No change in sexual activity during preconceptional multivitamin supplementation

Objective To study sexual activity related to preconceptional multivitamin supplementation.
Design The rate of sexual activity (weekly sexual intercourse number) was compared before and during multivitamin supplementation and between women with multivitamin and placebo-like trace element supplementation.
Setting The Hungarian randomised double blind controlled trial of periconceptional multivitamin supplementation.
Participants Six hundred and eighty-seven women with multivitamin and 655 women with trace element supplementation in the preconceptional period.
Results There was no difference in the rate of sexual activity between the multivitamin and the trace element groups.
Conclusion Multivitamins do not increase sexual activity.     

Periconceptional folic acid/multivitamin supplementation and twin pregnancy

OBJECTIVE: Results of our previous randomized controlled trial suggested an increase of twin pregnancies that was associated with the use of a multivitamin that contained folic acid during the periconceptional period. These findings were confirmed by US and Swedish studies, but not in the Chinese population. The aim of this analysis is to evaluate this possible association in a population-based data set. STUDY DESIGN: The population-based large control data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities (1980-1996) was evaluated. Control pregnant women were differentiated according to pre- and postconceptional supplementation of folic acid (in general 6 mg), multivitamins that contained 0.1 to 1.0 mg folic acid, folic acid plus multivitamin, and the prevalence of twin pregnancies was compared with the prevalence of twin pregnancies in the women who did not received supplements as referent. RESULTS: Of 38,151 women, 395 women gave birth to twins. The prevalence of twin births was 0.78% in the unsupplemented group; the rate of twin pregnancies was 1.52% after the preconceptional supplementation (adjusted odds ratio, 1.80; 95% CI, 1.14-2.85). The proportions of twin pregnancies were 1.14%, 1.45%, and 2.00% after the postconceptional folic acid, multivitamin, and folic acid plus multivitamin supplementation, respectively. CONCLUSION: Our findings suggest that both pre- and postconceptional supplementation of a high dose of folic acid and multivitamins are associated with a slight increase of the incidence of twin pregnancies.     

Effect of multivitamin versus multivitamin-mineral supplementation on metabolic profiles and biomarkers of oxidative stress in pregnant women: a double-blind randomized clinical trial

Objective: This study was designed to determine the favorable effects of received multivitamin versus multivitamin-mineral supplements on metabolic profiles and biomarkers of oxidative stress among Iranian pregnant women.

Methods: This double-blind randomized-controlled clinical trial was conducted among 70 pregnant women, primigravida, aged 18–35 years old between 16 and 37 weeks gestation. Subjects were randomly assigned to receive either the multivitamin (n?=?35) or multivitamin-mineral supplements (n?=?35) for 20 weeks. Fasting blood samples were taken at baseline and after a 20-week intervention to measure lipid profiles and biomarkers of oxidative stress.

Results: After 20 weeks of intervention, multivitamin-mineral supplementation resulted in a significant difference on serum triglycerides levels (changes from baseline in multivitamin-mineral group: +6.1 versus in multivitamin group: +45.9?mg/dl, p?=?0.04) compared with the multivitamin group. In addition, increased concentrations of serum HDL-cholesterol (changes from baseline in multivitamin-mineral group: +0.1 versus in multivitamin group: ?7.4?mg/dl, p?=?0.02) and total glutathione (GSH) levels (changes from baseline in multivitamin-mineral group: +151.09 versus in multivitamin group: ?116.21?µmol/l, p?=?0.003) were also seen in the multivitamin-mineral group compared with the multivitamin group.

Conclusion: Supplementation of multivitamin-mineral compared to multivitamin supplementation for 20 weeks during pregnancy had beneficial effects on triglycerides, HDL-cholesterol and GSH levels.     

Pregnancy outcomes in a randomised controlled trial of periconceptional multivitamin supplementation

The effect of periconceptional multivitamin/trace element supplementation on pregnancy outcomes was evaluated in a randomised controlled trial. The final data-base included 5,502 females with confirmed pregnancy. A multivitamin including 0.8 mg folic acid or a trace element were supplemented for at least 28 days before conception and continuing for at least until the second missed menstrual period. Number of pregnancies, terminations of pregnancies, four types of fetal deaths, livebirths including low birth weight, preterm birth and sex ratio were analysed. Periconceptional multivitamin supplementation increased fertility (higher rates of cumulative conceptions and multiple births), had no significant effect on the rate of different groups of fetal deaths, low birth weight and preterm birth in singletons. This primary preventive method can reduce the occurrence and recurrence of neural-tube defects and had no other significant effect on pregnancy outcomes except multiple births.     

