Where to buy Pharmacies address
Q & A Have questions? ask them

Study of efficiency and assessment of folic acid uptake of different regimens of reception of vitamin-mineral complex ALFAVIT Mom's health during pregnancy

Authors:Sumyatina LV, Skvortsova MY, Podzolkova NM
Location:Department of Obstetrics and Gynecology, Academy of Postgraduate Education

Currently there is no doubt that the favorable course of pregnancy and its outcome directly depends on the health status of mother and that nutritional status of the women has a direct impact not only on her body but also on the health of the developing fetus. Studies in the past 10 years, conducted in the Laboratory of vitamin and mineral metabolism in the Institute of Nutrition, demonstrate a widespread deficiency of vitamin in pregnant women in all parts of Russia (1).

However, no matter how well-balanced the diet of pregnant and nursing mothers is I could not fully satisfy their exclusively needs for vitamins. Even during normal course of pregnancy, starting from the fourth month of gestation the body's need for vitamins begins to increase, because supplies of vitamins and microelements are necessary for the growth of the fetus. During pregnancy, the mother’s body is the only source of vitamins and other nutrients for the fetus, so employment of vitamin therapy during pregnancy and lactation is fully reasonable.

According to several studies most doctors and patients prefer vitamin-mineral complexes, which contain the maximum number of components. Unfortunately, the simultaneous intake of the required daily dose of vitamins and minerals leads to substantial difficulties in achieving the ultimate goal - the prevention or treatment of certain symptoms. This is largely due to negative interactions between micronutrients on chemical and physiological levels. Consequently, the actual amount of vitamins or microelements in the preparation may be smaller than the stated amount. At the same time, there are numerous positive interactions between vitamins and minerals (2).

Vitamins are organic compounds, that act as essential intermediaries in metabolic reactions, co-factors or coenzymes. At present, there are more than 20 known vitamins and vitamin-like substances, which are with no doubt essential for humans. Each vitamin has a specific, and characteristic biological role. The most common deficiency during pregnancies are deficiencies of B-vitamins, ascorbic acid, carotenoids and folic acid (6).

Folic acid (vitamin Bc, folacin) is a water-soluble B vitamin essential for cell division and because of this especially important for tissues, which actively divide and differentiate, especially during pregnancy. Folacin is involved in the processes of assimilation, transport and utilization of proteins, facilitates the linking of the protein group and the gem in hemoglobin and myoglobin, stimulates the regenerative processes in all organs and tissues. Folic acid is essential for fixation of sugars and amino acids, synthesis of nucleic acids (DNA and RNA), involved in the passingf of hereditary traits. Folic acid is rapidly consumed during formation of placenta (5).

Recommended daily intake of folic acid for adults is 400 mg/day. During pregnancy the daily requirement of folic acid is increased to 800 mg/day (3). Folic acid deficiency is the most common vitamin deficiency among pregnant women, newborns and young children. Lack of folic acid during pregnancy may lead to the following consequences: pregnancy loss, partial or complete detachment of placenta, fetal birth defects, mental disability of the child, spontaneous abortion and stillbirth (4,7). It should be noted that deficiency of folic acid is transferred from mother to the fetus or newborn due to its deficiency in the mother’s organism during pregnancy or after birth - in the mother's milk (8). During the last weeks of the antenatal period the fetus consumes folic acid to increase its own mass and replenish its stocks. As a result, women which have a folic acid deficiency, would have an increased probability of having a child with malnutrition and a reduced content of folic acid.

Thus, the assessment of the appropriateness of vitamin prophylaxis on different stages of gestation is still valid, though it is the subject to numerous debates.

In the present time, new vitamin-mineral complexes were developed, in which the daily dose of vitamins and minerals is divided into several tablets, the content of which is developed on the basis of information on positive and negative interactions between different components in the process of their production, storage and assimilation in the body.

Aim: To evaluate the absorption of folic acid during different regimens of reception of ALFAVIT Mom’s health complex, during pregnancy in the II and III trimester of gestation. Materials and methods: Examination and treatment of 32 pregnant women with gestational age of the fetus from 16 to 33 weeks (31,2 ± 3,0).

The inclusion criteria: absence of exacerbations of chronic kidney diseases, cardio-vascular diseases, allergic diseases and of severe gestosis during pregnancy.

