A Deeper Dive on the Subject of Prenatal Vitamins

by Joann Romano-Keeler, MD, MS (Assistant Professor of Clinical Pediatrics / Director of Neonatal Transport Service / University of Illinois at Chicago)
Prenatal vitamins, whose composition is designed to best match a woman’s metabolic needs during pregnancy, are critical for optimizing fetal growth and decreasing the risk of preterm birth and low birth weight infants. While prenatal vitamins do not contain macronutrients such as protein and fat, they do provide key micronutrients that drive a host of cellular reactions including protein synthesis and immune system development (1).

In addition, while there are many factors contributing to preterm birth, modifiable risk factors include, nutrient intake, body mass index, and weight gain during pregnancy.
Every $5 given provides a 100-day supply of prenatal vitamins to one mom-to-be in need.
​Each micronutrient of prenatal vitamins has a distinct role in maternal health and fetal development. For example:
  • Zinc supplementation reduces the incidence and severity of maternal infections thereby reducing the risk of preterm birth (2).
  • Vitamin D deficiency, one of the most common deficiencies during early and late stage pregnancy, has been associated with small for gestational age, low birthweight and preterm birth (3).​ ​
  • Periconception folic acid has long been recognized as critical for prevention of neural tube defects (4,5) and newer studies are exploring other aspects of brain development and function that maternal folate status impacts (6,7).
  • Infants born to mothers who are iron deficient and anemic during pregnancy are more likely to be anemic. These infants are also at risk for decreased cognitive performance and longitudinal growth (8).
1. Brugman S, Perdijk O, van Neerven RJ, Savelkoul HF. Mucosal Immune Development in Early Life: Setting the Stage. Arch Immunol Ther Exp (Warsz). 2015;63(4):251-68. Epub 2015/02/11. doi: 10.1007/s00005-015-0329-y. PubMed PMID: 25666708; PMCID: PMC4499104.
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2. Samuel TM, Sakwinska O, Makinen K, Burdge GC, Godfrey KM, Silva-Zolezzi I. Preterm Birth: A Narrative Review of the Current Evidence on Nutritional and Bioactive Solutions for Risk Reduction. Nutrients. 2019;11(8). Epub 2019/08/09. doi: 10.3390/nu11081811. PubMed PMID: 31390765; PMCID: PMC6723114.

3. Barebring L, Bullarbo M, Glantz A, Hulthen L, Ellis J, Jagner A, Schoenmakers I, Winkvist A, Augustin H. Trajectory of vitamin D status during pregnancy in relation to neonatal birth size and fetal survival: a prospective cohort study. BMC Pregnancy Childbirth. 2018;18(1):51. Epub 2018/02/15. doi: 10.1186/s12884-018-1683-7. PubMed PMID: 29439677; PMCID: PMC5812027.

4. Werler MM, Shapiro S, Mitchell AA. Periconceptional folic acid exposure and risk of occurrent neural tube defects. JAMA. 1993;269(10):1257-61. Epub 1993/03/10. PubMed PMID: 8437302.

5. Williams J, Mai CT, Mulinare J, Isenburg J, Flood TJ, Ethen M, Frohnert B, Kirby RS, Centers for Disease C, Prevention. Updated estimates of neural tube defects prevented by mandatory folic Acid fortification - United States, 1995-2011. MMWR Morb Mortal Wkly Rep. 2015;64(1):1-5. Epub 2015/01/16. PubMed PMID: 25590678; PMCID: PMC4584791.

6. Naninck EFG, Stijger PC, Brouwer-Brolsma EM. The Importance of Maternal Folate Status for Brain Development and Function of Offspring. Adv Nutr. 2019;10(3):502-19. Epub 2019/05/17. doi: 10.1093/advances/nmy120. PubMed PMID: 31093652; PMCID: PMC6520042.

7. Caffrey A, McNulty H, Irwin RE, Walsh CP, Pentieva K. Maternal folate nutrition and offspring health: evidence and current controversies. Proc Nutr Soc. 2018:1-13. Epub 2018/12/27. doi: 10.1017/S0029665118002689. PubMed PMID: 30585558.
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8. WHO 2001. World Health Organization. Iron deficiency anemia assessment prevention and control: a guide for program managers. World Health Organization; Geneva: 2001. p. 132.
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