What Multivitamins should I take in pregnancy? Does taking multivitamins produce healthier babies?

Most of the pregnant women I see in my clinic are taking or are about to start taking some form of multivitamins. We emphasise a healthy diet during the pregnancy and taking multivitamins as supplements only.  A review of available evidence, published in the Drug and Therapeutics Bulletin, says pregnant women who want to help ensure their baby has the best start in life should focus on improving their overall diet instead. Read the full article below from Medscape.com:

Most moms-to-be who take multivitamin and mineral supplements are wasting their money because they are unlikely to need them, say researchers.
They should also follow official advice to take folic acid and vitamin D supplements, the researchers say.
Pregnancy Complications
Deficiencies in key nutrients have been linked to various complications during pregnancy and birth, including pre-eclampsia, restricted foetal growth, neural tube defects such as spina bifida, skeletal deformities and low birth weight.
This has led to a market in multivitamin and mineral supplements targeted specifically at pregnant women and marketed to protect their health and the health of their baby.
The review found these products typically contain 20 or more vitamins and minerals and cost around £15 per month.
Folic Acid and Vitamin D
The NHS recommends that pregnant women should eat a healthy, varied diet. Additionally, they should take:
10 micrograms of vitamin D each day throughout pregnancy and continue taking this supplement while breastfeeding
400 micrograms of folic acid each day before conceiving and until the 12th week of pregnancy to help prevent neural tube defects
5 milligrams of folic acid a day where there is a family history of neural tube defects or where they have diabetes or have had a previous baby with a neural tube defect
They are also caution against taking vitamin A supplements, or any multivitamin containing vitamin A (retinol), because too much could harm the baby.
Some women may be eligible for free vitamins through the Healthy Start scheme, which is designed to help poorer families in receipt of certain benefits.
The review found strong evidence to support the recommendation to take 400 micrograms of folic acid a day. Also, for women at a higher risk of having a child with neural tube defects, they agree with the advice that a 5 mg daily dose is appropriate.
The researchers say the evidence for taking vitamin D supplements is less clear-cut because little of the data available from trials showed any impact on reducing the risk of complications during pregnancy or at birth. However, they back the NHS advice for taking 10 micrograms each day to help ensure healthy bones and teeth.
Lack of Evidence
However, the researchers say nothing in the available evidence supports the use of multi-vitamin supplements for most mothers-to-be.
"We found no evidence to recommend that all pregnant women should take prenatal multi-nutrient supplements beyond the nationally advised folic acid and vitamin D supplements, generic versions of which can be purchased relatively inexpensively," they say.
They point out that much of the evidence behind marketing claims for multivitamin supplements come from studies carried out in low income countries, where women are more likely to be undernourished or malnourished than women in the UK.
"For most women who are planning to become pregnant or who are pregnant, complex multivitamin and mineral preparations promoted for use during pregnancy are unlikely to be needed and are an unnecessary expense," the review concludes.
However, the researchers recommend greater use of the Healthy Start scheme to ensure that low-cost tablets containing vitamin D, folic acid and vitamin C are made more widely accessible to women during pregnancy.
A Healthy, Varied Diet
Janet Fyle, from the Royal College of Midwives, comments in a statement: "We would encourage women who are pregnant or are thinking of becoming pregnant to have a healthy, varied diet including fresh fruit and vegetables, alongside taking folic acid supplements.
"We would also stress that there is no need for pregnant women to 'eat for two'. This is a myth and all that is required is a normal, balanced amount of food."
The industry-funded Health Supplements Information Service said the review "will only create confusion for pregnant women and dissuade more women from improving their vitamin and mineral intakes."
Article published through Medscape.com