Evidence based recommendations for an optimal prenatal supplement for women in the US: vitamins and related nutrients
- PMID: 35818085
- PMCID: PMC9275129
- DOI: 10.1186/s40748-022-00139-9
Evidence based recommendations for an optimal prenatal supplement for women in the US: vitamins and related nutrients
Abstract
The blood levels of most vitamins decrease during pregnancy if un-supplemented, including vitamins A, C, D, K, B1, B3, B5, B6, folate, biotin, and B12. Sub-optimal intake of vitamins from preconception through pregnancy increases the risk of many pregnancy complications and infant health problems. In the U.S., dietary intake of vitamins is often below recommended intakes, especially for vitamin D, choline and DHA. Many studies suggest that insufficient vitamin intake is associated with a wide range of pregnancy complications (anemia, Cesarean section, depression, gestational diabetes, hypertension, infertility, preeclampsia, and premature rupture of membranes) and infant health problems (asthma/wheeze, autism, low birth weight, congenital heart defects, intellectual development, intrauterine growth restriction, miscarriage, neural tube defects, orofacial defects, and preterm birth). The primary goal of this paper is to review the research literature and propose evidence-based recommendations for the optimal level of prenatal supplementation for each vitamin for most women in the United States. A secondary goal was to compare these new recommendations with the levels of vitamins in over 180 commercial prenatal supplements. The analysis found that prenatal supplements vary widely in content, often contained only a subset of essential vitamins, and the levels were often below our recommendations. This suggests that increasing prenatal vitamin supplementation to the levels recommended here may reduce the incidence of many pregnancy complications and infant health problems which currently occur.
Keywords: Folate; Pregnancy; Prenatal Supplements; Vitamin B12; Vitamin D; Vitamins.
© 2022. The Author(s).
Conflict of interest statement
JBA is the Chair of the Scientific Advisory Board of the Neurological Health Foundation (NHF), Chair of the NHF Task Force on Pregnancy-Safe Products, co-leader of the Scientific Advisory Board of the Autism Research Institute, member of the Scientific Advisory Board for an autism study of microbiota transplant for Finch Therapeutics, President of the Autism Nutrition Research Center, President of Autism Diagnostics, President of Autism Therapeutics, and President of the Autism Society of Greater Phoenix. He has received grant funding from the Department of Defense, Finch Therapeutics, Autism Research Institute, Autism Nutrition Research Center, and BHARE Foundation. He is a paid consultant for Finch Therapeutics and Healthy Nest, and in the latter case he led the development of their prenatal supplement. He has patents/pending patents licensed to Finch Therapeutics and Autism Diagnostics. All authors have a pending patent on prenatal supplements.
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References
-
- Prevention CfDCa . Reproductive health data and statistics. 2020.
-
- American College of Obstetricians and Gynecologists. ACOG practice bulletin. Management of recurrent pregnancy loss. Number 24, February 2001. (Replaces Technical Bulletin Number 212, September 1995). American College of Obstetricians and Gynecologists. The official organ of the International Federation of Gynaecology and Obstetrics. Int J Gynaecol Obstet. 2022;78(2):179–90. 10.1016/s0020-7292(02)00197-2. - PubMed
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