Role of vitamins and minerals: During pregnancy

During pregnancy close attention must be given to the increased vitamin and mineral intakes needed to assure your good health as well as the baby's proper general development. The following nutrients are critical elements that must be included in your diet.

Folate (Folic Acid)

Folate is a B complex vitamin. In pregnancy, women need more folate to support their expanding blood volume, the growth of maternal and fetal tissues, and to decrease the risk of neural tube defects.

The Dietary Reference Intakes recommend that pregnant women obtain 0.6 mg per day of folate. This vitamin can be found in dark green vegetables (broccoli, spinach, Romaine lettuce), legumes (peas, lentils, beans), oranges and whole grain products (see table). While it is possible to obtain this level by carefully planning your diet and including foods rich in folic acid every day, many women will not reach their recommended folate intake from diet alone. Due to this fact, healthcare professionals agree that all pregnant women should take a daily multivitamin containing folic acid (the synthetic form of folate found in supplements). Research findings to date are unclear whether folic acid taken alone will have the same proven beneficial effects as folic acid taken as part of a prenatal multivitamin/mineral supplement.

Recently published studies have also shown that a multivitamin containing folic acid may also reduce the risk of gestational hypertension (high blood pressure), which may lead to preeclampsia (gestational hypertension with adverse conditions).

There is evidence that the use of a folic acid supplement significantly reduces the baby's risk of developing neural tube defects. The Society of Obstetricians and Gynaecologists of Canada recommends that all women of childbearing age take a multivitamin containing at least 0.4 mg of folic acid as soon as pregnancy is contemplated and throughout pregnancy to prevent such defects.

Women with an intermediate to high-risk for NTD should be advised that a daily dose of 5.0 mg of folic acid is recommended by the SOGC. This applies to women with diabetes, malabsorption disorders, treated with folic acid inhibitors or antiepilepsy drugs. In that case, your health professional may prescribe PregVit folic 5. PregVit folic 5 is a prescription prenatal supplement with a high dose of folic acid and should be used under healthcare supervision.

Iron

Daily iron requirements increase during pregnancy to supply the growing baby and placenta and to augment the maternal red cell mass. If iron stores are depleted before pregnancy or during the 1st trimester maternal anemia (low iron levels in the blood) may occur by the 2nd and 3rd trimesters leading to fatigue, decreased work performance, cardiovascular stress, impaired resistance to infection, poor tolerance to blood loss and surgical intervention at birth. The mother's iron intakes and her storage capacity affect the baby's ability to store iron as well.

Pregnant women are recommended to take an iron supplement throughout their pregnancy. The Dietary Reference Intakes of iron for pregnant women is 27 mg per day.

Calcium and Vitamin D

Pregnant and lactating women need calcium and vitamin D to maintain their bones, to ensure the development of their baby's bones and to produce maternal milk. Calcium is essential to build bones and contributes to the normal development and maintenance of teeth. Vitamin D facilitates your body's ability to absorb calcium. Low dietary intake of calcium may contribute to the development of preeclampsia (pregnancy-induced hypertension), low birth weight babies and increased risks of miscarriage.

During pregnancy, the Dietary Reference Intakes for calcium and vitamin D are 1300 mg and 200 IU respectively.

Zinc

Zinc deficiency has been associated with complications of pregnancy and delivery, as well as with growth retardation, congenital abnormalities and retarded development in the fetus. Zinc can be found in meat, whole grain products, dried beans, and nuts. The Dietary Reference Intakes for zinc during pregnancy is 11 mg per day. Zinc deficiency rarely occurs  in Canada

Vitamin C

There is an association between low maternal dietary vitamin C intakes and increased risks for gestational diabetes. The Dietary Reference Intakes for vitamin C during pregnancy is 85 mg per day.