Caution: Reports vitamin B3 could "cure" miscarriage may be misleading

Bupa medical specialists say pregnant and breastfeeding women should be a little cautious before acting on a new study that suggests vitamin B3 supplements could prevent miscarriages and birth defects. 

If you’re pregnant or planning to start a family – it could be easy to jump to conclusions when reading the latest reports about a “ground-breaking” new pregnancy study. 
The headlines sound too good to be true. “Breakthrough discovery,” reads one, “Cure for miscarriage!” reads another. But Bupa has urged women to be cautious, and balance-up all the evidence before changing their behaviour dramatically.
The hype is related to a new study by a team at the Victor Chang Cardiac Research Institute in Sydney looking at the connection between a deficiency in NAD (nicotinamide adenine dinucleotide, a molecule found in all living cells), and birth defects and miscarriages in mice. 
The study has been heralded as a breakthrough because it suggests that there’s a simple solution: supplementing niacin or vitamin B3.
“Now, after 12 years of research, our team has also discovered that this deficiency can be cured and miscarriages and birth defects prevented by taking a common vitamin,” lead researcher Professor Dunwoodie said in a statement.
The study, “NAD Deficiency, Congenital Malformations, and Niacin Supplementation,” was published in one of the most highly regarded medical journals – the New England Journal of Medicine
But Dr Stan Goldstein, a senior medical officer at Bupa, says there are a few key factors people need to be aware of:
“Firstly, the study was a “mouse trial” (studied mice). How and whether it will relate to humans is yet to be seen,” he says. “Just because you see an effect in mice, it doesn’t necessarily mean you’ll see the same effect in a human.”

"Just because you see an effect in mice, it doesn’t necessarily mean you’ll see the same effect in a human."

“Secondly, it appears the results relate to a rare genetic condition. Hence it remains to be seen whether taking niacin [vitamin B3] could reduce miscarriages and possibly even birth defects, in the absence of the genetic NAD deficiency. Therefore, it can’t be determined yet whether vitamin B3 supplements might benefit pregnant women without this or similar genetic conditions.”
Around 9.7 million babies are born with birth defects world-wide every year, and roughly one in five confirmed pregnancies end in miscarriage. Some women will miscarry before they even know they’re pregnant. Sometimes miscarriages happen because a baby fails to develop properly, however most women who experience a miscarriage never find out the exact reason why.
Dr Goldstein says that while the study sounds promising, he has urged women not to start taking any new supplements without first speaking with their doctor.
“What we don’t know about this study is, a) what level of niacin may be beneficial in humans and b) if there are any down sides to increasing niacin intake beyond what is already recommended. So, we wouldn’t recommend people just try it out and see, when we don’t know if there are any harmful effects at doses beyond that which many women already take.”
“It would be wonderful to find that this study really does reveal that we have the means to reduce the chance of couples having to endure the emotional trauma of a miscarriage, but it’s far too early yet,” Dr Goldstein says.
Many pregnancy supplements already contain the recommended daily intake of niacin (vitamin B3) for pregnant women, as nicotinamide, in once-daily doses. 
The recommended daily intake for niacin for pregnant women is 18mg/day, with the upper limit at 35mg/day. This includes sources of niacin from all sources. 
Bupa dietitian Gemma Cosgriff says this can be achieved through dietary sources as well as a pregnancy-specific supplement. 
“Good sources of niacin or vitamin B3 include meats, fish, poultry, eggs, wholegrain breads and cereals, nuts, mushrooms, Vegemite, Marmite and protein-containing foods,” she says.
plate of mother's food rich in b3 and niacin to prevent miscarriage
“Unlike other B-group vitamins, niacin (vitamin B3) is heat stable so we don’t lose much through cooking. Large doses of niacin can have an impact on the nervous system and on blood fats, so we don’t want to jump too quickly into adding extra supplements into our routine. I would encourage anyone to consult their doctor or a dietitian first,” she says.

Nutrition plays a key role in this developmental period, and some supplements are recommended during different stages of pregnancy. 

Cosgriff says pregnant women or those trying to conceive should aim for a varied mix of nutritious foods to ensure an adequate intake of nutrients like niacin. 

“Particularly to support pregnancy, nutrition is fundamental to good health,” she says. “In the absence of human trials, it is always going to be beneficial to have another look at your food intake and potentially make some changes to ensure you’re getting good sources of vitamins like iron, folate and folic acid, calcium, iodine, zinc and protein.”

Dr Goldstein says he thinks this will now be the first of many studies that look into the link between niacin, NAD, miscarriages and birth defects.

“It is indeed an exciting prospect if we can reduce genetic defects and reduce the number of miscarriages, which can be a very distressing event for couples trying to have children.”

"It is indeed an exciting prospect if we can reduce genetic defects and reduce the number of miscarriages, which can be a very distressing event for couples trying to have children."

“The first thing that needs to happen is scientists need to see if the results are reproducible. Someone else should have a go at doing the same study, and hopefully they see the same results in creatures other than mice, that have the same genetic defect.”

Environment, as well as genetics, play an important part in a child’s development. There’s a growing body of evidence that the First Thousand Days, from conception until a child turns 2, is a critical time for a baby’s development. 

Senior Research Fellow Dr Tim Moore from the Murdoch Children’s Research Institute (MCRI) says couples who want to start a family should focus on their health and wellbeing before they even start trying to conceive.

“What you’re eating before you conceive matters, when it comes to both the mother and the father,” he says. “From the moment the egg is fertilised and starts to develop into a foetus, it is subject to exposure to the mother’s bodily function, and that begins to shape the way the foetus develops,” he says.

That’s why Bupa has teamed up with the MCRI to help support families during this important time, with information, support, tools and inspiration to help guide parents through their first thousand days.  

“Even things like sleep, social contacts and stress can have an impact on the development of a foetus, even before conception,” he says. 

For more information, support and guidance during the first thousand days of your parenting journey, click here.  

A button which you can click on to take you to a hub filled with information on the first thousand days.

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