Vitamin and mineral supplementation in pregnancy: evidence to practice

Pregnancy is a dynamic state that requires increased nutrient intakes in order to support the growing fetus, placenta and maternal tissues, and hence a successful pregnancy outcome. Although maternal micronutrient deficiencies during pregnancy are often associated with pregnancy complications, as well as adverse fetal growth and development, evidence to support routine vitamin and mineral supplementation is relatively scarce. This review summarises existing evidence and special considerations regarding folic acid, vitamin B₁₂, vitamin D, calcium, zinc, iron, selenium and iodine supplementation on pregnancy outcomes. Current practice recommendations are for routine supplementation of folic acid and iodine, but recommendations regarding other vitamins and minerals are based on an individualised approach in pregnancy, with supplementation restricted to women with insufficient dietary intakes or established deficiencies. This review aims to support pharmacists in evaluating the appropriateness of various individual and multicomponent vitamin and mineral supplements and providing balanced and up-to-date information to women who are either planning pregnancy or are already pregnant.