Adams James B, Kirby Jasmine K, Sorensen Jacob C, Pollard Elena L, Audhya Tapan
Arizona State University, Tempe, Arizona, USA.
University of Arizona College of Medicine, Tucson, Arizona, USA.
Matern Health Neonatol Perinatol. 2022 Jul 11;8(1):4. doi: 10.1186/s40748-022-00139-9.
The blood levels of most vitamins decrease during pregnancy if un-supplemented, including vitamins A, C, D, K, B1, B3, B5, B6, folate, biotin, and B12. Sub-optimal intake of vitamins from preconception through pregnancy increases the risk of many pregnancy complications and infant health problems. In the U.S., dietary intake of vitamins is often below recommended intakes, especially for vitamin D, choline and DHA. Many studies suggest that insufficient vitamin intake is associated with a wide range of pregnancy complications (anemia, Cesarean section, depression, gestational diabetes, hypertension, infertility, preeclampsia, and premature rupture of membranes) and infant health problems (asthma/wheeze, autism, low birth weight, congenital heart defects, intellectual development, intrauterine growth restriction, miscarriage, neural tube defects, orofacial defects, and preterm birth). The primary goal of this paper is to review the research literature and propose evidence-based recommendations for the optimal level of prenatal supplementation for each vitamin for most women in the United States. A secondary goal was to compare these new recommendations with the levels of vitamins in over 180 commercial prenatal supplements. The analysis found that prenatal supplements vary widely in content, often contained only a subset of essential vitamins, and the levels were often below our recommendations. This suggests that increasing prenatal vitamin supplementation to the levels recommended here may reduce the incidence of many pregnancy complications and infant health problems which currently occur.
如果不额外补充，大多数维生素的血液水平在孕期会下降，包括维生素A、C、D、K、B1、B3、B5、B6、叶酸、生物素和B12。从孕前到孕期维生素摄入不足会增加许多妊娠并发症和婴儿健康问题的风险。在美国，维生素的膳食摄入量往往低于推荐摄入量，尤其是维生素D、胆碱和二十二碳六烯酸。许多研究表明，维生素摄入不足与多种妊娠并发症（贫血、剖宫产、抑郁症、妊娠期糖尿病、高血压、不孕、先兆子痫和胎膜早破）以及婴儿健康问题（哮喘/喘息、自闭症、低出生体重、先天性心脏缺陷、智力发育、宫内生长受限、流产、神经管缺陷、口面部缺陷和早产）有关。本文的主要目的是回顾研究文献，并为美国大多数女性的每种维生素的最佳产前补充水平提出基于证据的建议。第二个目的是将这些新建议与180多种商业产前补充剂中的维生素水平进行比较。分析发现，产前补充剂的成分差异很大，通常只包含必需维生素的一部分，而且其含量往往低于我们的建议水平。这表明将产前维生素补充剂增加到此处推荐的水平可能会降低目前发生的许多妊娠并发症和婴儿健康问题的发生率。
