Prenatal Vitamins

Prenatal vitamins consist of a variety of vitamins and minerals to help your baby get the nutrients that are essential for healthy development. During pregnancy, a woman’s daily intake requirements for certain nutrients, such as folic acid (folate), calcium, and iron will increase.  Vitamins and minerals such as iron, calcium, and folic acid are vital for proper fetal growth, development, and healthy adult living. To help increase your chances of creating a healthy and nutritious environment in which your baby can develop, it is important that you establish a well-balanced diet and exercise routine before you get pregnant. If you choose to supplement your diet with prenatal vitamins, be sure to keep track of the daily amounts that you take and let your healthcare provider know.

Choosing Your Prenatal Vitamins

As a society we are led to believe that taking a prenatal vitamin during pregnancy will provide all the nutrients needed for a happy and healthy birth outcome. Although most prenatal vitamins do provide calcium, vitamin A, vitamin B1 (thiamine), vitamin B5 (pantothenic acid), vitamin B6 (pyridoxine), vitamin B7 (biotin), vitamin B9 (folic acid) or folate, vitamin B12 (cobalamin), vitamin C, vitamin E and vitamin D, there are three critical nutrients that your prenatal may lack, or be missing entirely. In other words, there is no such thing as a “perfect” prenatal vitamin that can meet all of your prenatal needs.

Vitamin D Supports a Healthy Pregnancy

It’s common knowledge that vitamin D benefits our bone, brain, cardiovascular, immune, metabolic, and respiratory health, but did you know that vitamin D is also critical for maintaining a healthy pregnancy? Emerging research strongly links vitamin D to a reduced risk of pregnancy complications including preeclampsia, gestational diabetes, preterm birth, and C-section delivery.  Unfortunately, research also indicates that an estimated 33% of pregnant women in the U.S. do not get enough vitamin D. The majority of prenatal vitamins contain vitamin D within the range of 400 IU (10 mcg) to 1,000 IU (25 mcg). These values may not be enough. In a study examining the vitamin D levels of women consuming a prenatal supplement with 600 IU/day and two glasses of vitamin D fortified milk, researchers found that 76% of moms and 81% of newborn babies were deficient in vitamin D (levels <  20 ng/mL). This raises the question – how much vitamin D do you need to increase your levels? In a study comparing doses of 400, 2000 and 4000 IU/ day in pregnant women from early pregnancy (12 – 16 weeks) to delivery, researchers found that 4000 IU was the most effective at safely increasing vitamin D blood levels. Does this mean that every pregnant woman needs 4000 IU of vitamin D? Not exactly. The best thing to do is to get your vitamin D levels tested and talk to your doctor about what dose is right for you.

Choline Benefits Pregnancy and Beyond

Choline doesn’t get a lot of attention, but it is a nutrient with a number of impressive, long lasting benefits, making it an indispensable component of prenatal vitamins. For example, higher maternal choline intakes have been shown to reduce the risk of neural tube defects (independent of folate intake) while also improving cognition and lowering levels of circulating cortisol. This is significant because lowering a baby’s production of cortisol could, over their lifetime, reduce their risk of certain stress-related disorders. In terms of improving cognition, research finds that children who received additional choline in utero showed increased attention span, memory, and problem solving at age seven. For mom, the benefits of increased choline intake are linked to a reduced risk of certain complications during pregnancy and an increase in placenta and liver function during pregnancy. The benefits of choline during pregnancy make it one nutrient you’re going to want to make sure is on your prenatal vitamin’s supplement facts panel. Although the recommended Adequate Intake (AI) of choline for pregnant women is 450 mg/d, studies show only 10% of pregnant women in the U.S are actually meeting the AI.  Partly to blame for this is many prenatal vitamins lack sufficient choline support. A recent study evaluating the top 25 prenatal vitamins found that none contained the daily-recommended choline intake for a pregnant woman, and over half contained none at all. To help remedy this, make sure you are consuming enough choline through your diet, and supplement as needed. If you’re aiming to get your choline from food first, one of the highest sources of choline is eggs. The egg yolk is where the choline lives (about 147 mg per egg yolk), so you won’t get your choline from an egg white omelet. See the chart below for more choline sources and their amounts. You will notice that animal sources contain the greatest amounts of choline, so vegans and vegetarians run an even greater risk of choline deficiency. Therefore, it’s critical that vegans and some vegetarians supplement with choline during pregnancy.
Food Source Choline (mg)
Beef liver, 3 oz pan fried 356
Egg yolk, large 147
Beef, 3 oz. lean top round braised 117
Ground beef, 3 oz. cooked 85
Pork tenderloin, 3 oz. cooked 83
Salmon, 3oz. 77
Cod, 3oz baked 71
Chicken breast, 3oz. 65
Shiitake mushrooms, 1/2 cup cooked 58
Soybeans, 1/4 cup cooked 53
Broccoli, 1 cup cooked 51
Kidney beans, 1/2 cup canned 45
Quinoa, 1 cup cooked 43
Garbanzo beans, 1/2 cup cooked 35

DHA and Healthy Development of the Fetus

DHA, an omega-3 fatty acid, is one of the key building blocks for fetal development. During pregnancy the fetus obtains DHA through the mother, and it is imperative the mother has adequate DHA stores to support both her and her developing baby’s needs. If mom already has a low DHA status, the fetus’s reliance on her for DHA can put her at a heightened risk for DHA deficiency, and importantly,  place her baby at risk of missing out on some of the nutrient’s key benefits. To learn more about the multitude of DHA benefits during pregnancy see “Why Do I Need DHA During Pregnancy?”. Pregnant women need a minimum of 300 mg of DHA a day. Because many prenatal vitamins do not contain DHA, this means pregnant women need to obtain their daily minimum through fatty fish or fish oil. Given that pregnant women are advised to limit consumption of low-mercury fish to 2-3 times per week, incorporating a fish oil supplement containing at least 300 mg/d can help support your DHA needs if your prenatal is lacking. However, your individual needs may not be met by 300 mg/d, making it important to talk to your doctor and get tested. You can determine your needs through a simple blood test to find out what dose is best for you. The American Pregnancy Association recommends Safe Catch because they test every fish for mercury. Check out our delicious recipes made with Safe Catch tuna, salmon and more!

Talk to Your Health Care Provider

Always let your health care provider know what prenatal vitamins you are taking. Consider taking your supplement bottles with you to your first prenatal visit. Prenatal vitamins can be helpful ways of including vital nutrients in your daily meals. Vitamins and minerals are essential to the healthy development of your baby, as well as your own physical health. Be sure to speak with your health care provider about nutrition before you conceive if you are planning to get pregnant in the near future, or as soon as you know you are pregnant. The American Pregnancy Association recommends a selection of liquid supplements including:
  • Vitamin D3
  • Omega-3D
  • Children’s DHA
  • Cod Liver Oil
Article contributed by Kate Turner, MA, RD, CPT Nutrition Specialist.

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