**5.2 Use of vitamin D in pregnancy**

Calciferol is taken into account a pre-hormone in steroid structure [1]. It's 2 sources: D₃ (cholecalciferol), that is synthesized within the skin by daylight, and vitamin D₂ (ergocalciferol), which is taken through diet and dietary supplements [26]. They are often hold on in the liver in the body [27]. It's the foremost poisonous of the fat-soluble vitamins [28]. Calciferol is provided by dietary intake and also the result of sunlight on the skin. Therefore, vitamin D deficiency develops thanks to inadequate diet, living inside or in unsunny climates, and sporting sun-proof covering [18]. Vitamin D regulates Ca and phosphorus metabolism alongside hormone and thyrocalcitonin [14]. It will increase calcium resorption and decreasing calcium excretion by taking part in a task in maintaining bone balance [24]. It also has results on the nervous system, heart and clotting mechanism [14]. There also are studies showing that it's necessary for immune operate concerning aldohexose regulation, fetal brain development, and female internal reproductive organ contractions at birth [12]. As a results of clinical studies on the effect of calciferol on pregnancy outcomes, it's been determined that vitamin D deficiency is also related to preeclampsia, pregnancy diabetes, low birth weight, preterm delivery, cesarean section and enlarged risk of infectious diseases [26]. Calciferol deficiency throughout pregnancy is that the most significant risk issue for vitamin D deficiency in newborns and infancy. Since maternal vitamin D deficiency is common in Turkey, it's declared that vitamin D deficiency is liable for symptom in early infancy [24].

## **5.3 Use of vitamin E in pregnancy**

Use of vitamin E in pregnancy is important for tissue development, cell membrane structure, and red blood cell integrity. However, its most important physiological result is its being inhibitor [18]. It's the smallest amount poisonous of the fat-soluble vitamins. Once taken over necessary, it's excreted in excreta and urine. Terribly high doses can cause nausea and symptom [28]. The necessity for vitamin E will increase throughout pregnancy and particularly within the trimester [12]. The most finding in its deficiency is anemia. However, additionally to this, muscle and system disorders and muscle fatigue also can be seen. Though its use is controversial, premature newborns are ordinarily supplemented with vitamin E to stabilize erythrocytes and haemolytic anemia is prevented [28]. Maternal level of vitamin E increases during pregnancy. It peaks around thirty seven weeks and

returns to pre-pregnancy levels shortly once birth. The rationale for this increase throughout pregnancy are often attributed to the enlarged would like thanks to fetal growth [18]. Pre-eclampsia is a vital pregnancy-related complication and is related to each maternal and fetal problems. it's thought that preeclampsia symptoms can be reduced by inhibitor support in early pregnancy. Vitamin E additionally plays a task in reducing preeclampsia in pregnancy due to its antioxidant properties [24]. The suggested intake for vitamin E during pregnancy is fifteen mg per day, and also the most quantity to be taken is a 1000 mg per day [14].

## **5.4 Use of vitamin K in pregnancy**

Vitamin K exists in nature in two forms, K₁ and K₂. fat-soluble vitamin K₁ is synthesized within the leaves of inexperienced plants. The well-liked variety of drugs is fat-soluble vitamin K₁ sort. Vitamin K₂ is of microbic origin. It's synthesized by microorganism bacterium settled in the small intestine and colon in humans and by another bacteria. The synthetically derived type is vitamin K₃ [16, 28]. Though the foremost important operate of vitamin K is anticoagulant, it additionally has a vital result on bone health [28]. Vitamin K has been shown to repair bone deformation and forestall bone loss caused by corticosteroids [14]. In newborns, the symptom of fat-soluble vitamin deficiency throughout the amount once microorganism is not shaped is manifested as a bent to bleeding. Breast milk is poorer in vitamin K than ready-made formulas. Therefore, the very fact that the baby is fed solely with breast milk could cause low vitamin K levels. If vitamin K is not given to the baby at birth, disorders within the action mechanism may occur. Therefore, for prophylaxis, administration of vitamin K straightaway once delivery is suggested [28]. If high doses of artificial vitamin K (K₃) are administered to the newborn for a long time, poisonous effects are seen, leading to anemia and jaundice [28]. High doses of vitamins A and E intake could interfere with the viscus absorption of fat-soluble vitamin [18]. Like all fat-soluble vitamins, overdoses of vitamin K accumulate within the body and are toxic. However, the traditional average diet provides over adequate amounts of vitamin K and does not need routine supplementation throughout pregnancy. However, vitamin K supplementation is suggested for a few sure indications [18]. With a traditional average diet, the necessity for vitamin K is more than met. There's no need for routine supplementation during pregnancy. The daily dose needed for non-pregnant ladies and pregnant women is that the same and this value is 90 mcg. [14].

## **5.5 Use of vitamin B₁ in pregnancy**

Though vitamin B₁ is not used directly within the body, it takes half in several mechanisms. It's used as a molecule in the synthesis of acetylcholine, that is concerned in neurotransmission [14]. Vitamin B₁ is required for aldohexose chemical reaction in the body for hormone production from exocrine gland cells and cell growth [18]. It additionally plays a vital role in macromolecule metabolism [29]. Daily supplementation of vitamin B₁ in pregnant women prevents low birth weight, ensures intrauterine growth and will increase aldohexose tolerance [18]. Higher intake of vitamin B₁ than the most needed dose could cause nausea, vomiting, lethargy, and eating disorder [18]. The number of vitamin B₁ that a pregnant girl ought to take daily is 1.4 mg.

#### **5.6 Use of vitamin B₂ in pregnancy**

Riboflavin acts as a molecule in chemical reaction and reduction reactions, in tissues that manufacture energy through respiration [18]. Vitamin B₂ 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 formation of red blood cells and production of antibodies, that are a vital a part of the body' defense system. it's also accountable for getting energy from supermolecule associated fats [14]. Whereas the number that an adult girl ought to take daily is 1.1 mg, the daily amount that a pregnant woman should take is 1.4 mg [14].
