
The use of nutritional supplements during pregnancy: A guide for moms-to-be
Highlights
- Nutritional supplements during pregnancy are a significant part of the diet.
- Eating the right foods and getting the correct nutritional supplements are vital for preserving foetus health.
- Only adequate levels of correct nutritional supplements are the optimal strategy during pregnancy.
- 80% of Americans’ eating habits are not sufficient for optimum health.
- Folic acid, vitamin D, vitamin C, vitamin E, vitamin B12, vitamin B6 and iron are some of the important nutritional supplements that may exert benefit to moms-to-be and their babies.
Pregnancy is a period when moms focus on their eating habits to optimise their physical and mental health and for the health of their baby. There is a lot of inconsistent information concerning the safety and benefits of nutritional supplements during pregnancy. In the growing supplement market, moms are getting lost in choosing the correct nutrients during their pregnancy. This article aims to provide evidence-based information for pregnant moms about the optimal use of nutritional supplements, as well as their benefits.
What is the importance of nutritional supplements during pregnancy?
The unborn baby or in other words "foetus" health status is primarily determined by “maternal consumption” (eating habits of the mom). It has long been recognised that deficits in important nutrients can result in abnormalities and poor health outcomes for pregnant mothers and their babies. Eating the right foods and getting the correct nutritional supplements is vital for preserving foetus health.
Pregnant women should not forget that 9 months of pregnancy is the most significant period that may affect the children’s future life. While correct supplements in correct doses have beneficial effects, wrong supplements and wrong doses may have detrimental outcomes.

What are the right nutritional supplements during pregnancy?
Pregnant moms need a wide range of nutritional intake than others. This is because pregnant moms are not only feeding themselves but also feeding their babies. Some mothers are reporting low appetite during pregnancy which requires the involvement of nutritional supplements.
Food may not always be enough to get sufficient and vital nutrients because moms-to-be may need higher amounts than normal during pregnancy. Statistical data shows that 80% (1) of Americans' eating habits are not sufficient for optimum health and that does not exclude pregnants. Some "essential nutrients," or those that the body cannot produce on its own, can have a significant positive effect on pregnancy and must be obtained through supplements when food is an insufficient source.
Folic acid
Folic acid or in other terms vitamin B9 or folate is one of the essential nutrients that are significant during pregnancy. “Neural tube defect” is a significant birth defect that babies born with severe disabilities such as deafness, blindness and other malformations. The “incidence” (the occurrence rate) of neural tube defects is rare but affects 1 in every 1000 births (2), globally.
The evidence-based information published by the journal of Nutrition Reviews (3) and Reproductive Toxicology (4) answers the questions: How much folic acid do I need to take? When should I start folic acid during pregnancy?
4 µg daily folic acid takes around 20 weeks to reach sufficient levels in the blood. Thus, women should start folic acid supplementation 5-6 months before pregnancy (6).
Folic acid or folate supplementation is linked to a reduced risk of heart disease in the baby and abortion.
Vitamin D
Vitamin D is another important nutrient during pregnancy but the available evidence is not as crystal clear as folic acid. Insufficient levels of vitamin D during the first 13 weeks of pregnancy (1st trimester) does not interfere with abnormal pregnancy results, however, very high levels of vitamin D deficiency of nearly 70% is linked to insufficient vitamin D levels in young women.
Vitamin D deficiency is mostly associated with lower exposure to sunlight. Despite some countries such as Cyprus getting a tremendous amount of sunlight, vitamin D deficiency is still a big problem.
Similarly, in a study (5) conducted in The Hague, Netherlands, monitoring of vitamin D levels was recommended during pregnancy because Danish moms-to-be demonstrated up to 18% of insufficient vitamin D levels during their pregnancy.
Another report from Poland shows the importance of vitamin D on newborns. According to a study, a high level of vitamin D deficiency was observed in newborns regardless of which month they were born.
The only natural source of vitamin D is sunlight. Females with winter pregnancy, black ethnicity, and living in places such as northern latitudes are the risk groups.
According to the European Food Safety Authority (6), 600 IU of vitamin D daily is the optimal dose.
Vitamin B12
Vitamin B12 plays an important role in health and well-being in a wide range of people groups including pregnants. Insufficient levels of vitamin D are linked to severe malformations in newborns and in moms-to-be. These include neural tube defects, pre-eclampsia, instant abortions and low weight in newborns.
A routine blood test can easily reveal the vitamin B12 levels of women but a common sign of vitamin B12 deficiency is “macrocytic anaemia” which is when red blood cell is bigger than normal and also there are insufficient levels of haemoglobin.
Vitamin B12 sources are meat, fish, milk and other dairy products. Vegans or vegetarian women are at risk of vitamin B12 deficiency during pregnancy.
