It’s the winner of pregnancy product of the year for Boots, so it has to be something that’s great for pregnant women, right? Pregnacare Max, according to the Boots website, is “the ultimate formula” for mums-to-be. It includes not only folic acid and vitamin D at amounts recommended by the Department of Health, but also zinc, magnesium, niacin, vitamins B6, B12 and C, iron and a host of other vitamins and minerals. All for £19.99 for a 42-day supply. So is that the price a mother has to pay for the health of her and her newborn?
Well, according to a review of vitamin supplements in pregnancy in the latest Drug and Therapeutics Bulletin, the true price may be less. The article said: “For most women who are planning to become pregnant or who are pregnant, complex multivitamin and mineral preparations promoted for use during pregnancy are unlikely to be needed and are an unnecessary expense.”
Women would be better off, said the bulletin, sticking to vitamin D (10 micrograms a day) and folic acid (400 micrograms before pregnancy and until the end of the first trimester) and spending their money on a healthy diet. Buying both tablets separately is usually cheaper than multivitamin preparations – Boots sells vitamin D at £1.09 for 90 tablets. But surely the more vitamins your developing baby gets, the better?
The solution
This latest review agrees with guidance from the National Institute for Health and Care Excellence (Nice): there is no evidence that anything other than vitamin D and folic acid are needed as supplements in pregnancy. Folic acid reduces the likelihood of brain and spinal cord defects in babies (anencephaly and spina bifida) – and higher doses may be needed in women with greater risk of these conditions. The evidence for folic acid is strong. The research to support vitamin D supplements in strengthening the development of bones and teeth in babies is not as strong, but good enough for the bulletin and Nice to recommend it. But there is no such recommendation for vitamins C and E.
High levels of vitamin A may cause birth defects, so those supplements are a no-no; iron is needed only for women who are anaemic, as it can irritate the stomach and cause constipation or diarrhoea. Only research from low-income countries where pregnant women are more likely to be malnourished suggests any benefit from multivitamins, although advice varies around the world. Pregnant women in the US are advised to take iron and folic acid supplements, but not vitamin D. So does it really matter if pregnant women take multivitamins? Probably not, as long as they check the amount of vitamin A in the preparation. But why spend more on supplements if they won’t make you or your baby any healthier?