The study excluded patients with chronic infectious diseases (tuberculosis, viral hepatitis, HIV, etc.) with chronic diseases of gastrointestinal tract, in the acute stage of disease, and women with a history of allergenic anamnesis, primarily, in relation to vitamin-mineral preparations.

The criteria for the possible interruption of the study were: patient refusal to continue the study and serious adverse events occurring during the study.

Vitamin-mineral complex ALFAVIT Mom's health was administered in the II and III trimester of pregnancy, when the mother and child have the largest requirement for micronutrients and a manifestation of latent vitamin deficiency, which can lead pathological changes in the fetoplacental system is possible.

For each patient enrolled in the study, a specially designed " survey card” was completed, in which information about previous diseases (childhood infections, chronic, and common gynecological diseases, surgery, etc.), hereditary factors, the nature of the menstrual and generative functions, data for previous pregnancies, childbirth, postpartum, the presence of artificial and spontaneous abortions was recorded; special attention was given to the data on the course of the present pregnancy. In the absence of contraindications 22 patients were assigned with ALFAVIT Mom’s health preparation and the control group of 10 received placebo - tablets, which completely imitated the preparation in appearance and mode of application.

ALFAVIT Mom’s health is a vitamin-mineral complex containing a daily dose of vitamins and minerals, divided into 3 tablets. Tablet № 1 (orange) contains Vitamin B1 - 1,2 mg, vitamin C - 50 mg, folic acid - 300 ug, beta-carotene - 2 mg, iron sulfate - 20 mg, copper sulphate - 1mg, Taurine - 50 mg. Pill number 2 (yellow) contains: Vitamin E - 12 IU, Nicotinamide - 19 mg, Vitamin B2 - 1 mg, vitamin C - 40 mg, beta-carotene - 2 mg, Vitamin B6 - 2 mg, zinc sulphate - 12 mg, Manganese Sulphate - 1 mg, potassium iodate - 150 ug, Selenium - 40 ug, magnesium oxide - 50 mg, Molybdenum - 25 ug. Tablet № 3 (white) contains: Biotin - 30 mg, calcium pantothenate - 5 mg Vitamin B12 - 3 ug, Vitamin K1 - 60 ug, Vitamin D3 - 400 IU, folic acid - 300 micrograms, chromium picolinate - 25 micrograms, carbonate Calcium - 250 ug.

Depending on the scheme of treatment, all surveyed women were divided into 3 groups by random selection:

  • 10 pregnant women recieved ALFAVIT Mom’s Health № 60 (3 tablets taken separately)
  • 10 women received ALFAVIT Mom’s Health № 60 (3 tablets taken together)
  • 12 women received placebo.

In all pregnant women the content of folic acid in the blood was examined before the start of the reception of the complex and after 15 (interim controls) and 30 days of treatment (the result of preparation action). The duration of the study for each patient was 1 month.

Measurement of folic acid concentration in blood plasma, was performed the morning, on an empty stomach in the Vacutainer tubes. Blood was left at room temperature for 30 min, for clot formation, then centrifuged at 1500 rpm for 15 min, at 40 C. The normative figure for folic acid was 3-17 ng/ml.

Throughout the trial, the women were observed to assess the tolerability of the product and their health.
After the end of the study all patients were offered a specially compiled questionnaire, reflecting the subjective assessment of the effectiveness of treatment.
Full Name.____________________________________________________________
Method of taking of vitamin-mineral complex :____________________

1. Tolerability:
a) change in appetite:
loss of appetite
b) Change in taste preferences:
If yes, specify the changes: __________________________________

2. Gastrointestinal disturbances:
abdominal panes
no notes

3. Intestinal habits:
a) the multiplicity:
1 time in 2 days
1 time in 3 days or more
1 time per day
2 times a day
3 times a day or more
b) consistency:
watery - foamy
false diarrhea (in the form of a solid plug
followed by liquid feces)
"Sheep" feces (round bulb-like
dry and dense) or as sintered
"cedar cones" balls
formed, without
c) pathological inclusion:
no inclusions
d) odor:
without special properties
e) color:
white - gray
light - yellow
golden - yellow (ocher)
without special properties

4. Allergic manifestations:
If yes, what manifestations in particular___________________________________________

5. Condition of skin and mucous membranes:

gray ("earthy")

Statistical processing of data was performed using conventional methods of medical statistics, using Microsoft Excel and Biostat. The data was presented in the format M ± Sd, where the M is mean value of the studied trait, and Sd is standard deviation. The significance of studied parameters differences were determined using the nonparametric Wilcoxon test. The differences were recognized significant at a significance level of P <0.05.

