**5.9 Use of vitamin B6 in pregnancy**

It's the beginning material within the biogenesis of the most molecule of supermolecule metabolism. The breakdown of all amino acids in protein metabolism and also the synthesis of non-essential amino acids occur in the presence of coenzymes of vitamin B₆ [28]. Therefore, vitamin B₆ has to be enlarged in parallel with the rise in the amount of supermolecule within the diet throughout pregnancy [16]. At identical time, vitamin B₆ helps the event of the central system [12]. Nausea and innate reflex are one among the foremost common and necessary symptoms in pregnant women, occurring in the early stages of pregnancy [28]. Vitamin B₆ is employed as an alternate treatment to forestall nausea and vomiting during pregnancy [30]. At the same time, vitamin B₆ is of interest as a result of the preservation of the placental tube-shaped structure bed [18]. Clinical manifestations of vitamin B₆ deficiency are epilepsy-like convulsions and dermatitis [28]. An awfully high dose (2–6 g/d) is needed for toxicity in dults. This toxicity happens at mega doses given for the treatment of carpal tunnel syndrome and preeclampsia. No fetal effects are reportable thanks to dose [18]. Whereas the number of vitamin B₆ that an adult girl ought to take daily is 1.3 mg, this amount is 1.9 mg in a pregnant woman [11]. The most dose that a pregnant woman should take is 100 mg [14].

#### **5.10 Use of vitamin B9 in pregnancy**

Vitamin B₉ plays a vital role within the construction of latest cells by serving to the assembly of desoxyribonucleic acid (DNA) and ribonucleic acid (RNA), that management cell proliferation within the body [12]. It additionally facilitates biological processes as a compound for enzymes involving polymer and RNA synthesis [31]. In addition, it works in conjunction with cobalamin to create hemoglobin in erythrocytes [12]. It should be infatuated food, and also the totally different forms

it enters to be used in the body are usually referred to as 'folate' [28]. All defects that occur throughout pregnancy occur in the 1st 28 days of pregnancy, largely once the expectant mother does not apprehend she is pregnant yet. The foremost common of those is NTD (Neural Tube Defect). It is one among the common and severe malformations among inborn malformations. All of the malformations similar to anencephaly, encephalocele, meningocele, myelocele, meningomyelocele and myelosis, which are caused by the neural tube during which the brain and neural structure develop, stay open once it ought to be closed till the tip of the fourth week of intrauterine life, are all serious congenital anomalies and are expressed underneath the name of 'neural tube defect' [31]. It's suggested to begin vitamin B₉ supplementation with four hundred mcg with the design of pregnancy and three months before, and to continue it throughout the primary trimester of pregnancy [32]. So as to be shielded from NTD, 600 mcg vitamin B₉ supplement ought to be taken daily. The most quantity of folic acid that a pregnant girl should take daily is a thousand mcg [14].

#### **5.11 Use of vitamin B12 in pregnancy**

In contrast to different soluble vitamins, up to four mg of vitamin B₁₂ is hold on within the body. Therefore, vitamin deficiency is not determined for several years. Those with deficiency are additional doubtless to be strict vegetarians [28]. Vitamin B₁₂ may be a molecule essential for organic process and lipid, protein, and macromolecule metabolism. It is synthesized within the liver and is named extrinsic factor. Though it acts on all cells, it plays a serious role in the bone marrow, gastrointestinal system and central nervous system. It acts as a compound for polymer synthesis in the bone marrow. Though we have got little information on the necessity for vitamin B₁₂ throughout pregnancy, in step with some studies, body fluid vitamin B₁₂ values decrease in the advancing weeks of pregnancy. Tries to interchange this decline in pregnancy are unsuccessful. This fact supports the idea that serum vitamin B₁₂ level is freelance of diet and this decrease will not necessitate a decrease in maternal aliment stores [18]. Vitamin B₁₂ is very important for the continuity of cell division. In its deficiency, methylcobalamin cannot be shaped and polymer synthesis cannot be made of quick growing tissues throughout pregnancy. As a result, megaloblastic anemia, inborn anomalies and issues within the system develop. Low plasmic vitamin B₁₂ concentration was found to be related to high plasmic homocysteine level, pre-eclampsia and preterm birth risk all told age groups. It's been reportable that maternal insufficiencies cause NTD and spina bifida. Vitamin B₁₂ is infatuated foods of animal origin. In humans, viscus bacterium also can synthesize vitamin B₁₂ [28]. The number of vitamin B₁₂ that an adult girl ought to take daily is 2.4 mcg. This dose will increase to 2.6 mcg in an exceedingly pregnant woman [11]. There aren't any adequate resources for the most daily intake throughout pregnancy [14].

#### **5.12 Use of calcium in pregnancy**

Calcium is an inorganic element that's the foremost superabundant and essential mineral element within the human body. Ca metabolism is regulated by hormones similar to vitamin D, parathyroid gland hormone, and calcitonin. Oral calcium is absorbed from the intestines by the result of vitamin D. Parathyroid gland hormone, on the opposite hand, will increase viscus Ca absorption and bone calcium mobilization by increasing calciferol synthesis within the kidneys [14]. The fullness of iron stores together with calcium is very important for bone and red blood cell development [33]. Enlarged calcium intake throughout pregnancy is important for

#### *The Effects of Multivitamin Use in Pregnancy on Mother and Fetus Health DOI: http://dx.doi.org/10.5772/intechopen.98925*

the health of mother and baby. Throughout this period, the utilization of calcium supplements reduces preeclampsia. At identical time, once enough calcium is not taken during pregnancy, the necessity is met by retreating calcium from the bones. Frequent births, lack of movement and lean use of daylight cause bone softening and tooth decay. Adequate vitamin D intake is important to facilitate Ca absorption [33]. It's wrong to assume that dental caries happens thanks to calcium deficiency throughout pregnancy which each pregnancy causes a tooth loss. Changes within the composition of spittle during pregnancy accelerate the progression of prepregnancy caries and also the gums bleed easily. Despite harm gums, teeth ought to be brushed regularly. All types of dental treatment (tooth symptom treatment, tooth extraction) are often done during pregnancy. Long-run treatments (such as passage treatment) can be delayed for once six months [6]. Whereas the number of calcium that girls would like during pregnancy is a 1000 mg, the most quantity to be taken is 2500 mg [14].
