During pregnancy, nutrient requirements increase to support fetal growth and development as well as maternal metabolism and tissue development specific to this period in the lifespan . Although meeting these increased nutrient requirements can and perhaps should be achieved by the consumption of appropriate amounts of foods in a balanced and varied diet, the use of dietary supplements may be beneficial in some situations . Indeed, prenatal vitamin and mineral supplementation is common among women living in the United States.
Using the 1988 National Maternal and Infant Health Survey, Yu and colleagues concluded that 97% of US women are advised to take multivitamin multimineral (MVMM) supplements as part of their routine prenatal care, and 67 and 84% of African-American and Caucasian women, respectively, comply with this recommendation . These authors also reported that women who do not choose to consume prenatal MVMM preparations tend to be nonsmokers, less educated, younger, and/or unmarried. Data from another study suggested that prenatal supplements were taken by 86% of a culturally diverse group of low-income pregnant women . In addition to MVMM supplements, some pregnant women use botanical preparations to treat common symptoms such as nausea.
The fundamental purpose of this chapter is to review the strength of the evidence that use of MVMM, single-nutrient, and botanical supplements during pregnancy can safely enhance pregnancy outcome and pregnancy-related symptoms. In particular, we will focus mainly on (1) if and when they may be indicated, and (2) whether they are efficacious and safe when taken by otherwise apparently healthy women living in economically developed countries. It is noteworthy that the topic of nutritional supplement intake during pregnancy is also covered within other chapters of this publication. For example, the relationship between folate (folic acid) intake and birth defects is discussed in detail in Chap. 17, "Folate: a Key to Optimal Pregnancy Outcome," and the potential impact of iron supplementation on birth outcome is covered in Chap. 16, "Iron Requirements and Adverse Outcomes." These nutrients, therefore, will be discussed here only briefly, and the reader is directed to these more detailed chapters as appropriate. This chapter will also provide basic information regarding functions and food sources of each of the nutrients covered as well as published guidelines for dietary supplement usage during pregnancy.
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