Department of Pharmaceutical Sciences, University of Toronto, Toronto, Ontario, Canada. The Motherisk Program, Division of Clinical Pharmacology Toxicology, The Hospital for Sick Children, Toronto, Ontario, Canada.
Prenatal supplementation of folic acid has been shown to decrease the risk of several congenital malformations. Several studies have recently suggested a potential protective effect of folic acid on certain pediatric cancers. The protective role of prenatal multivitamins has not been elucidated. We conducted a systematic review and meta-analysis to assess the potential protective effect of prenatal multivitamins on several pediatric cancers. Medline, PubMed, EMBASE, Toxline, Healthstar, and Cochrane databases were searched for studies published in all languages from 1960 to July 2005 on multivitamin supplementation and pediatric cancers. References from all articles collected were reviewed for additional articles. Two blinded independent reviewers assessed the articles for inclusion and exclusion. Rates of cancers in women supplemented with multivitamins were compared with unsupplemented women using a random effects model. Sixty-one articles were identified in the initial search, of which, seven articles met the inclusion criteria. There was an apparent protective effect for leukemia, pediatric brain tumors and neuroblastoma. In conclusion, maternal ingestion of prenatal multivitamins is associated with a decreased risk for pediatric brain tumors, neuroblastoma, and leukemia. Presently, it is not known which constituent(s) among the multivitamins confer this protective effect.

Prenatal Vitamins May Reduce Risk of Brain Tumors in Children
Women who take multivitamins early in pregnancy may reduce the risk that their child will develop some types of brain tumors. Public health agencies already urge pregnant women to take multivitamins that contain folic acid early in pregnancy to reduce their fetus's risk of developing a neural tube defect such as spina bifida. Another possible protective effect for the vitamins could be a reduced risk for medulloblastoma and primitive neuroectodermal tumors of the brain. Childhood brain tumors are relatively rare, but medulloblastoma is the second most common brain tumor in children. Occurring in one in 20,000 children under age six, it appears in the cerebellum, the lower portion of the brain, and the area of the brain that coordinates movement. Primitive neuroectodermal tumors of the brain are similar to medulloblastoma but occur in other parts of the central nervous system. Dr. Bunin's co-authors were Paul R. Gallagher, Lucy B. Rorke-Adams, M.D., and Avital Cnaan, Ph.D., all of The Children's Hospital of Philadelphia, as well as Leslie R. Robison, Ph.D., of St. Jude Children's Research Hospital, Memphis, Tenn. Drs. Bunin and Cnaan also are faculty members of the University of Pennsylvania School of Medicine.

About The Children's Hospital of Philadelphia: The Children's Hospital of Philadelphia was founded in 1855 as the nation's first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children's Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country, ranking third in National Institutes of Health funding. In addition, its unique family-centered care and public service programs have brought the 430-bed hospital recognition as a leading advocate for children and adolescents.