Supplement Research

Prenatal Multi-Vitamins: Skip These Ingredients

by Cassandra Delage, Founder and CEO

Reviewed by Stephanie Dang, Registered Dietitian, Co-Founder at CAYA Health Centre & Vancouver Dietitians

Published June 6, 2024 — Last Reviewed March 25, 2024

  • Full Article

  • Contributors

  • References

Excerpt

Navigating the world of prenatal supplements can be overwhelming, especially when you're bombarded with lists of ingredients you should be taking. But what about the ones you don't need? Let's break down the unnecessary ingredients often found in prenatal supplements to help you make informed choices for you and your baby.

Introduction

To decide which ingredients to include or exclude, we reviewed all the ingredients typically found in prenatal supplements and examined the associated scientific literature. The list below summarizes the ingredients that are sometimes included in prenatal supplements but were not supported by sufficient scientific evidence to be included in our formula.

Manganese

Manganese deficiency has not been observed in human adults, including pregnant women. The intestine, through absorption, and liver, through biliary excretion, provide strong homeostatic controls of body manganese. Thus, manganese supplements are not necessary during pregnancy [1].

Copper

Copper deficiency has not been documented in humans during pregnancy. Evidence suggests that copper absorption may actually be more efficient during pregnancy, and such efficiency could result in absorption of an increased amount of copper, therefore no additional increment would be required during pregnancy [2].

Vitamin K

The specific importance of vitamin K during pregnancy is largely undetermined. Data pertaining to vitamin K status of pregnant women are limited but suggest that status is not different from that of non pregnant women, that is, lack of signs of clinical deficiency and comparable circulating vitamin K concentrations. Furthermore, there is no data on the vitamin K content of fetal tissue for estimating additional needs during pregnancy.

 

No vitamin K supplement is indicated in the routine care of pregnant women. No general public health problems have been associated with vitamin K deficiency. There does not appear to be a need to supplement normal pregnant women with vitamin K [3].

Boron

Boron requirement for humans has not been proven. In animals, boron has been shown to have a role in reproduction and development. The collective body of evidence, however, has yet to establish a clear biological function for boron in humans. Therefore, neither an Estimated Average Requirement, Recommended Dietary Allowance, nor Adequate Intake was established for boron.

 

Further investigation is required regarding boron, as comprehensive studies have not yet been conducted on their effects during pregnancy [4].

CoEnzyme Q10 / CoQ10

The safety of use of CoQ10 during pregnancy and breast-feeding hasn't been established.

Supplementation with CoQ10 has only been shown to reduce the risk of developing pre-eclampsia in women already at risk for the condition [5].

Vitamin B1 / Thiamine Mononitrate

Thiamine, or vitamin B1, is essential for energy metabolism and nerve function. However, B1 deficiencies are uncommon and most individuals can obtain sufficient B1 levels from a balanced diet, making additional supplementation unnecessary. [6]

Niacinamide / Vitamin B3

Niacinamide, or vitamin B3, is another common ingredient in prenatal supplements. While niacinamide plays a vital role in energy production and skin health, excessive intake can lead to flushing and liver toxicity. Pregnant individuals can obtain sufficient niacinamide from a balanced diet, making additional supplementation unnecessary. [7]

Biotin / Vitamin B7

Biotin, also known as vitamin B7 or vitamin H, is important for maintaining healthy hair, skin, and nails. While biotin deficiency is rare, excessive supplementation of biotin during pregnancy is not recommended. Moreover, there is a lack of sufficient evidence supporting its necessity for neonatal development [8].

Vitamin E

In pregnant women, there have been no definable deficiency syndromes for vitamin E, and intakes below the RDA have not been accompanied by an obvious clinical morbidity. Thus, supplementation of healthy pregnant women appears to be unnecessary [9].

Selenium

Selenium deficiency is very rare in the US and Canada. There is no indication of a need to conduct laboratory tests to assess selenium status during pregnancy or to advise pregnant women to take supplemental selenium [10].

Iron

Iron is a vital nutrient essential during pregnancy, playing a crucial role in preventing anemia and promoting fetal growth and development. However, it's imperative to recognize that iron demands vary significantly among individuals, and can trigger gastrointestinal issues such as constipation and nausea. Therefore, it's advisable to control iron intake primarily through dietary sources rather than relying solely on supplements. When considering prenatal supplements, ensure they offer the appropriate iron dosage tailored to your specific needs. Consulting with your healthcare provider regarding iron supplementation is recommended if you have any concerns [11]

Choosing the Right Prenatal Supplement

When selecting a prenatal supplement, focus on quality ingredients that are essential for maternal and fetal health. Look for supplements that contain the necessary vitamins and minerals without unnecessary additives. Transparency is key, so be sure to research the formulation and testing practices of the supplement manufacturer to ensure their products meet your standards.

