Periconceptional Vitamins Linked to Better Pregnancy Outcome

Emma Hitt, PhD

August 24, 2011

August 24, 2011 — Periconceptional intake of multivitamins is linked with a lower risk for small-for-gestational age (SGA) infants and preterm births (PTBs), according to the findings of a new study conducted in Denmark.

Janet M. Catov, PhD, with the Department of Obstetrics, Gynecology, and Reproductive Sciences at the University of Pittsburgh, Pennsylvania, and colleagues reported the findings in the September issue of the American Journal of Clinical Nutrition.

According to the researchers, based on previous findings, the relationship of multivitamin supplementation with SGA and PTB might be linked to the timing of supplementation (preconception and/or postconception) and also weight status.

The current study sought to relate the timing and frequency of periconceptional multivitamin use to SGA births and PTBs and their clinical presentations, including the development of preterm labor, premature rupture of membranes, and medical induction.

Data from 35,897 participants in the Danish National Birth Cohort were analyzed. They reported the number of weeks of multivitamin use during a 12-week periconceptional period.

The association between periconceptional multivitamin use and PTBs was related to prepregnancy overweight status, but the interaction was not significant (P for interaction = .07).

In nonoverweight women (body mass index [BMI] < 25 kg/m2), regular preconception and postconception multivitamin use was associated with a decreased risk for PTB (hazard ratio [HR], 0.84; 95% confidence interval [CI], 0.73 - 0.95) and preterm labor (HR, 0.80; 95% CI, 0.69 - 0.94). However, these associations were not present in overweight women.

The adjusted risk for an SGA birth was reduced in multivitamin users regardless of their prepregnancy BMI (HR, 0.83; 95% CI, 0.73 - 0.95; P for interaction = .49), with the strongest association in regular multivitamin users in the postconception period.

"These findings should be interpreted with caution because multivitamin use, as demonstrated in our results, correlated strongly with other lifestyle factors," the study authors conclude.

According to the researchers, "multivitamin use around the time of conception could be a safe and simple strategy to improve pregnancy outcomes, similar to folate supplementation. However, before such advice is given, studies are needed to evaluate possible risks of early and late fetal deaths associated with periconceptional multivitamin use as well as other outcomes in the life course of the child."

This study was supported by the Danish National Research Foundation, which established the Danish Epidemiology Science Centre that initiated and created the Danish National Birth Cohort. In addition, the cohort is a result of a major grant from the Danish National Research Foundation, the Pharmacy Foundation, the Egmont Foundation, the March of Dimes Birth Defects Foundation, the Augustinus Foundation, and the Health Foundation. The study authors have disclosed no relevant financial relationships.

Am J Clin Nutr. 2011;94:906-912.

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