Abstract
BackgroundPrenatal micronutrient combinations with high iron content are associated with high rates of gastrointestinal symptoms. This coupled with nausea and vomiting of pregnancy results in women often discontinuing their multivitamins.A new prescription supplement (PregVit®) that separates iron from calcium in two tablets – morning and evening, has lower elemental iron content (35 mg), but results in similar extent of iron absorption when compared to another supplement containing (60 mg) of elemental iron (Materna®). The objectives of this study were to compare tolerability and compliance with PregVit® vs. a supplement with high iron content (Materna®), in pregnant women.MethodsRandomized, crossover open labeled study in 135 pregnant women attending outpatient clinics in Ontario and Quebec.ResultsUse of PregVit® was associated with a 30% reduction in constipation rate as compared to Materna®. Both products demonstrated similar compliance rates.Compliance of Materna® was negatively associated with the severity of nausea and vomiting of pregnancy. No such correlation was found for PregVvit®.ConclusionPregVit®, a supplement with lower iron content (35 mg), has significantly decreased constipation rates as compared to 60 mg iron- Materna and has similar compliance rates. High iron content in multivitamin supplements is associated with adverse effects in pregnancy.
Highlights
Prenatal micronutrient combinations with high iron content are associated with high rates of gastrointestinal symptoms
High iron content in multivitamin supplements is associated with adverse effects in pregnancy
Prenatal micronutrient supplementation is indicated for all pregnant women, because the recommended daily allowances (RDA) for many vitamins and minerals are not met during pregnancy with dietary sources alone [1,2]
Summary
Prenatal micronutrient combinations with high iron content are associated with high rates of gastrointestinal symptoms This coupled with nausea and vomiting of pregnancy results in women often discontinuing their multivitamins. Proving the ability of folic acid supplementation to prevent neural tube defects, has led to the recommendation to start prenatal micronutrient supplementation when planning pregnancy [3,4]. Many prenatal supplements contain, among other minerals, elemental iron at 50–60 mg, to prevent pregnancy-induced anemia secondary to increasing fetal needs. This level of iron content has been associated adverse gastrointestinal effects, including nausea, vomiting and constipation. The common occurrence of nausea and vomiting of pregnancy (NVP) has further led women to discontinue prenatal supplementation containing these levels of iron [7]
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