Joanna Cosgrove04.26.10
An increasing number of women are turning to natural supplements and functional foods products while they are pregnant, despite warnings from obstetricians about the potential risks to both mother and unborn baby.
According to a study recently published in the American Journal of Obstetrics & Gynecology, about 1 in 10 pregnant women in the U.S. expose themselves—and their babies—to herbal products. The report was compiled using data collected from 4239 mothers in the National Birth Defects Prevention Study who delivered liveborn infants with no major birth defects from 1998 to 2004. The study reported that 6.9% of mothers turned to herbal products during the critical first three months of their pregnancies, while another 9.4% confirmed using herbal products “anytime” during their pregnancy. Excluding 86 mothers who reported that their only use of herbs involved herbal teas, the prevalence of herb exposure before or during pregnancy was 8.9%.
Herbal teas and chamomile were the most often used herbal products, as was ginger, which has historically been used to ease the nausea associated with morning sickness. Ginger does not convey any known harmful side effects to the unborn child.
Oddly, ephedra was another herbal supplement used by those in the study. The herbal stimulant was banned in the U.S. in 2004 after it was linked to heart attacks, strokes and at least 155 deaths.
Of those polled, the pregnant herbal products users were typically women older than 30 and with more than 12 years of education. Of the 10 states studied, Iowa had the lowest rate of herbal use (5.4 %) and Utah had the highest (16.5%).
In an interview with Reuters Health, the study’s lead author, Dr. Cheryl Broussard, of the Centers for Disease Control and Prevention in Atlanta, expressed concern over the impact herbal exposure could have on developing babies. “The fact that use of herbal products was greatest during the first trimester raises concerns about fetal safety, because this is a critical period of fetal organ development,” she said. “Providers should inform patients that it would be prudent to err on the side of caution regarding use of herbal products just before and during pregnancy because little is known about their potential risks.”
Vitamins Too?
Though prenatal vitamins are routinely prescribed to pregnant women in an effort to lessen the risk of birth defects, a study published in the most recent issue of the British Journal of Obstetrics and Gynecology asserted that multivitamins taken late in pregnancy could contribute to a premature delivery.
Here in the U.S., prenatal multivitamins are routinely recommended before and during pregnancy to prevent birth defects, but that’s not the case in the UK. While women are strongly advised to take folic acid supplements before conception and through the first trimester to prevent neural tube defects, the consumption of a broader multivitamin and mineral supplement is not typically recommended.
Dr. Nisreen Alwan,Wellcome Trust Clinical Research Fellow, Specialist Registrar in Public Health and a member of the Faculty of Medicine at the University of Leeds in the UK, explained the differences between the two different approaches and why the results of the study she contributed to merited the warning it sounded.
“Although multivitamin-mineral preparations are not routinely recommended during pregnancy in the UK, they are readily-available to buy over the counter (in pharmacies, supermarkets, etc). and many women do take them, as shown in our study,” she said. “Commercial preparations are likely to be slightly different in the doses of their vitamins/minerals contents between the UK and the USA (even between different brands within the UK). However, most contain similar combinations of vitamin/minerals. The research evidence supporting the use of multivitamin-mineral supplements mainly comes from developing countries where the nutritional status of pregnant women is likely to be different from that in Western countries.”
Dr. Alwan went on to say that the factors surrounding prenatal vitamin consumption that might have attributed to the incidences of premature births detailed in the study findings were not clear and required further research. “One possible mechanism is potential interactions between the different vitamins and minerals taken together leading to a reduction of availability to the growing fetus during the last months of pregnancy,” she said. “It is important to note that our study population already had a sufficient dietary intake of most micronutrients, so it may be that the findings are only applicable to women who already have a healthy diet.”
She also said that other factors unmeasured by the researchers could have played a role in the study’s outcome. “Ideally a randomized trial study design in a well-nourished population is needed to confirm our findings, where pregnant women are assigned ‘at random’ to taking or not taking multivitamin-mineral supplements in the last three months of pregnancy and the effects on the incidence of preterm birth are monitored in the two groups,” she said. “This study design may be difficult to conduct especially if most women are already recommended to take these preparations throughout pregnancy such as in the USA. Alternatively, pregnant women cohorts of larger numbers can be studied to see if our study findings are replicated.”
Booming Product Market
Despite the well-intentioned warnings of doctors, expectant moms continued to be drawn to products that exude benefits in the holistic, natural and wellness veins. Natural supplement and related product suppliers are heeding the call.
Adult vitamin D supplementation captured global headlines in the last year and now the focus has begun to shift over to how this vitamin might positively impact fetal development during pregnancy. But following the credence given to folic acid, perhaps no other supplement received more press than docosahexaenoic acid (DHA) which captured the attention of consumers and physicians alike after it was found to play a role in baby’s pre- and postnatal brain, eye and nervous system development; increase the baby’s gestation period, birth weight and size; lead to higher visual acuity at age 60 days; and increase cognitive and psychomotor developments.
In 2004, Mead Johnson, makers of Enfamil brand baby formula, launched Expecta, a non-fish DHA soft gel exclusively for nursing and pregnant women, and in 2008, San Antonio, TX-based Mission Pharmacal launched CitraNatal Assure Prescription Prenatal Vitamin, which was formulated with increased levels of several vitamins and minerals, plus 300 mg of Martek Bioscienses’ life’sDHA, a patented, plant-based form of the omega 3 fatty acid DHA.
Earlier this month, San Mateo, CA-based NutraBella, makers of the Bellybar range of all-natural line of foods, beverages and supplements designed to meet the nutritional needs of women before, during and after pregnancy, revamped and expanded its product offerings to better meet the needs of pregnant and nursing women.
The new nutritional system features three categories of convenient foods and supplements. The first is Bellybar Prenatal, a chewable mixed fruit-flavored daily prenatal supplement that provides a dose of OB-recommended nutrients. According to the company, two tablets provide 100% of the daily recommended dose of nutrients pregnant and nursing mothers need, including iron, folic acid, zinc, vitamins B6 and 12, and 200% of vitamin D. Bellybar Prenatal chewable vitamins are said to support “healthy fetal growth, full-term pregnancy, healthy nursing and bone health in mothers and their babies.” The vitamins are available in Mixed Fruit (cherry/orange) flavor, and also provide a nourishing dose of vitamins A, C and E, thiamin and niacin.
“Pregnant and nursing women are constantly telling us how difficult it can be to take—and actually keep down—bulky prenatal vitamins,” said Leslie Barber, co-founder of Bellybar. “We created Bellybar Prenatal chewable vitamins to provide a delicious and enjoyable alternative for women who struggle with taking the 'horse pill' while still delivering the high-quality nutrients they need during this important time.”
The second component of the new nutrition system is Bellybar Boost, a four-flavored range of on-the-go bar snacks formulated with “critical nutrients” like protein, choline, magnesium, iodine, calcium and vitamin D.
The final component is Bellybar DHA, a supplement chew that contains 200+ mg of DHA in each serving.
“We hear concerns all the time from women who are looking for an easier way to manage their health before, during and after pregnancy,” said Meredith Lincoln, co-founder of Bellybar. “Bellybar’s enhanced new line enables women to customize their nutritional plans based on their specific needs and daily diets in a great-tasting and easy-to-follow system.”
