Pharmacists should recommend a multivitamin to women trying to conceive and also suggest that both partners skip caffeinated drinks.

“An important and previously unreported lifestyle behavior is the tremendous reduction in pregnancy loss associated with vitamin adherence irrespective of sensitive window,” stated the researchers of a new study published in Fertility and Sterility.
 
The study found that women who were 100% adherent to their daily vitamins in the preconception window saw a 55% reduction in their odds of pregnancy loss compared with women who didn’t take vitamins. A 79% reduction was also seen among women with 100% adherence during early pregnancy, as well.

The goal of the study was to find out more about pregnancy loss through the lens of a contemporary group of couples. The lifestyles of these couples were examined during “sensitive windows of reproduction” (preconception, early pregnancy, and periconception) to determine which factors may play a role in pregnancy loss.

The study participants came from 16 counties in Michigan and Texas. Upon enrollment, the researchers collected information about the couples’ sociodemographic, lifestyle, and medical histories, plus height and weight.

The 344 couples were instructed to keep daily logs of their use of cigarettes, caffeinated and alcoholic drinks, and multivitamins (including OTC multivitamins and prescription prenatal vitamins). Women also reported sexual intercourse, menses, and home pregnancy test results.

These journals were updated on a daily basis until they reported a positive home pregnancy test or up to 12 months of trying to get pregnant. Then, women who did get pregnant kept journaling daily through 7 postconception weeks of gestation, followed by monthly journals until they delivered or experienced a pregnancy loss.

Pregnancy loss was defined by a negative pregnancy test, the beginning of a woman’s period, or clinical confirmation depending upon gestation.

Of the 344 couples, 28% experienced a miscarriage.

Another finding from the study was that a woman’s age of 35 years or older was positively associated with pregnancy loss.

The researchers also discovered that women’s vitamin adherence was negatively associated with pregnancy loss in the preconception time period, while men’s caffeinated beverage consumption was positively associated with pregnancy loss.

“We are hoping other scientists will affirm the vitamin finding,” Germaine M. Buck Louis, PhD, MS, of the Eunice Kennedy Shriver National Institute of Child Health & Human Development, told Pharmacy Times.

During the early pregnancy and periconception time periods, multivitamin adherence continued to be negatively associated with pregnancy loss, while both partners’ caffeine intake was positively associated with pregnancy loss.

The researchers neither collected information on the specific kinds of caffeinated beverages or vitamins taken, nor had information on other behaviors such as exercise, diet, recreational drugs, or sleep habits.

“As such, we cannot rule out the potential for residual confounding,” the researchers stated.
 
They also noted that their findings don’t suggest that men and women can safely use decaffeinated or caffeine-free drinks as a safe substitute because they didn’t analyze intake of these products.  
 
The researchers concluded that preconception guidance, or education about healthy lifestyles before women become pregnant, is important for a healthy pregnancy.
 
“[O]ur findings are highly relevant for contemporary cohorts of couples at risk for or planning pregnancy who might want to adopt or maintain lifestyles that minimize the risk of pregnancy loss,” the researchers concluded. “All such lifestyles are amenable to change, and such guidance has been shown to influence healthy behaviors.”