Pregnancy outcome following use of large doses of vitamin B6 in the first trimester.
ABSTRACT Vitamin B6 is often prescribed for the treatment of nausea and vomiting of pregnancy (NVP), at much higher doses than initially recommended. Large doses of vitamin B6 have been associated with cases of neuropathy. We set out to assess whether higher than standard doses of vitamin B6 during the first trimester of pregnancy were associated with a risk of maternal adverse events, major malformations, miscarriages or low birth weight. This was a prospective comparative observational study. The study group included women who were exposed to >50 mg/day of vitamin B6 during the first trimester; the control group included pregnant women with a non-teratogen exposure. A total of 192 pregnancies were followed-up. The mean dose of B6 used in the study group was 132.3 mg/day (median 110 mg/day, range 50 - 510 mg/day), for a mean period of 9 +/- 4.2 weeks. In this group (n = 96), there were 91 live births, one major malformation and the mean birth weight was 3,542 +/- 512 g. There were no statistical differences in the study endpoints between the vitamin B6 and the control groups. Within the limits of our sample size, higher than standard doses of vitamin B6 do not appear to be associated with an increased risk for major malformations.
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ABSTRACT: QUESTIONMy patient has severe nausea and vomiting of pregnancy (NVP). I am having difficulty treating her, as nothing she has tried so far has been really effective. I heard that there is some new information regarding the treatment of this condition.ANSWEREven a less severe case of NVP can have serious adverse effects on the quality of a woman's life, affecting her occupational, social, and domestic functioning, and her general well-being; therefore, it is very important to treat this condition appropriately and effectively. There are safe and effective treatments available. We have updated Motherisk's NVP algorithm to include recent relevant published data, and we describe some other strategies that deal with secondary symptoms related to NVP.Canadian family physician Medecin de famille canadien 01/2008; 53(12):2109-11. · 1.40 Impact Factor
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ABSTRACT: Women often seek alternative treatment options such as herbs, dietary supplements, and vitamins and minerals to treat women's health issues across the lifespan. Women may use complementary and alternative supplements for dysmenorrhea, premenstrual syndrome, infertility, nausea and vomiting during pregnancy, and symptoms of menopause. In general, there is a deficit of well-designed, randomized, controlled trials to evaluate the efficacy and safety of complementary and alternative medicine for these indications, which makes it difficult to provide evidence-based recommendations. This review outlines the evidence for efficacy and safety that is currently available for dietary supplement use by women to manage health conditions specific to the female patient.Nutrition in Clinical Practice 10/2009; 24(5):589-608. DOI:10.1177/0884533609343001 · 2.06 Impact Factor
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ABSTRACT: Nausea and vomiting in pregnancy is a continuum that ranges from mild discomfort to significant morbidity. Systematic assessment with the use of the Pregnancy-Unique Quantification of Emesis/Nausea (PUQE) index and timely treatment using evidence-based protocols can decrease the time that many women spend using treatment recommendations that are inadequate. This article reviews the epidemiology of nausea and vomiting in pregnancy, use of the PUQE index, and the evidence for specific nonpharmacologic and pharmacologic treatment regimens. A protocol for clinical management is presented.Journal of midwifery & women's health 11/2009; 54(6):430-44. DOI:10.1016/j.jmwh.2009.08.005 · 1.04 Impact Factor