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Vitamin E in Pregnancy:

 It was suggested at one point that Vitamin E supplements might help prevent miscarriage and pre-eclampsia and low birth weight. This remained unproven.  More recent studies show that high intake of Vitamin E during pregnancy actually increases risk of stillbirth. Overall, the advice now is that Vitamin E supplementation should be avoided during pregnancy.

Vitamin K in Pregnancy:

Vitamin K1 is the naturally occurring form of this Vitamin mainly found in plants. This is the main source of this vitamin for humans. Green leafy vegetables and dairy products are rich in Vitamin K1. In addition, bacteria in the gut make Vitamin K2 which is the other, less important, source of the vitamin.

Vitamin K is essential in the normal process of clotting of blood. Severe deficiency of this vitamin can therefore lead to an increased risk of excessive bleeding. Vitamin K deficiency is generally quite rare and rarer still in pregnant women. In a straight-forward pregnancy, Vitamin K supplementation is rarely required.

There are situations where a woman may be advised to have Vitamin K supplements to reduce the risk of bleeding for her newborn. This could be in cases where she is taking anticonvulsant medication for epilepsy. These drugs tend to increase the consumption of Vitamin K and therefore pose the risk of creating a deficiency. The baby may be at risk of cerebral haemorrhage in case of a pre-term or a traumatic birth especially if instruments (forceps) are used.

Other conditions with increased risk of Vitamin K deficiency are ulcerative colitis, sprue and other chronic bowel diseases where absorption of dietary Vitamin K might be impaired. Obstetric cholestasis is another condition where Vitamin K supplementation may be required.

Vitamin K is routinely given to all new-borns to minimise the risk of internal bleeding.

Vitamin C in Pregnancy:

Vitamin C is also known as Ascorbic Acid. It is a very important antioxidant protecting the body against harmful free radicals. Its benefits are many and varied, well beyond the scope of this article. We will confine ourselves to the need of supplementation during pregnancy.

It is believed, with some evidence, that deficiency of Vitamin C during pregnancy could increase the risk of anaemia, preterm rupture of membranes, low-birth weight and the serious pregnancy complication pre-eclampsia.

Even where there is no obvious deficiency, supplements may help prevent or reduce the risk of this complication but evidence to this is inconclusive. The taking of Vitamin C supplements is encouraged especially in situations where it is difficult to get it via the normal dietary route.

Vitamin C is water-soluble and cannot be stored in the body. This means, regular replenishment is essential. Citrus fruits, strawberries, tomatoes and other vegetables are rich sources of vitamin C.

For those taking supplements, the recommended daily dose is 85-100mg. Very high doses are actively discouraged, not only because they will not confer any additional benefit but also because effects on the baby are unknown. There is also the fact that old literature from the former Soviet Union show that, high doses of Vitamin C were employed, with some claimed success, to terminate pregnancy. Whilst the evidence is not solid, it is enough reason to pause.

Vitamin B1 (Thiamine) in Pregnancy:

Like all vitamins in the ‘B’ group, Thiamine is water-soluble and therefore not stored in the body. Regular replenishments are required. Heavy alcohol intake and smoking can lead to thiamine deficiency.

This Vitamin is essential for the building and the functioning of the nerves, brain and muscles. The demand is increased during pregnancy so if the diet is poor, deficiency can result. Whole grain, beans, yeast, milk, beef, nuts and many other common staples are rich in Thiamine. White bread, unless fortified, will have little if any Thiamine. It is destroyed during processing. It is also important to remember that frying and excessive cooking will destroy Thiamine.

Folic Acid (Vitamin B9) in Pregnancy:

Many people, probably most, now know the importance of Folic Acid and this is one of the most popular supplements taken during pregnancy.

Folic Acid is essential for efficient DNA synthesis and rapid cell division which characterise pregnancy and, indeed, early infancy. It is an established fact that taking Folic Acid supplements from the preconception period and continuing through the first trimester does significantly reduce the risk of neural tube defects such as Spina bifida.

Folic Acid is also important in preventing anaemia. It plays an essential role in the formation of blood cells.

Folic Acid deficiency can develop in chronic liver disease or where the individual is taking anti-epileptic medication.

A healthy balanced diet will normally give adequate Folic Acid. Green leafy vegetables, fruits, beans and peas are rich sources of Folic Acid as are a variety of fortified cereals.

The recommended daily intake is 400mcg. For those concerned about risk of spina bifida and other neural tube defects, it is essential that the supplements are commenced before conception. Starting after one has missed a period is usually too late.

Where there is an identifiable risk factor such as use of anticonvulsant (anti-epileptic) medication or history of a previous spina bifida, the supplements dose should be at least ten times that i.e. 4 or 5 mg daily, again commenced pre-conception.


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