Possible association of folic acid supplementation during pregnancy with reduction of preterm birth: a population-based study

Objective

Periconceptional folic acid or multivitamin supplementation is recommended for prospective pregnant women to prevent neural-tube defects. The question is whether it is worth continuing these supplementations after the first trimester of pregnancy or not. Thus the possible fetal growth promoting and/or preterm birth reducing effect of vitamin supplements in the second and mainly in the third trimester was studied.

Study design

Comparison of birth outcomes of singletons born to primiparous pregnant women with prospectively and medically recorded vitamin supplement in the population-based data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities (HCCSCA), 1980–1996 contained 6293, 169, and 311 primiparae with folic acid alone, multivitamins and folic acid + multivitamin supplementation, respectively, and their data were compared to the data of 7319 pregnant women without folic acid and folic acid-containing multivitamin supplementation as reference.

Results

Mean gestational age was 0.3 week longer and mean birth weight was by 37 g higher in the group of folic acid alone, than in the reference group (39.2 weeks; 3216 g). The rate of preterm births (7.6%) was significantly lower compared with the reference sample (11.8%), but the rate of low birth weight newborns did not show significant reduction. Folic acid alone in the third trimester associated with 0.6 week longer gestational age and a more significant reduction in the rate of preterm births (4.8%).

Conclusions

Minor increase in mean birth weight after high dose of folic acid supplementation during pregnancy would not be expected to result in too large babies; however, the significant reduction in the rate of preterm births may have great public health benefit.     

Periconceptional multivitamin supplementation and multimalformed offspring

OBJECTIVE: To study the human teratogenic risk of a folic acid-containing multivitamin. METHODS: We evaluated the data set of two Hungarian intervention studies: a randomized double-blind, controlled trial and a two-cohort, controlled study of the same folic acid-containing multivitamin in participants of the Hungarian periconceptional service. RESULTS: Of 2471 supplemented and 2391 unsupplemented women, 18 and 21, respectively, had multiple congenital abnormalities in the randomized, controlled trial. Of 3056 supplemented and unsupplemented pairs in the two-cohort, controlled study, 33 and 32, respectively, were affected with multiple congenital abnormalities. After the combination of two data sets, the number of cases with multiple congenital abnormalities was 51 in the supplemented group and 53 in the unsupplemented group (odds ratio 0.89; 95% confidence interval 0.45, 1.68). In addition, there was no difference in the occurrence of specified multiple congenital abnormality entities or of unidentified multimalformed informative offspring. CONCLUSION: We found no evidence that periconceptional folic acid-containing multivitamin supplementation either prevents or induces multiple congenital abnormalities.     

Understanding the role of LH: myths and facts

This review summarizes a series of lectures given at a recent Continuing Medical Education meeting in Hamburg, Germany (May 2007), aiming to understand the role of luteinizing hormone (LH) in follicular development during the natural menstrual cycle and controlled ovarian stimulation. Clinical situations and target groups of patients who might benefit from LH supplementation during their ovarian stimulation were discussed and defined. The lectures updated knowledge on the physiology of LH during the normal menstrual cycle and the role of LH in ovarian stimulation. The concept of the 'LH window' was presented, and the use of LH supplementation in different groups of patients undergoing controlled ovarian stimulation was discussed, including those with advanced age, hypogonadotrophic hypogonadism, pituitary down-regulation and poor response. In addition, the different ways of using LH or human chorionic gonadotrophin supplementation in ovulation induction protocols were described.     