4.5 µg daily vitamin B12 is the optimal recommended dose for pregnant women (6).
Vitamin C
Vitamin C is one the most well-known type of vitamin, worldwide. Its antioxidant property and international popularity make vitamin C to be one of the most popular vitamins, globally.
Published research does not support the everyday intake of vitamin C during pregnancy for the prevention of unexpected results such as spontaneous abortions.
Vitamin C can be good supplementation for the risk of “premature rupture of the membranes”. What is premature rupture of the membranes? Premature rupture of the membranes is the condition when the sac surrounding the unborn baby break off that triggering the infection mechanisms.
It is advised that 100 mg of vitamin C (synonym for vitamin C: ascorbic acid) prevents urinary tract infections in pregnancy.
The major food source of vitamin C is kiwi. Lemon, cauliflower and broccoli are also significant sources.
Note: Levels of vitamin C decrease in overcooked or over-steamed vegetables. Raw broccoli should be lightly steamed for optimal levels of vitamin C.
105 mg of vitamin C supplement daily is recommended for pregnant women (6).
Vitamin E
Vitamin E is another antioxidant and popular nutrient. It is proposed to prevent premature rupture of the membranes and preeclampsia. Vitamin E plays a role in increasing the levels of prostacyclin and that reduces the risk of uterine contractions during pregnancy.
According to the Journal of Medical Sciences, 100 mg/d of vitamin E is recommended for preventing leg cramps during pregnancy.
Vitamin E deficiency risk group people are the ones who have poor dietary intake. Food sources of vitamin E include avocado, egg, spinach, sunflower seed and nuts.
11 mg of vitamin E supplement daily is recommended for pregnant women (6).

Vitamin B6
Vitamin B6 plays a significant role in the development of the foetus. The development of the central nervous system of the babies is linked with the vitamin B6 intake of the mom.
Vitamin B6 deficiency in pregnancy is linked to early pregnancy loss and low birth weight.
30 to 75 mg/d (7) divided doses of vitamin B6 can prevent mild nausea during pregnancy.
Another interesting recommendation is that vitamin B6 (8) is a valuable option for the treatment of anaemia in pregnant women who did not respond well to iron supplementation.
Fish, nuts, eggs and meat are valuable sources of vitamin B6.
1.8 mg of vitamin B6 supplement daily is recommended for pregnant women (6).
Iron
According to the World Health Organisation, the rate of anaemia in pregnant women is 41.8% (9) and iron deficiency is responsible for half of the cases.
Iron can be found in red meat, nuts and green vegetables primarily dark green ones.
Vegans and vegetarians are the most susceptible group of pregnants who can suffer from iron deficiency.
16 mg of the iron supplement daily is recommended for pregnant women (6).
Others
Other supplements such as calcium, iodine, choline, vitamin K, Myo-inositol and vitamin A are also important sources for pregnant women. The group of pregnant women who needs to take these supplements and doses are demonstrated below.
- Calcium: People who are vegans and pregnant with a risk of preeclampsia should take it. 1000 mg daily (6).
- Vitamin K: People that have poor diets should take it. 70 µg daily (6).
- Choline: People with genetic variations in choline and also folate mechanisms should take it. 400 mg daily and can be more after the third trimester of the pregnancy (6).
- Myo-inositol: People with a risk of gestational diabetes mellitus and neural tube defect should take it. 2 to 4 grams daily in only pregnant women who are at risk of gestational diabetes mellitus and neural tube defect (6).
- Vitamin A: People who have low meat, fresh vegetables in their diet and poor food intake should take it. 540 µg RE daily (6).
Conclusion
Pregnancy is one of the most hopeful but also one of the hardest times in a woman's life. The nutritional supplement is an important topic that every pregnant mom should have an idea about. Taking all of the supplements at a time is not a good choice but searching for the best nutrients according to your needs is the most important investigation.
9 Sources
- Morbidity and Mortality Weekly Report (MMWR) https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6426a1.htm
- American Journal of Medical Genetics https://pubmed.ncbi.nlm.nih.gov/15800877/
- Nutrition Reviews https://pubmed.ncbi.nlm.nih.gov/23356639/
- Reproductive Toxicology https://pubmed.ncbi.nlm.nih.gov/29777755/
- American Journal of Clinical Nutrition https://pubmed.ncbi.nlm.nih.gov/16895882/
- European Food Safety Authority https://www.efsa.europa.eu/en/supporting/pub/e15121
- Cochrane Library https://pubmed.ncbi.nlm.nih.gov/26348534/
- European Journal of Clinical Nutrition https://pubmed.ncbi.nlm.nih.gov/19920848/
- Lancet https://pubmed.ncbi.nlm.nih.gov/26314490/