Prenatal Supplements or Iron and Folic Acid Only?

Reproductive Health2

Obie Editorial Team

Most soon-to-be mothers are encouraged to adopt comprehensive prenatal supplements once they realize they’re pregnant. However, recent research explores how a full-spectrum approach stands against the classic combination of iron and folic acid supplements.

What Research Reveals About Iron and Folic Acid Supplementation

Dr. Keith P. West, Jr., has conducted pioneering research focusing on mothers in Bangladesh, seeking to uncover the best supplementation strategy for newborns in this region. Babies here face challenges that threaten their survival and that of their mothers, linked to complications created by inadequate nutrition. Such challenges include:

Empowered by this mission, Dr. West and his team at the prestigious Johns Hopkins Bloomberg School of Public Health engaged 44,567 mothers from Bangladesh in a study conducted at The JiVitA Project in Gaibandha. These mothers were generally at their 9th week of pregnancy upon starting supplementation. They were thoughtfully divided into two groups for comprehensive analysis:

  • 15 micronutrients were supplemented (22,405 women tested)
  • Iron and folic acid supplementation exclusively (22,162 women tested)

Results of Early Pregnancy Supplementation 

Live births:

  • 14,373 in the multi-supplement group
  • 14,142 in the iron/folic acid group

Infant mortality at 6 months:

  • 764 (54.0 per 1,000 live births) for the multi-supplement group
  • 741 (51.6 per 1,000) for the iron/folic acid group

Stillbirths:

  • 43.1 per 1,000 live births in the multi-supplement group
  • 48.2 in the iron/folic acid group

Preterm births:

  • 18.6 per 100 live births in the multi-supplement group
  • 21.8 in the iron/folic acid group

Low birth weight:

  • 40.2 per 100 live births in the multi-supplement group
  • 45.7 in the iron/folic acid group

The research results indicate statistically notable benefits, particularly in reducing preterm births and low birth weights in those who took the full spectrum of supplements. For you, this suggests a potential difference a comprehensive supplement strategy may offer—an advantage towards a healthier pregnancy and birth.

The American College of Obstetricians and Gynecologists (ACOG) Recommendations

ACOG suggests varying folic acid intake according to your pregnancy stage:

  • 400 micrograms (mcg) daily for at least 1 month before conception
  • 600 mcg during pregnancy

Moreover, it is recommended to consume 27 milligrams daily of iron consistently throughout pregnancy.

Additionally, ACOG emphasizes a well-rounded, nutrient-dense diet as the foundational source of all essential nutrients, while recommending supplements if your dietary intake is insufficient to meet these needs.

Sources:

  1. West, Jr., Keith P., et al. "Effect of Maternal Multiple Micronutrient vs Iron–Folic Acid Supplementation on Infant Mortality and Adverse Birth Outcomes in Rural Bangladesh: The JiVitA-3 Randomized Trial." JAMA - The Journal of the American Medical Association. American Medical Association, 24 Dec. 2014. The JAMA Network. Web. 3 Jan. 2015.
  2. "Nutrition During Pregnancy." ACOG / The American Congress of Obstetricians and Gynecologists. American Congress of Obstetricians and Gynecologists, Sep. 2013. Web. 3 Jan. 2015.