Parental employment status and neural-tube defects and folic acid/multivitamin supplementation in Hungary

OBJECTIVE: To study the role of parental employment status as indicator of socio-economic status (SES) in the origin of neural-tube defect (NTD) and in the use of periconceptional folic acid/multivitamin supplementation. MATERIALS AND METHODS: One thousand two hundred and two cases with neural-tube defects, 38,151 population controls without any defects and 22,475 patient controls with other defects were compared in the population-based data set of the Hungarian case-control surveillance of congenital abnormalities, 1980-1996. RESULTS: The proportion of professionals was lower, while the proportion of semi- and unskilled workers was higher in the neural-tube defect group compared with the population control group. However, the comparison of neural-tube defect and patient control groups showed a lower socio-economic status in the patient control group. In addition, the socio-economic status of fathers in the neural-tube defect group seemed to be better than in the population and patient control groups. The higher periconceptional folic acid supplementation and the higher use of multivitamins during pregnancy occurred in the professional and managerial categories in all the three study groups. CONCLUSION: The occurrence of neural-tube defect shows a slight socio-economic dependence in the mothers at the comparison with population control group, however, patient control group had the lowest socio-economic status. The higher maternal education goes together with a higher proportion of periconceptional folic acid supplementation.     

Omega-3 Supplements in Pregnancy: Are We Too Late to Identify the Possible Benefits?

ObjectivePostpartum depression (PPD) is a common and recurring illness. Most women who experience PPD do not seek professional help; for those who do, the available treatment options are not supported by extensive research evidence. Several lines of research have linked omega-3 fatty acids (omega-3) supplementation with a reduced risk of PPD. Although it has been suggested that women in the perinatal period consume sufficient omega-3 to potentially prevent PPD, there is a lack of definitive research evidence. This pilot study surveyed pregnant women’s current use of omega-3, multivitamin, and other supplements, as well as their attitudes toward omega-3 research during pregnancy, to assess the feasibility of pregnant women’s participation in a large randomized controlled trial evaluating omega-3 supplementation.MethodsWomen attending prenatal clinics over a three-week period were invited to participate in a survey. The survey contained an information letter that was followed by a brief questionnaire assessing the use of nutritional supplements and opinions regarding the likelihood of participating in a clinical trial during pregnancy.ResultsOf the 176 women who completed the survey, six women were in the first trimester of pregnancy, 82 were in the second trimester, and 87 were in the third trimester. One hundred fifty-nine respondents (90.3%) reported taking a multivitamin supplement but none were taking a supplement that contained omega-3; only 20 (11.4%) were taking omega-3. Seventy-eight women (44.4%) responded that they would participate in a clinical study evaluating the effects of fish oil on their health.ConclusionThe results of our study indicate that many pregnant women take prenatal multivitamins and nutritional supplements, that there are currently few pregnant women attending clinics at our hospitals who are supplementing with omega-3, and that pregnant women would be willing to participate in a clinical trial evaluating the effects of omega-3.     

Iron supplementation in pregnancy—does the preparation matter?

Objective To assess the use, side effects and discontinuation rates of iron preparations during pregnancy. Design Six hundred and twelve randomly selected postpartum women completed a questionnaire on iron supplement use in the second and third trimesters. Results Of the 517 women (84.5%) reported using iron supplements, 453 were eligible for the study. The most common preparation was ferrous fumarate (46.8%, P < 0.01), followed by ferrous sulfate (31.8%), ferric polymaltose (12.4%), and ferric bisglycinate (7.3%). Almost half the participants (45%) reported at least one adverse effect, especially constipation (27.4%, P < 0.01), nausea (10.8%). Multivitamin preparations and ferric bisglycinate were associated with the fewest side effects (23.7, 21.2% respectively, P < 0.01), and ferrous fumarate and immediate-release ferrous sulfate with the most (56.3, 53.7% respectively). Eighty-three women discontinued their originally prescribed iron preparation, mainly (89%) due to side effects. Discontinuation rates were lowest for the multivitamin and ferric bisglycinate (10.5, 9.1%, respectively). In most cases, the specific preparation was recommended by the women’s physician (76%). Conclusion Ferrous fumarate-containing multivitamin preparations and ferric bisglycinate, although infrequently recommended as the first-line of iron supplementation, may be associated with less side effects and better compliance.     