Title

References to the research cited in this article can be found in the "References" tab at the top of this page.

Contributors

Author(s)

Cassandra Delage

Founder and CEO of Bia

Reviewer(s)

Stephanie Dang

Registered Dietitian, Co-Founder at CAYA Health Centre & Vancouver Dietitians

References

Bia follows strict article guidelines and only uses credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. In addition, when necessary, each article is reviewed by a member of our healthcare community to further ensure up-to-date information.

[1] Manganese

Ramakrishnan, U., Gonzalez-Casanova, I., Schnaas, L., DiGirolamo, A., Quezada, A. D., Pallo, B. C., Hao, W., Neufeld, L. M., & Rivera, J. A. (2016). Manganese intake and status during pregnancy and lactation: Progress and research gaps. Nutrients, 8(7), 1-15. https://doi.org/10.3390/nu8070409

Institute of Medicine (US) Committee on Nutritional Status During Pregnancy and Lactation. Nutrition During Pregnancy: Part I Weight Gain: Part II Nutrient Supplements. Washington (DC): National Academies Press (US); 1990. 15, Trace Elements. Available from: https://www.ncbi.nlm.nih.gov/books/NBK235243/

Institute of Medicine (US) Panel on Micronutrients. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington (DC): National Academies Press (US); 2001. 10, Manganese. Available from: https://www.ncbi.nlm.nih.gov/books/NBK222332/

[2] Copper

Ceko, M. J., Hummitzsch, K., & Hatzirodos, N. (2018). Copper and its role in embryo physiology during pregnancy. Cell and Tissue Research, 372(3), 399-414. https://doi.org/10.1007/s00441-017-2753-4

Institute of Medicine (US) Committee on Nutritional Status During Pregnancy and Lactation. Nutrition During Pregnancy: Part I Weight Gain: Part II Nutrient Supplements. Washington (DC): National Academies Press (US); 1990. 15, Trace Elements. Available from: https://www.ncbi.nlm.nih.gov/books/NBK235243/

Institute of Medicine (US) Panel on Micronutrients. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington (DC): National Academies Press (US); 2001. 10, Manganese. Available from: https://www.ncbi.nlm.nih.gov/books/NBK222332/

[3] Vitamin K

Institute of Medicine (US) Panel on Micronutrients. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington (DC): National Academies Press (US); 2001. 10, Manganese.

Institute of Medicine (US) Committee on Nutritional Status During Pregnancy and Lactation. Nutrition During Pregnancy: Part I Weight Gain: Part II Nutrient Supplements. Washington (DC): National Academies Press (US); 1990. 17, Vitamins A, E, and K. 

[4] Boron

Wells, E. M., Herdt-Losavio, M. L., Druschel, C. M., & Lin, S. (2015). Boron during pregnancy: Exposure assessment and epidemiological evidence of birth outcomes. Journal of Exposure Science & Environmental Epidemiology, 25(5), 523-530. https://doi.org/10.1038/jes.2015.25

Khayat S, Fanaei H, Ghanbarzehi A. Minerals in Pregnancy and Lactation: A Review Article. J Clin Diagn Res. 2017 Sep;11(9):QE01-QE05. doi: 10.7860/JCDR/2017/28485.10626. Epub 2017 Sep 1. PMID: 29207789; PMCID: PMC5713811.

Institute of Medicine (US) Panel on Micronutrients. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington (DC): National Academies Press (US); 2001. 13, Arsenic, Boron, Nickel, Silicon, and Vanadium. Available from: https://www.ncbi.nlm.nih.gov/books/NBK222322/

[5] Coenzyme Q10

Teran, E., Hernandez, I., Nieto, B., & Tavara, R. (2019). Role of Coenzyme Q10 in pregnancy and infant health. The Journal of Maternal-Fetal & Neonatal Medicine, 32(1), 172-178. https://doi.org/10.1080/14767058.2017.1418321

[6] Vitamin B1 / Thiamine Mononitrate

Mok, K. C., & Chen, C. T. (1979). B1-adenosine thiamine diphosphate, a fluorescent analogue of thiamine diphosphate: Binding studies with enzymes involved in thiamine metabolism. Journal of Biological Chemistry, 254(5), 1461-1467. https://www.jbc.org/article/S0021-9258(19)38963-5/fulltext

Adams JB, Kirby JK, Sorensen JC, Pollard EL, Audhya T. Evidence based recommendations for an optimal prenatal supplement for women in the US: vitamins and related nutrients. Matern Health Neonatol Perinatol. 2022 Jul 11;8(1):4.

Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. A Report of the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes and its Panel on Folate, Other B Vitamins, and Choline and Subcommittee on Upper Reference Levels of Nutrients, Food and Nutrition Board, Institute of Medicine 6 x 9, 592 pages, 2000.

[7] Niacinamide / Vitamin B3

Adams JB, Kirby JK, Sorensen JC, Pollard EL, Audhya T. Evidence based recommendations for an optimal prenatal supplement for women in the US: vitamins and related nutrients. Matern Health Neonatol Perinatol. 2022 Jul 11;8(1):4.

Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. A Report of the Standing Committee on the Scientific Evaluation of Dietary Reference Intes and its Panel on Folate, Other B Vitamins, and Choline and Subcommittee on Upper Reference Levels of Nutrients, Food and Nutrition Board, Institute of Medicine 6 x 9, 592 pages, 2000.

[8] Biotin / Vitamin B7

Adams JB, Kirby JK, Sorensen JC, Pollard EL, Audhya T. Evidence based recommendations for an optimal prenatal supplement for women in the US: vitamins and related nutrients. Matern Health Neonatol Perinatol. 2022 Jul 11;8(1):4.

Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. A Report of the Standing Committee on the Scientific Evaluation of Dietary Reference Intes and its Panel on Folate, Other B Vitamins, and Choline and Subcommittee on Upper Reference Levels of Nutrients, Food and Nutrition Board, Institute of Medicine 6 x 9, 592 pages, 2000.

[9] Vitamin E

Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Panel on Dietary Antioxidants and Related Compounds, Subcommittees on Upper Reference Levels of Nutrients and Interpretation and Uses of DRIs, Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board 6 x 9, 529 pages, 2000.

Adams JB, Kirby JK, Sorensen JC, Pollard EL, Audhya T. Evidence based recommendations for an optimal prenatal supplement for women in the US: vitamins and related nutrients. Matern Health Neonatol Perinatol. 2022 Jul 11;8(1):4.

Institute of Medicine (US) Committee on Nutritional Status During Pregnancy and Lactation. Nutrition During Pregnancy: Part I Weight Gain: Part II Nutrient Supplements. Washington (DC): National Academies Press (US); 1990. 17, Vitamins A, E, and K. Available from: https://www.ncbi.nlm.nih.gov/books/NBK235251/

[10] Selenium

Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Panel on Dietary Antioxidants and Related Compounds, Subcommittees on Upper Reference Levels of Nutrients and Interpretation and Uses of DRIs, Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board 6 x 9, 529 pages, 2000.

Institute of Medicine (US) Committee on Nutritional Status During Pregnancy and Lactation. Nutrition During Pregnancy: Part I Weight Gain: Part II Nutrient Supplements. Washington (DC): National Academies Press (US); 1990. 15, Trace Elements. Available from: https://www.ncbi.nlm.nih.gov/books/NBK235243/

[11] Iron

Pena-Rosas, J. P., De-Regil, L. M., Dowswell, T., & Viteri, F. E. (2012). Iron supplementation during pregnancy: A review of the evidence and possible mechanisms for risk reduction of adverse pregnancy outcomes. Nutrients, 4(7), 1045-1070. https://doi.org/10.3390/nu4071045

Name JJ, Vasconcelos AR, Valzachi Rocha Maluf MC. Iron Bisglycinate Chelate and Polymaltose Iron for the Treatment of Iron Deficiency Anemia: A Pilot Randomized Trial. Curr Pediatr Rev. 2018;14(4):261-268. doi: 10.2174/1573396314666181002170040. PMID: 30280670; PMCID: PMC6416187.

Teichman J, Nisenbaum R, Lausman A, Sholzberg M. Suboptimal iron deficiency screening in pregnancy and the impact of socioeconomic status in a high-resource setting. Blood Adv. 2021; 5(22): 4666-4673.

Barton JC, Wiener HH, Acton RT, et al. Prevalence of iron deficiency in 62,685 women of seven race/ethnicity groups: the HEIRS study. PLoS One. 2020; 15(4):e0232125.

Lönnerdal, B. Calcium and Iron Absorption—Mechanisms and Public Health Relevance. Int. J. Vitam. Nutr. Res. 2010, 80, 293–299.

Shawki, A.; Mackenzie, B. Interaction of calcium with the human divalent metal-ion transporter-1. Biochem. Biophys. Res. Commun. 2010, 393, 471–475.

Hidalgo, C.; Nunez, M.T. Calcium, iron and neuronal function. IUBMB Life 2007, 59, 280–285

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