What are the recommendations for prenatal vitamins (PNV) during pregnancy?

From the Guidelines

I strongly recommend taking a prenatal vitamin that contains at least 400-600 mcg of folic acid, 27 mg of iron, 1000 mg of calcium, 600 IU of vitamin D, and 150 mcg of iodine, as supported by the USPSTF recommendation statement 1.

Key Components of Prenatal Vitamins

• Folic acid: 400-600 mcg to prevent neural tube defects in early pregnancy
• Iron: 27 mg to support increased blood volume and prevent anemia
• Calcium: 1000 mg to promote proper bone development
• Vitamin D: 600 IU to support bone development and overall health
• Iodine: 150 mcg to support thyroid function and brain development

Timing and Administration

• Start taking prenatal vitamins at least one month before conception and continue throughout pregnancy and breastfeeding
• Take prenatal vitamins with food to reduce nausea and improve absorption, especially for iron

Individualized Recommendations

• Consult with a healthcare provider to determine the best prenatal vitamin for individual health needs
• Women with a history of bariatric surgery or other medical conditions may require additional supplements or monitoring 1

Monitoring and Follow-up

• Regular monitoring of nutrient levels, including ferritin, folate, vitamin B12, calcium, vitamin D, and vitamin A, is recommended during pregnancy, especially for women with a history of bariatric surgery 1

From the FDA Drug Label

The usual therapeutic dosage in adults and children (regardless of age) is up to 1 mg daily... 0.8 mg for pregnant and lactating women, but never less than 0. 1 mg/day. The recommended dose of folic acid for pregnant women is 0.8 mg daily 2.

• The dose should not be less than 0.1 mg/day.
• The maintenance dose for pregnant women is 0.8 mg daily.

From the Research

Prenatal Vitamin Recommendations

• The daily antepartum supplementation of 0.4-0.8 mg of folic acid and 30-60 mg of elemental iron is currently recommended 3
• Prenatal supplements should probably contain other nutrients such as pyridoxine hydrochloride, cholecalciferol, vitamin E, pantothenic acid, calcium, magnesium, zinc, copper, and possibly selenium 3
• A high percentage of pregnant women presented iron deficiency anemia, being recommended intermittent use of iron supplements 4
• Calcium absorption is increased up to 40% in gestation, its supplementation is not recommended for mothers with adequate intakes (3 dairy / day) 4
• The World Health Organization recommends 1.5 to 2.0 g of elemental calcium per day for pregnant women with low dietary calcium intakes (as well as 60 mg of iron and 400 microg of folic acid) 5

Key Nutrients for Prenatal Supplements

• Folic acid: 400 mcg / day and 5 mg/day in risk pregnant 4
• Iron: 30-60 mg of elemental iron per day 3, 60 mg of iron per day for pregnant women with low dietary calcium intakes 5
• Calcium: 1.5 to 2.0 g of elemental calcium per day for pregnant women with low dietary calcium intakes 5
• Vitamin A and D: not recommended its supplementation except in cases of deficiency 4
• Omega-3 FAs: ≥59 mg 6

Considerations for Prenatal Supplements

• Interactions among the minerals and vitamins commonly found in prenatal supplements may affect the absorption of various nutrient components 3
• The chemical form of minerals should also be considered 3
• Products should have demonstrated bioavailability for iron, zinc, and other components that are subject to bioavailability problems 3
• Use of low-potency product that contains a wide range of vitamins and minerals appears to be the most prudent approach to prenatal vitamin and mineral supplementation 3