Clinical and endocrine effects of ovulation induction with FSH and hCG supplementation in low responders in the midfollicular phase. A pilot study

OBJECTIVE: To assess the endocrine and clinical effects of luteinizing hormone (LH) activity supplementation administered in the midfollicular phase during controlled ovarian hyperstimulation to poor responders who were candidates for in vitro fertilization (IVF)--embryo transfer. STUDY DESIGN: Prospective, controlled, nonrandomized trial with historical controls. Twenty-five IVF patients who had shown a poor response to standard, long-protocol GnRH-a and FSH only in a preceding cycle (cycle A), were stimulated in the next cycle after six months with hCG supplementation (50 I.U. subcutaneously daily) starting on day 7 during standard, long-protocol GnRH-a and FSH (cycle B). The comparative analysis of clinical effects (duration of stimulation, total highly purified (HP)-FSH dose, number of oocytes retrieved and pregnancy rate) and endocrine responses (serum E2, follicular E2 and androstenedione levels) were determined between cycles A and B. RESULTS: Maximum serum E2 levels and clinical pregnancy rate were higher in cycle B, with hCG supplementation. Also, the follicular E2 and androstenedione levels were higher in cycle B. No differences were noted between cycles as regards the duration of stimulation, total HP-FSH dose and number of oocytes retrieved. CONCLUSION: LH activity supplementation in the midfollicular phase yields favorable pregnancy results in low responders. This may be due to enhanced release of follicular precursors for greater synthesis of E2.     

Vitamin B12 and folate bioavailability from two prenatal multivitamin/multimineral supplements

In this crossover, single-blind study, the bioavailability of B12 and folate, fasting and postprandially, was measured in 30 pregnant women for two prenatal multivitamin/multimineral supplements (Stuartnatal Plus and Materna, Wyeth-Ayerst Pharmaceuticals, Philadelphia, PA) and a placebo. Blood samples were obtained before supplementation and at 1, 3, 6, and 8 hr after supplementation serum levels of the two vitamins were measured by radioimmunoassay. The maximum postabsorption serum level was multiplied by the total body plasma levels to obtain the total rate of body absorption. The absorption peak of both vitamins occurred at 3 hours after ingestion of a supplement. The total body absorption of the two vitamins was greater during fasting than it was postprandially. There was 30% greater B12 absorption for Stuartnatal Plus (371 +/- 56 vs. 285 +/- 34 pmol) and 33% for Materna (315 +/- 34 vs. 236 +/- 4 pmol, p < or = 0.05). Similarly, there was 117% greater folate absorption fasting for Stuartnatal Plus (163 +/- 15 vs. 75 +/- 15 nmol, p < or = 0.001) and 57% greater absorption for Materna (207 +/- 21 vs. 132 +/- 13 nmol, p < or = 0.01). Both vitamins were readily absorbed (within 3 hours) into the maternal hepatic portal circulation. The absorption of both vitamins was significantly less when ingested after the test meal than when fasting.     

Oral melatonin supplementation improves oocyte and embryo quality in women undergoing in vitro fertilization-embryo transfer

The aim of this study was to evaluate the efficacy of oral melatonin supplementation on oocyte and embryo quality in patients in an assisted reproductive technologies program. All patients were treated for at least 2 weeks with melatonin (3?mg/day). To evaluate the cumulative effect of melatonin supplementation, we compared cycle outcomes between the first (no supplementation) and second cycles (melatonin supplementation) of patients who completed two treatment cycles. There were no significant differences in maturation rates (p?=?0.50), blastocyst rates (p?=?0.75), and the rate of good quality blastocysts (p?=?0.59) between the first and second cycles. The fertilization rate of ICSI was higher in the second cycle than that in the first cycle (69.3 versus 77.5%). Being limited to patients with a low fertilization rate in the first cycle (<60%), the fertilization rate dramatically increased after melatonin treatment (35.1 versus 68.2%). The rate of good quality embryos also increased (48.0 versus 65.6%). An important finding in our study was that oral melatonin supplementation can have a beneficial effect on the improvement of fertilization and embryo quality and this may have occurred due to a reduction in oxidative damage.     

Dehydroepiandrosterone supplementation increases baseline follicular phase progesterone levels

The use of dehydroepiandrosterone (DHEA) supplementation in infertile patients with diminished ovarian reserve (DOR) has become increasingly popular. It has been our observation that serum progesterone levels during the follicular phase are often increased during controlled ovarian stimulation when DHEA is coadministered. Our aim was to compare progesterone levels during the follicular phase before and during DHEA supplementation in women with DOR undergoing in vitro fertilization (IVF). In a case–control study, we compared progesterone levels during the follicular phase in IVF cycles before and during DHEA supplementation in 15 women with DOR who received 75?mg of DHEA daily. Progesterone levels on stimulation day 5 (0.58?±?0.29 ng/ml vs. 1.54?±?0.49 ng/ml; p?<?0.0001) and on the day of human chorionic gonadotropin administration (0.75?±?0.31 ng/ml vs. 1.87?±?0.49 ng/ml; p?<?0.0001) were significantly higher during DHEA treatment. The number of retrieved and fertilized oocytes was similar in both the groups. DHEA administration during IVF cycles in women with DOR causes a significant elevation of progesterone levels without an apparent deleterious effect on cycle outcome.     

