The association between third trimester multivitamin/mineral supplements and gestational length in uncomplicated pregnancies

  • J.M. McAlpine
    School of Medical Science, Menzies Health Institute Queensland, Griffith University Gold Coast Campus, Southport, QLD, Australia

    Department of Women's and Newborn Health, Gold Coast University Hospital, Southport, QLD, Australia
    Search for articles by this author
  • R. Scott
    School of Medicine, Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, QLD, Australia
    Search for articles by this author
  • P.A. Scuffham
    School of Medicine, Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, QLD, Australia
    Search for articles by this author
  • A.V. Perkins
    School of Medical Science, Menzies Health Institute Queensland, Griffith University Gold Coast Campus, Southport, QLD, Australia
    Search for articles by this author
  • J.J. Vanderlelie
    Corresponding author at: School of Medical Science, Griffith University Gold Coast Campus, Parklands Drive, Southport, QLD 9726, Australia. Tel.: +61 07 5552 8746.
    School of Medical Science, Menzies Health Institute Queensland, Griffith University Gold Coast Campus, Southport, QLD, Australia
    Search for articles by this author
Published:August 26, 2015DOI:



      Widespread use of maternal micronutrient supplements have been correlated to gestational length and outcome in women predisposed to pre-eclampsia and preterm birth. However, research is yet to be conducted examining the influence of micronutrient supplements on outcomes at term in uncomplicated pregnancies.


      To analyse the relationship between third trimester micronutrient supplementation and gestation length at birth, demographics and maternal birthing outcomes in well women at term in a South East Queensland representative population.


      This research retrospectively analysed existing data pertaining to 427 uncomplicated, pregnancies birthing at the Gold Coast and Logan Hospitals using information gathered through the Environments for Healthy Living Study and Queensland perinatal data collection. Data were analysed using SPSS v20 by Chi square, ANOVA and regression analysis.


      Women in the third trimester taking individual zinc, folic acid or iron supplements in combination with a multivitamin were twice as likely to birth beyond 41 completed weeks (AOR 2.054, 95% CI 1.310–7.383, p = 0.038) then those who did not take any supplement when controlled for established confounders. Non supplement users were found to experience a lower rate of post dates labour and requirements for induction (AOR 0.483, 95% CI 0.278–0.840, p = 0.01).


