Multivitamin Supplements in Pregnancy

Products

In many countries, various multivitamin preparations are on the market in the form of tablets and capsules that are specifically adapted to the needs of pregnant women. While some are approved as medicines and are covered by basic insurance, others are sold as dietary supplements and are not mandatorily covered by insurance. A selection:

  • Andreavit
  • Bonal Vital – food supplement
  • Burgerstein Pregnancy & Lactation – Nutritional supplements.
  • Elevit Pronatal
  • Natalben Plus (formerly Gynefam Plus) – food supplement.

Ingredients

The products contain vitamins, minerals and trace elements. Omega-3 fatty acids are not included in all preparations and are sometimes administered separately see Omega-3 fatty acids and pregnancy. Possible ingredients include:

  • Vitamin A or beta-carotene
  • Vitamin B1
  • Vitamin B2
  • Nicotinamide (vitamin B3)
  • Calcium pantothenate (vitamin B5)
  • Vitamin B6
  • Biotin (vitamin B8)
  • Folic acid (vitamin B9)
  • Vitamin B12
  • Vitamin C
  • Vitamin D
  • Vitamin E
  • Calcium
  • Iron
  • Iodine
  • Magnesium
  • Molybdenum
  • Phosphorus
  • Zinc
  • Copper
  • Chrome
  • Manganese
  • Selenium
  • Omega-3 fatty acids

Effects

The drugs promote the optimal supply of vitamins, minerals and trace elements before, during and after pregnancy. This prevents diseases and deficiencies of the mother and the child. Like all medical topics, vitamin supplementation during pregnancy is controversial and it is critically questioned whether it is really necessary in the case of a balanced diet without risk factors such as underweight or a vegan diet. The administration of folic acid as well as iron and iodine is relatively undisputed. The risk of a possible vitamin overdose is also classified as critical by some authors.

Indications

Increased need for vitamins, minerals, and trace elements before, during, and after pregnancy. To prevent embryonic neural tube defects and anemia during pregnancy.

Dosage

According to the package insert. Medicines are usually taken once daily in the morning with breakfast. Folic acid should be taken as early as four weeks before pregnancy. Pregnancy vomiting may reduce absorption of the active ingredients. If vomiting occurs mainly in the morning, the tablets can be given at noon or in the evening (and vice versa).

Contraindications

The drugs are contraindicated in hypersensitivity, hypervitaminosis A, hypervitaminosis D, renal insufficiency, iron overload, iron utilization disorders, hypercalcemia, and hypercalcuria. Care should be taken not to administer other medications or foods that also contain vitamins at higher doses so that an overdose is not given. This is particularly relevant for vitamin A and vitamin D. Full precautions can be found in the drug label.

Interactions

Drug-drug interactions are possible with tetracyclines and antiepileptic drugs. In our view, other drugs should preferably be administered at least 2 hours apart to rule out interactions.

Adverse effects

The most common potential adverse effects include digestive symptoms such as nausea and constipation. Occasionally, headache, abdominal pain, stomach discomfort, dyspepsia, vomiting, diarrhea, and reversible tooth discoloration are also observed. The iron contained may cause a harmless darkening of the stool.