Prenatal multivitamins may provide early life growth benefits for children

By Stephen Daniells

- Last updated on GMT

© iStock/KatarzynaBialasiewicz
© iStock/KatarzynaBialasiewicz
A regular prenatal multivitamin may support "normal" fat gain in infants in the first five months of life, says a new study.

Data from the Healthy Start Study indicated that prenatal multivitamin supplementation had no deleterious effects on early infant growth, but was associated with slower fattening.

“Our study suggests that, in an urban population from Western USA, prenatal multivitamin supplementation during pregnancy has no deleterious effects on infant body size and composition and may in fact be protective against early life adiposity,”​ wrote researchers in Pediatric Obesity​.

Prenatal nutrients

Prenatal multivitamin supplements are generally recommended​ to help fill potential nutrient gaps for expectant mothers or women trying to conceive to improve offspring outcomes. While it is well known that nutrient insufficiency/deficiency during pregnancy produces adverse health outcomes for offspring, some concerns have emerged suggesting that "over-nutrition" may produce rapid growth and result in detrimental effects in the infants, like increased risk of obesity and metabolic syndrome, explained the researchers behind the new study.

Data from 626 women participating in the Healthy Start Study showed that, “maternal multivitamin use was not related to offspring mass or body composition at birth, or rate of change in total or fat-free mass in the first 5 months”​.

“In contrast to the animal literature that suggests an adverse effect of high prenatal multivitamin supplementation on offspring obesity and cardiometabolic health, our results indicate that daily multivitamin use throughout the pre-conception and prenatal period has no deleterious effects on body size at birth and overall rate of growth in early life and may in fact be somewhat protective at least with regard to relative growth in adiposity,” ​wrote the researchers.

“Assuming an increase of 3.0% per month in fat mass (adiposity) represents normal growth in the first 5 months, our study indicates that offspring of mothers who did not use prenatal multivitamins gained fat mass at a greater rate (3.45% per month), while offspring of mothers who used multivitamins throughout the pre-conception and prenatal periods gained fat mass at a normal rate (3.06%),” ​they added.

“Additional longitudinal assessment of offspring body composition and growth in pre-birth cohorts such as Healthy Start is needed to further examine whether in utero exposure to multivitamin supplementation is associated with obesity and cardiometabolic risks, or protection from such risks, later during childhood or adolescence.”

Health and healthcare cost benefits

vitamin D pregnancy folic acid mother infant baby iStock Antonio Gravante
Image © iStock/Antonio Gravante

The benefits from pre-natal supplements, from multivitamins and minerals to omega-3 fatty acids, include both the health of the baby and mother (which you cannot put a price on) to the associated healthcare costs savings such benefits can provide (which you can put a price on).

Results from the Longitudinal Investigation of Fertility and the Environment (LIFE) Study, published earlier this year in Fertility and Sterility​, indicated that a daily prenatal multivitamin during pregnancy may reduce the risk of losing the baby by 55%, compared to not taking a multivitamin. That is huge.

 “This strong protective effect for preconception multivitamin usage is somewhat consistent with findings from a preconception cohort of female Chinese textile workers, where women in the highest versus lowest quartile of vitamin B6 had a lower odds of pregnancy loss,” ​wrote the researchers, led by Germaine Buck Louis, PhD, from the National Institute of Child Health and Human Development.

For omega-3s, there is data to support that DHA supplements may significantly reduce early preterm birth, and this would result in significant hospital cost savings.

Data from the Kansas University DHA Outcomes Study (KUDOS)​ indicated that universal supplementation with DHA during the last two trimesters of pregnancy could result in cost savings of $1,678 per infant. Taking out the $166.48 cost of the DHA supplements for 26 weeks and a $26 increase in maternal care costs, the net saving became $1,484.

For the nearly 4 million live births in the US every year this cost saving would become almost $6 million, reported the researchers in Prostaglandins, Leukotrienes and Essential Fatty Acids​ (Vol. 111, pp. 8–10).

Results of a cost-benefit analysis published in The Lancet Diabetes and Endocrinology​ last year concluded that pregnant women in the UK who take iodine supplements compared to those who do not can save the National Health Services about £200 in direct service costs and save the larger society £4,476 per child over their lifetime of earning and in public sector costs.

And all this without considering the elephant in the room: Folic acid. A meta-analysis​ published in 2010 showed an overall 46% reduction in neural tube defects such as spina bifida and anencephaly in countries where wheat flour was fortified with this B vitamin.

The US Centers for Disease Control and Prevention (CDC) has listed the prevention of neural tube defects through flour fortification amongst its list of 10 great health achievements​ in the US for the last decade.

Source: Pediatric Obesity
Volume 11, Issue 5, pages 434–441, doi: 10.1111/ijpo.12084
“Exploring the association between maternal prenatal multivitamin use and early infant growth: The Healthy Start Study”
Authors: K.A. Sauder et al

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