The science behind B-natal.

In 2004, the American College of obstetricians and gynaecologists (ACOG) issued guidance for physicians on the treatment of morning sickness. After reviewing the scientific literature, they concluded that the first defence against morning sickness is vitamin B₆ in the form of pyridoxine. [1]

The role vitamin B₆ plays in alleviating the nausea and vomiting of morning sickness is poorly understood because the root cause of the condition is poorly understood. The two leading theories for the onset of morning sickness are:

1. hormonal changes and
2. lower blood sugar levels during pregnancy. [2]

It is likely, however, that morning sickness results from a combination of factors.

Whatever the underlying cause, vitamin B₆ as pyridoxine appears to be the most effective treatment available to reduce morning sickness symptoms. Vitamin B₆ is the most commonly studied treatment methodology and has been recommended by physicians since 1942. [3]

Additionally, supplementation of vitamin B₆ for expectant mothers may be necessary because many women suffer from vitamin B₆ deficiency during pregnancy. A lack of vitamin B₆ has been linked to interference with protein absorption, the underutilization of amino acids and the presence of toxaemia.

Vitamin B₆ is found in a wide variety of foods, including fortified cereals, beans, meat, poultry, fish, and some fruits and vegetables. [4, 5]

Other treatments, such as the use of ginger or antihistamine H1 receptor blockers, are, according to AGOG "based on limited or inconsistent evidence." [1]

Vitamin B₆ is essential for good overall health, whether one is pregnant or not. It is a water-soluble vitamin that exists in three chemical forms: pyridoxine, pyridoxal and pyridoxamine. [4, 6] All three forms have been studied extensively and have been shown to be essential for:

• the synthesis of pyridoxal 5-phosphate, a cofactor of many essential enzymes[4, 7]
• protein metabolism
• red blood cell metabolism
• nervous system function [8, 9]
• immune function [8,9]
• the conversion of tryptophan (an amino acid) to niacin
• the maintenance of normal blood glucose levels [4, 10-12]

A small sampling of the many studies on vitamin B₆ and morning sickness are summarized below:

• A randomized, double-blind study of 342 women at more than 17 weeks' gestation showed that there was a significant decrease in the mean of post-therapy nausea scores in the pyridoxine group compared with that in the placebo group. [13]
• A randomized, double-blind study of 59 women experiencing the nausea and vomiting of morning sickness showed that the mean "difference in nausea" score (severe = 7 or above; mild = 7 or below) was significantly reduced following Vitamin B therapy. In fact, after 3 days of therapy, only eight of 31 patients in the Vitamin B cohort had any vomiting, compared with 15 of 28 in the placebo group. [14]
• A meta-analysis of morning sickness treatment studies found that vitamin B₆ as pyridoxine was more effective in reducing the severity of nausea. Other treatments included antihistamines, the prescription medication for morning sickness, Debendox, P6 acupressure and ginger. [15]

References