      Length of gestation demonstrates significant associations with micronutrient supplementation practices. Well women consuming third trimester individual micronutrient supplements in addition to multivitamins experienced a longer gestation at term compared to women taking no micronutrients, increasing their risk for postdates induction of labour.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Women and Birth
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Vayssière C.
        • Haumonte J.-B.
        • Chantry A.
        • Coatleven F.
        • Debord M.P.
        • Gomez C.
        • et al.
        Prolonged and post-term pregnancies: guidelines for clinical practice from the French College of Gynecologists and Obstetricians (CNGOF).
        Eur J Obstet Gynecol Reprod Biol. 2013; 169: 10-16
        • Catov J.M.
        • Bodnar L.M.
        • Olsen J.
        • Olsen S.
        • Nohr E.A.
        Periconceptional multivitamin use and risk of preterm or small-for-gestational-age births in the Danish National Birth Cohort.
        Am J Clin Nutr. 2011; 94: 906-912
        • Kawai K.
        • Spiegelman D.
        • Shankar A.H.
        • Fawzi W.W.
        Maternal multiple micronutrient supplementation and pregnancy outcomes in developing countries: meta-analysis and meta-regression.
        Bull World Health Organ. 2011; 89 (402–11B)
        • Vanderlelie J.
        • Scott R.
        • Shibl R.
        • Lewkowicz J.
        • Perkins A.
        • Scuffham P.
        First trimester multivitamin use is associated with reduced risk of preeclampsia among overweight and obese women..
        Griffith University, 2013
        • National Institute for Health Clinical Excellence
        Intrapartum care: management and delivery of care to women in labour (guideline 55).
        • Mittendorf R.
        • Williams M.A.
        • Berkey C.S.
        • Cotter P.F.
        The length of uncomplicated human gestation.
        Obstet Gynecol. 1990; 75: 929-932
        • Sfakianaki A.K.
        Prenatal vitamins: a review of the literature on benefits and risks of various nutrient supplements.
        Formulary. 2013; 48: 77-82
        • Dhobale M.
        • Chavan P.
        • Kulkarni A.
        • Mehendale S.
        • Pisal H.
        • Joshi S.
        Reduced folate, increased vitamin B12 and homocysteine concentrations in women delivering preterm.
        Ann Nutr Metab. 2012; 61: 7-14
        • Walker J.J.
        Inflammation preeclampsia.
        Pregnancy Hypertens. 2011; 1: 43-47
        • International Food Policy Research Institute
        Global nutrition report 2014: actions and accountability to accelerate the world's progress on nutrition. Washington, DC.
        • Blumfield M.L.
        • Hure A.J.
        • Macdonald-Wicks L.
        • Smith R.
        • Collins C.E.
        A systematic review and meta-analysis of micronutrient intakes during pregnancy in developed countries.
        Nutr Rev. 2013; 71: 118-132
        • Organisation WH
        Recommendations for induction of labour. Geneva.
        • Hilder L.
        • Zhichao Z.
        • Parker M.
        • Jahan S.
        • Chambers G.M.
        Australia's mothers and babies 2012.
        AIHW, Canberra2014
        • de Jersey S.J.
        • Nicholson J.M.
        • Callaway L.K.
        • Daniels L.A.
        An observational study of nutrition and physical activity behaviours, knowledge, and advice in pregnancy.
        BMC Pregnancy Childbirth. 2013; 13: 115
        • Wennberg A.L.
        • Lundqvist A.
        • Högberg U.
        • Sandström H.
        • Hamberg K.
        Women's experiences of dietary advice and dietary changes during pregnancy.
        Midwifery. 2013; 29: 1027-1034
        • Girard A.W.
        • Olude O.
        Nutrition education and counselling provided during pregnancy: effects on maternal, neonatal and child health outcomes.
        Paediatr Perinat Epidemiol. 2012; 26: 191-204
        • Cameron C.
        • Scuffham P.
        • Spinks A.
        • Scott R.
        • Sipe N.
        • Ng S.K.
        • et al.
        Environments for Healthy Living (EFHL) Griffith birth cohort study: background and methods.
        Matern Child Health J. 2012; 16: 1896-1905
        • Beck S.
        • Wojdyla D.
        • Say L.
        • Betran A.P.
        • Merialdi M.
        • Requejo J.H.
        • et al.
        The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity.
        Bull World Health Organ. 2010; 88: 31-38
        • Bloomfield F.H.
        How is maternal nutrition related to preterm birth?.
        Annu Rev Nutr. 2011; 31: 235-261
        • Hauth J.C.
        • Clifton R.G.
        • Roberts J.M.
        • Spong C.Y.
        • Myatt L.
        • Leveno K.J.
        • et al.
        Vitamin C and E supplementation to prevent spontaneous preterm birth: a randomized controlled trial.
        Obstet Gynecol. 2010; 116: 653-658
        • Papadopoulou E.
        • Stratakis N.
        • Roumeliotaki T.
        • Sarri K.
        • Merlo D.F.
        • Kogevinas M.
        • et al.
        The effect of high doses of folic acid and iron supplementation in early-to-mid pregnancy on prematurity and fetal growth retardation: the mother–child cohort study in Crete, Greece (Rhea study).
        Eur J Nutr. 2013; 52: 327-336
        • Callaway L.K.
        • Prins J.B.
        • Chang A.M.
        • McIntyre H.D.
        The prevalence and impact of overweight and obesity in an Australian obstetric population.
        Med J Aust. 2006; 184: 56-59
        • Daly R.M.
        • Gagnon C.
        • Lu Z.X.
        • Magliano D.J.
        • Dunstan D.W.
        • Sikaris K.A.
        • et al.
        Prevalence of vitamin D deficiency and its determinants in Australian adults aged 25 years and older: a national, population-based study.
        Clin Endocrinol (Oxf). 2012; 77: 26-35
        • Frawley J.
        • Adams J.
        • Sibbritt D.
        • Steel A.
        • Broom A.
        • Gallois C.
        Prevalence and determinants of complementary and alternative medicine use during pregnancy: results from a nationally representative sample of australian pregnant women.
        Aust N Z J Obstet Gynaecol. 2013; 53: 347-352
        • Australian Bureau of Statistics
        Statistics ABO Year book Australia. ABS, Canberra2012
        • Quantin C.
        • Benzenine E.
        • Ferdynus C.
        • Sediki M.
        • Auverlot B.
        • Abrahamowicz M.
        • et al.
        Advantages and limitations of using national administrative data on obstetric blood transfusions to estimate the frequency of obstetric hemorrhages.
        J. Public Health. 2013; 35: 147-156
        • Lain S.J.
        • Hadfield R.M.
        • Raynes-Greenow C.H.
        • Ford J.B.
        • Mealing N.M.
        • Algert C.S.
        • et al.
        Quality of data in perinatal population health databases: a systematic review.
        Med Care. 2012; 50: e7-e20
        • Stephen G.
        • Lui S.
        • Hamilton S.
        • Stevens A.
        • Jones R.
        PLD.24 gene expression profiling of human decidua during term labour: inflammation as a key driver of labour.
        Arch Dis Child Fetal Neonatal Ed. 2014; 99: A113
        • Unal E.R.
        • Cierny J.T.
        • Roedner C.
        • Newman R.
        • Goetzl L.
        Maternal inflammation in spontaneous term labor.
        Am J Obstet Gynecol. 2011; 204: 223.e1-223.e5
        • Kim M.W.
        • Hong S.C.
        • Choi J.S.
        • Han J.Y.
        • Oh M.J.
        • Kim H.J.
        • et al.
        Homocysteine, folate and pregnancy outcomes.
        J Obstet Gynaecol. 2012; 32: 520
        • Sahni S.
        Dinitrosyl iron complexes and their role in patho-physiological conditions.
        ProQuest, UMI Dissertations Publishing, 2011
        • Caulfield L.E.
        • Zavaleta N.
        • Shankar A.H.
        • Merialdi M.
        Potential contribution of maternal zinc supplementation during pregnancy to maternal and child survival.
        Am J Clin Nutr. 1998; 68: 499S
        • Mori R.
        • Ota E.
        • Middleton P.
        • Tobe-Gai R.
        • Mahomed K.
        • Bhutta Z.A.
        Zinc supplementation for improving pregnancy and infant outcome.
        Cochrane Database Syst Rev. 2012; : 7