The effect of multivitamin supplements on continuation rate and side effects of combined oral contraceptives: A randomised controlled trial

Abstract

Objectives This study aimed to assess the effect of multivitamin use during the pill-free interval on the continuation rate and side effects of combined oral contraceptives (COCs) within the first few cycles of use.

Methods In this trial, 332 women presenting to public health centres in an Iranian city each received a COC pack containing 21 pills and were randomised to one of three groups: two of the groups also received 42 multivitamin pills or 42 placebo pills to be taken once a day for 7 days before starting COCs and again during the 7-day pill-free interval for five cycles, while the third group received no multivitamin or placebo pills with their COCs. The groups were compared using Cox regression and χ² tests.

Results There were no losses to follow-up. Continuation rates at the sixth cycle were 88% for the multivitamin group, 75% for the placebo group and 67% for the no intervention group. Compared with the multivitamin group, the six-cycle discontinuation rate was significantly higher in the placebo group (hazard ratio [HR] 2.26, 95% confidence interval [CI] 1.15–4.45; p = 0.019) and no intervention group (HR 3.15, 95% CI 1.66–5.99; p < 0.001). Nausea, mood changes, weight gain and breast tenderness were significantly less common in the multivitamin group than in the other groups in all cycles, and spotting/irregular bleeding and dizziness were significantly less common in most of the second, third and sixth cycle follow-up.

Conclusions Multivitamin supplements could significantly reduce the side effects of COCs in the initial cycles and improve continuation rates. However, the study limitations do not allow for any definite conclusion for their use in clinical practice, especially in communities rich in nutrients.

Chinese Abstract

摘要

目的：本研究旨在评估在不服避孕药的间歇期口服多种维生素对续用率的影响,及服用复方避孕药（COCS）最初几个周期的副作用。

方法：在这项试验中,在伊朗城市代表公众健康中心的332名女性均收到含有21粒药物的复方口服避孕药包,并被随机分到3组。其中2组的妇女还分别收到了42粒维生素或42粒安慰剂,这些药物需要在服用口服避孕药之前及不同周期的间歇期内每天服用1次,连续服用7天;第三组只有复方口服避孕药。不同组之间用COX回归及卡方检验进行比较。

结果：目前还没有丢失的随访。三个组在第六个周期的续用率分别为：口服维生素组88%,口服安慰剂组75%,无干预组67%。与口服多种维生素组比较,口服安慰剂组在第六周期的停药率明显高（HR2.26,95%CI1.15-4.45;p=0.019）,无干预组的停药率也明显高于口服维生素组（HR 3.15, 95% CI 1.66 ? 5.99; p = 0.001）。在所有周期中,恶心、情绪变化、体重增加及乳房触痛在维生素组明显少于其他2组,瘀点、不规则出血、眩晕在第二、三、六周期很少见。

结论：多种维生素的应用可以显著降低开始口服复方避孕药的最初几个周期内的副作用,同时可以提高续用率。然而,由于这篇文章的限制,并无明确结论支持他们广泛应用于临床,尤其是在有丰富营养物质的社区。

关键词：副作用,复方口服避孕药,续用率,维生素     

Preconceptional and prenatal predictors of folic acid intake in Hungarian pregnant women

Objective

The purpose of the study was to determine demographic, obstetric and pregnancy care related factors of folic acid intake during preconceptional and prenatal period of pregnancy.

Study design

A questionnaire-based retrospective study was delivered at the Department of Obstetrics and Gynecology and Pregnancy Care Centre. The frequency of folic acid intake was measured before and during pregnancy in 349 pregnant women.

Results

Factors influencing preconceptional folic acid consumption were planning of pregnancy, previous infertility therapy, multivitamin intake before pregnancy, and folic acid intake during pregnancy. Probability of taking folic acid during pregnancy increased with age, and decreased with gestational age. Earlier detection of pregnancy corresponded to a higher chance of folic acid intake. Prenatal folic acid intake significantly related to the earlier intake of folic acid, and prenatal multivitamin medication.