The results of the study:

27 (84,4 %) pregnant women received full course treatment . 5 (15,6%) patients dropped out of the study, particulary:1 patient (3.1%) refused to continue the study because of increased gag reflex when taking tablets, 2 patients (6,3%) excluded, because their were taking their medications irregularly, and 2 (6.3%) patients had premature labor, which did not allow them to complete the study.

After 2 weeks of receiving ALFAVIT Mom's health a subjective improvement in well-being of pregnant women was noted, with at 74,1% reporting increase in work efficiency. 59.3% of the surveyed noted the disappearance of fatigue, weakness, decreased frequency of complaints about poor sleep and depression. None of the surveyed women noted adverse effects of preparation on the motility of gastrointestinal tract, which distinguishes ALFAVIT Mom's health from similar preparations.
Before intake of the preparation all 3 groups, had the quantitative content of folic acid within normal values. 2 groups which received vitamin-mineral complex ALFAVIT Mom's health had a significant increase in the level of folic acid, in contrast to the placebo group, where the rate of folic acid did not differ significantly from the previous measurement and was within the normal range (P>0,05). By the end of the study increase of folic acid in serum was recorded only in the group taking the preparation in distributed way (1 tablet x 3 times per day) (P <0,05). The average values (M ± m) and the reliability of the difference in values of folic acid prior to the study, after 14 days and 30 days are presented in Table 1.

Table 1. Indicators of the level of folic acid in the trial.


Base level, ng/ml

after 14 days, ng/ml

Significance of differences Р

after 30 days ng/ml

Significance of differences Р

Separated reception






Simultaneous reception (n=10)






Placebo (п=12)






It should be noted that there were no intolerance or allergic reactions to components of the vitamin-mineral complex.

Conclusion. Thus, the results of the study show that prophylactic use of vitamin and mineral complex ALFAVIT Mom’s health during the second and third trimester of pregnancy is safe and efficient. Dynamics of absorption of folic acid in the regimen of separated intake of three pills is optimal compared with one-stage regimen. Good tolerance and regular reception of the preparation contribute to the maintenance of favorable course of pregnancy, a satisfactory health status and well-being of expectant mothers.


  1. Vitamins and trace elements in pregnant and nursing as a prerequisite of healthy offspring/ Guidelines, Parts 1 and 2 (№ 22,23). - M.: MAKS Press, 2007. – 48 pp.
  2. Interactions of components of vitamin - mineral complexes and rational vitamin therapy. Vitamin-mineral complex ALFAVIT. - Moscow: Publishing House "MEDPRAKTIKA - M, 2006, 44 pp.
  3. Korovin, N.A., Podzolkova N.M., Zakharova I.N., Skvortsova M.Y., Malova N.E. Features of nutrition of pregnant and lactating women (a guide for physicians) - Moscow: Publishing House "Medpraktika - M, 2004, 64 pp.
  4. Lutsenko N.N. Multivitamins and minerals as an integral part of the rational nutrition of women before, during and after pregnancy. Eng. med. Zh. 2006; vol.12 № 13: 815 -818.
  5. Podzolkova N.M. et al. Experience with complex drug "Elevit pronatal" in pregnant women with thyroid diseases. Gynecology. 2004; vol.6 number 3: 147 - 150.
  6. Serov V.N. Rational vitamin in pregnant women \ Guidelines for obstetricians - gynecologists and general practitioners. - M.: 2007. - 32s.: Ill.
  7. Tyutyunnik V., Yakunin, N.A., Shchetinina N.S. Prevention of hypovitaminosis in obstetric practice. Eng. med. Zh. 2006; t.14 № 18: 1319 - 1319
  8. Allen L. Multiple micronutrients in pregnancy and lactation: anoverview. / / American Journal of Clinical Nutrition, 2005. - V. 81. - 5. - pp. 1206S - 1212S