Supplements for Pregnancy

As a naturopathic doctor, I'm occasionally asked by my patients whether or not they should take a multivitamin. In the majority of cases, my answer is to encourage them to adopt a whole foods diet, since no pill can compensate for the wide variety of health promoting nutrients found in unprocessed foods. However, there are circumstances where supplementing even the best diet seems to have a significant health impact, and pregnancy is one of these times.

It has long been known that supplementing with the B vitamin folic acid before conception and during the first trimester helps prevent neural tube defects, a potentially fatal anomaly. However, two recent studies suggest that taking a daily prenatal vitamin (a mixture of all the vitamins plus many key minerals) prior to conception and during pregnancy sharply reduced a number of serious birth defects and several early childhood cancers.

The first paper reviewed the findings of 41 studies looking at the impact of prenatal vitamins on birth defects. It found that taking a daily prenatal vitamin was associated with a 48% reduction in neural tube defects, a 39% reduction in cardiovascular deformities, a 47% drop in limb deformities, 58% fewer cases of cleft palate, 52% fewer urinary tract defects and a 63% reduction in cases of hydrocephalus, a life-threatening accumulation of fluid on the brain (J Obstet Gynaecol Can. 2006 Aug;28(8):680-9).

The second study reviewed seven papers, and found that a daily prenatal vitamin was associated with a 47% protective effect for neuroblastoma (the most common tumor in children under five), a 39% reduction in cases of leukemia, the most common childhood cancer overall, and a 27% reduction in brain tumors (Clin Pharmacol Ther. 2007 May;81(5):685-91). Both studies were spearheaded by doctors at the Motherrisk program at the Hospital for Sick Children in Toronto.

In addition, a well formulated prenatal supplement will provide therapeutic doses of vitamin B6 to combat morning sickness, folic acid, and easily absorbed iron to prevent anemia.

These findings suggest that taking a daily dose of prenatal vitamins before conception and during pregnancy aren't just "insurance" against dietary lapses, but rather a profound strategy that can prevent a variety of life-threatening conditions.

Of course, it is possible to deliver a healthy baby without ever taking a prenatal supplement. A supplement is no substitute for a nutritious diet, which provides much more than just vitamins and minerals. And many other factors contribute to the development of cancer, including genetic and environmental influences that cannot be changed with any supplement.

Since disease prevention is one of the principles of naturopathic medicine, I recommend a prenatal vitamin to any of my patients who are even considering becoming pregnant, and instruct them to continue to take them throughout the pregnancy. With an almost non–existent risk profile, the evidence suggests that a prenatal multivitamin can play a key role in preventing many serious conditions in the developing baby.