DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20172305

Prenatal multivitamin supplementation increases birth weight

Müberra Namli Kalem, Zeynep Kamalak, Nermin Kosus, Aydin Kosus, Ziya Kalem

Abstract


Background: The aim of this study is to examine whether there is any positive impact of prenatal iron and vitamin supplementation on birth weight, and if this practice could be a cause of macrosomia.

Methods: A total of 1,838 term pregnant women were included in this study and were divided into four groups: iron group (women having only iron supplementation), vitamin (women using only multivitamins), vitamin+iron (women using both iron and multivitamin preparations), and control group (women having neither iron nor vitamin supplements). Statistical analysis was performed to compare age, gravida, parity, hemoglobin, BMI and birth weight. Groups were compared in terms of macrosomia and correlation analysis carried out between demographics and birth weight.

Results: The birth weight was significantly higher in the vitamin group and the vitamin+iron group than in the iron group and the control group. Vitamin supplementation increased the risk of macrosomia 3.9 times, while vitamin+iron usage increased the risk 4.8 times.

Conclusions: Uncontrolled use of multivitamins and/or iron supplements may increase tendency for fetal macrosomia. The use of multivitamins and/or iron supplements by pregnant women must take into account maternal age, maternal diet and maternal BMI. Our findings support a reduction in the unnecessary use of vitamin and iron supplements in pregnancy, and a reversal of the trend to start vitamin and iron supplementation without any control. The increasing prevalence of obesity and excessive weight in pregnant women should be a warning against the uncontrolled usage of vitamins and iron during pregnancy.


Keywords


Birth weight, Iron, Macrosomia, Prenatal vitamin supplementation

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References


Janna ML, and Regnault RH. "Nutrition in Pregnancy: Optimising Maternal Diet and Fetal Adaptations to Altered Nutrient Supply. 2016;342.

Oken E, Ning Y, Rifas-Shiman SL, Rich-Edwards JW, Olsen SF, Gillman MW. Diet during pregnancy and risk of preeclampsia or gestational hypertension. Ann Epidemiol. 2007;17:663-8.

Changamire FT, Mwiru RS, Peterson KE, Msamanga GI, Spiegelman D, Petraro P. Effect of multivitamin supplements on weight gain during pregnancy among HIV‐negative women in Tanzania. Mat child nutrit. 2015;11:297-304.

Zhang Q, Ananth CV, Li Z, Smulian JC. Maternal anaemia and preterm birth: a prospective cohort study. Int J Epidemiol. 2009;38:1380-9.

Lee HS, Kim MS, Kim MH, Kim YJ, Kim WY. Iron status and its association with pregnancy outcome in Korean pregnant women. Eur J Clin Nutr. 2006;60: 1130-5.

Christian P, Tielsch JM. Evidence for multiple micronutrient effects based on randomized controlled trials and meta-analyses in developing countries. J Nutr. 2012;142:173-7.

Ramakrishnan U, Manjrekar R, Rivera J, Gonzales-Cossio, Martorell R. Micronutrients and pregnancy outcome: a review of the literature. Nutrit Res. 1999; 19: 103-9.

Nils Hovdenak N, Haram K. Influence of mineral and vitamin supplements on pregnancy outcome. Eur J Obstet Gynecol Reprod Biol. 2012;164:127-32.

George L. Wehby, Eduardo E. Castilla, Jorge S. Lopez-Camelo, Jeffrey C. Murray Predictors of multivitamin use during pregnancy in Brazil. Int J Public Health. 2009;54:78-87.

Blumfield M, Hure A, MacDonald-Wicks L, Smith R, Simpson S, Raubenheimer, D. The association between the macronutrient content of maternal diet and the adequacy of micronutrients during pregnancy in the Women and Their Children’s Health (Watch) study. Nutrients. 2012;4(12):1958-76.

Watson PE, McDonald BW. The association of maternal diet and dietary supplement intake in pregnant New Zealand women with infant birthweight. Eur J Clin Nutr. 2010;64:184-93.

Urbaniak T, Klejewski A, Pisarska M, Kostecka E. Influence of dietary supplementation on newborn weight. Przegl Lek. 2012;69:1015-20.

Hodgetts VA, Morris RK, Francis A, Gardosi J, Ismail KM. Effectiveness of folic acid supplementation in pregnancy on reducing the risk of small‐for‐gestational age neonates: a population study, systematic review and meta‐analysis. BJOG: An International Journal of Obstetr Gynaecol. 2015;122(4):478-90.

Sauder KA, Starling AP, Shapiro AL, Kaar J L, Ringham BM, Glueck DH. Exploring the association between maternal prenatal multivitamin use and early infant growth: The Healthy Start Study. Pediatric obesity; 2015.

Haider BA, Bhutta ZA. Multiple‐micronutrient supplementation for women during pregnancy. The Cochrane Library; 2012.

Yang, Z, Huffman, SL. Nutrition in pregnancy and early childhood and associations with obesity in developing countries. Maternal child nutrition. 2013; 9(S1),105-19.

Dougan, MM, Willett WC. Michels KB. Prenatal vitamin intake during pregnancy and offspring obesity. Internat J Obesit. 2015;39(1):69-74.

WHO Global Database on iron deficiency and anaemia, micronutrient deficiency information system. Iron deficiency anaemia, assessment, prevention, and control. A guide for programme managers. Geneva, World Health Organization; 2001.

Milman N, Bergholt T, Byg KE, Eriksen L, Graudal N. Iron status and iron balance during pregnancy. A critical reappraisal of iron supplementation. Acta Obstet Gynecol Scand. 1999;78:749-57.

Long H, Yi JM, Hu PL, Li ZB, Qiu WY, Wang F. Benefits of Iron supplementation for low birth weight infants: A systematic review. BMC Pediatr. 2012;12:99.

Milman N. Iron prophylaxis in pregnancy--general or individual and in which dose? Ann Hematol. 2006; 85:821-8.

Ehrenberg H, Mercer B, Catalano P. The influence of obesity and diabetes on the prevalence of macrosomia. Am J Obstet Gynecol. 2004;191:964-8.

Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA 2012;307: 491-7.

Tenenbaum-Gavish K, Hod M. Impact of maternal obesity on fetal health. Fetal Diagn Ther. 2013;34:1-7.