Motherisk update: Multivitamin supplements for pregnant women

Question. One of my patients is planning pregnancy and has started taking multivitamin supplements. She is experiencing gastric discomfort. What are the alternatives? Answer. Gastric discomfort is usually related to iron intake; pregnant women could use supplements with less iron. Pregnant women need 0.4 to 1.0 mg of folic acid daily. If they have a family history of neural tube defects (NTDs), insulin-dependent diabetes mellitus, or epilepsy, or are currently taking valproic acid, carbamazepine, or antifolates (eg, sulfonamides), they are at intermediate-to-high risk of having babies with NTDs and need 4.0 to 5.0 mg of folic acid daily.