Conclusion

It is important to target women who are less likely to take periconceptional folic acid as well as to increase awareness of women of childbearing age in general through an intensive campaign and improved education.     

French maritime pine bark extract significantly lowers the requirement for analgesic medication in dysmenorrhea: a multicenter, randomized, double-blind, placebo-controlled study

OBJECTIVE: A previous open study demonstrated that French maritime pine bark extract (Pycnogenol) may soothe menstrual pain in dysmenorrhea. We thus investigated the effects of Pycnogenol on menstrual pain in a double-blind study. STUDY DESIGN: Subjects were 116 women aged 18-48 years. The first 2 menstrual cycles served as a control period; during the subsequent 2 menstrual cycles women received either a Pycnogenol supplement (60 mg/day) or a placebo in identical capsule form. One further cycle was monitored after cessation of capsule administration. Women were assigned to either a group with low menstrual pain or a group with dysmenorrhea. The criterion for assignment to the first group was absence of analgesic medication. RESULTS: In women with low menstrual pain, no significant difference for lowering of pain scores was found. In contrast, women with dysmenorrhea had a significantly lower pain score and required statistically significantly less analgesic medication during supplementation with Pycnogenol. The number of days women required analgesic medication was likewise found to be statistically significantly lowered in the Pycnogenol group. Even after discontinuation of Pycnogenol supplementation, the required analgesic medication remained significantly decreased. CONCLUSION: The analgesic-sparing effect of Pycnogenol increases with duration of supplementation and benefits persist even after discontinuation.     

Modified Natural Cycle Using GnRH Antagonist Can Be an Optional Treatment in Poor Responders Undergoing IVF

Purpose: To investigate the efficacy of gonadotrophin-releasing hormone (GnRH) antagonist supplementation during natural cycles in poor responders undergoing IVF-ET treatment.Methods: We retrospectively evaluated 540 cycles of 433 suitable patients who were divided by treatment protocol into modified natural, antagonist, and long agonist groups. There were 52 modified natural cycles with GnRH antagonist supplementation, 200 stimulated cycles with GnRH antagonist, and 288 long GnRH agonist cycles. Cycle characteristics and treatment outcomes were compared between the groups.Results: The mean number of oocytes retrieved in the modified natural group was significantly lower than in the stimulated antagonist and long agonist groups (1.4± 0.5 vs. 2.3± 1.1 and 2.5± 1.1, respectively, p < 0.05). The respective implantation and pregnancy rates were 10% and 14.3%, 6.75% and 10.2%, and 7.4% and 10.6%. Cycle outcome and cycle properties were similar.Conclusions: Modified natural IVF cycle with GnRH antagonist supplementation is a feasible alternative to ovarian stimulation protocols in poor responders.     

Bioavailability of iron in two prenatal multivitamin/multimineral supplements

OBJECTIVE: To determine the iron bioavailability in two popular prenatal multivitamin/multimineral supplement tablets containing 27 mg elemental iron. STUDY DESIGN: Iron absorption during an eight-hour period following ingestion of a multivitamin/multimineral formulation, both fasting and with a standardized meal, was measured in a group of 30 pregnant women (24-32 weeks of gestation) and statistically compared. The prenatal formulations were Stuartnatal Plus and Materna (Wyeth-Ayerst Pharmaceuticals, Philadelphia, Pennsylvania), and each contains 27 mg of elemental iron. A placebo was included in the study for the control group in this crossover, single-blind study. RESULTS: The net iron bioavailability (mean +/- SE) of Stuartnatal Plus and Materna, accounting for diurnal variation, and the iron ingested with the standardized meal was 5.4 +/- 0.4 and 4.6 +/- 0.2 mg, respectively, while fasting and 2.9 +/- 0.4 and 2.7 +/- 0.4 mg, respectively, postprandially. The total amount of iron absorption in the fasting states from both prenatal formulations exceeded the 3 mg of supplemental iron absorption per day recommended by the National Academy of Sciences. CONCLUSION: The results of this study indicate that these two prenatal multivitamin/multimineral formulations provide > 3.0 mg of supplemental iron absorption (fasting) as recommended by the National Academy of Sciences and 2.7 mg of iron absorption above the levels achieved following ingestion of a standard, low-iron test meal.