Interventions with Vitamins B6, B12 and C in Pregnancy

Abstract

The water‐soluble vitamins B6, B12 and C play important roles in maternal health as well as fetal development and physiology during gestation. This systematic review evaluates the risks and benefits of interventions with vitamins B6, B12 and C during pregnancy on maternal, neonatal and child health and nutrition outcomes. Relevant publications were identified by searching PubMed, Popline and Web of Science databases. Meta‐analyses were conducted for outcomes where results from at least three controlled trials were available. Potential benefits of vitamin B6 supplementation were reduction in nausea and vomiting, improvement in dental health, and treatment of some cases of anaemia. In meta‐analysis based on three small studies, vitamin B6 supplementation had a significant positive effect on birthweight (d = 217 g [95% confidence interval (CI) 130, 304]). Interventions with vitamin C alone or combined with vitamin E did not systematically reduce the incidence of pre‐eclampsia, premature rupture of membranes, or other adverse pregnancy outcomes. In meta‐analyses, vitamins C and E increased the risk of pregnancy‐related hypertension (relative risk 1.10 [95% CI 1.02, 1.19]). Effects of vitamin B6 or C intervention on other neonatal outcomes, including preterm birth, low birthweight, and perinatal morbidity and mortality, were not significant. Data on child health outcomes were lacking. Despite the prevalence of vitamin B12 deficiency amongst populations with limited intake of animal source foods, no intervention trials have evaluated vitamin B12 supplementation before or during pregnancy. In conclusion, existing evidence does not justify vitamin C supplementation during pregnancy. Additional studies are needed to confirm positive effects of vitamin B6 supplementation on infant birthweight and other outcomes. While vitamin B12 supplementation may reduce the incidence of neural tube defects in the offspring based on theoretical considerations, research is needed to support this hypothesis.

Vitamin B-12 and Cognition in Children

“…Individuals with a low intake of meat and dairy products, such as vegans and vegetarians, are at high risk of vitamin B-12 deficiency (5). Several studies conducted in low-and middleincome countries also have reported a high prevalence of vitamin B-12 deficiency, particularly in pregnant women and young children (6), in part due to inadequate dietary vitamin B-12 intake (7,8), increased requirements during pregnancy and lactation, and low vitamin B-12 content and bioavailability in breast milk (9). Micronutrient supplementation is a common strategy to prevent and treat cobalamin deficiency (10), and there is emerging interest in mandatory food fortification with vitamin B-12 (11).…”

Suplementos en gestación: últimas recomendaciones

“…1). Una alimentación deficiente en micronutrientes está relacionada con preeclampsia, partos prematuros, crecimiento intrauterino retardado (CIR), bajo peso al nacer (BPN) y malformaciones congénitas (1,2).…”

Vitamin B12 Deficiency in Pregnancy and Lactation: Is there a Need for Pre and Post-natal Supplementation?

“…The well-nourished human adult has about 2-5 mg of the vitamin, the majority being stored in the liver which is adequate without repletion for 3-5 years. A healthy prepregnancy body stores of B12 are, therefore, sufficient to meet increased demand during pregnancy [13].…”