Ephedra, once a common ingredient in weight loss and energy supplements, is now banned in many countries because of its dangerous side effects. Your body is creating new life and taking these supplements daily can affect the baby adversely. Check out this link to why Genate should be your first stop to prenatal vitamin shopping! Looking for a prenatal vitamin that was created perfectly for your genes? 2.1. Prophylaxis Iron Supplements This review will exclude studies in which vitamin K was given to women at risk of imminent preterm birth for preventing neonatal PVH, as this is covered in an existing review by Crowther 2010. We will include trials in which pregnant women are a subset of the participants included in the study, if reported in a way that relevant data can be extracted. All randomised (individual and cluster) or quasi‐randomised controlled trials assessing the effect of vitamin K supplementation during pregnancy. Antenatal vitamin K supplementation may help to reduce the risk of haemorrhagic complications in infants born to WWE who take antiepileptic drugs during pregnancy (Choulika 2004; Kaaja 2002), including a reduction in the occurrence of vitamin K deficiency in such infants (Cornelissen 1993). Pregnant women deficient in vitamin K may need to incorporate vitamin K supplements into their prenatal vitamin regimen. Weight Loss Myths Guide The safety of dietary supplements during pregnancy can vary depending on the specific product and the individual woman. Healthcare professionals can provide guidance on which supplements are safe to take during pregnancy based on individual needs and circumstances. While it is possible to obtain the required nutrients through a balanced diet, some pregnant women may find it challenging to meet their nutritional needs solely through food. One study included 21 trials with more than 21,000 women and analysed vitamin E supplementation in pregnancy. The general recommendation of folic acid supplementation at 0.4 mg/day of folic acid may be appropriate for healthy and normal‐weight women without the risk factors detailed above, who sustain this intake for at least 6 months prior to conception. Repeated studies have shown increased risk of NTD among pregnant women subjected to active and passive smoking.33 Here too, although the mechanisms leading to increased risk of NTDs have not been elucidated, it is reasonable to try and prevent them by avoiding active and passive smoking as well as increasing folate supplementation for a brief period of time. We anticipate that the findings of this review will help advance the recommendations for scaling up multiple micronutrient supplementation during pregnancy 17,18,41. Consequently, there is a need to systematically synthesize the evidence to decide which micronutrients are of greatest concern in LMICs, the criteria for prophylactic single nutrient or multiple micronutrient supplementation, and the outcomes to be measured. In contrast, the lower dose of 30 mg iron is included in the UNIMMAP preparation (together with 14 other micronutrients) , as the absorption of iron is expected to be enhanced due to vitamins C, A, and B2. The prevalence of concurrent deficiencies of multiple micronutrients among pregnant women and young children is well documented, particularly in LMICs 5-8. Analysis of the data identified themes that impacted pregnant women's experiences adhering to recommendations regarding physical activity and nutrition. Healthy pregnant women were recruited from three urban centres in south‐western Ontario using posted advertisements at local hospitals, service organizations and medical and midwifery offices. The aims of the current study were to explore women's view of nutrition and physical activity during pregnancy and to describe the barriers and facilitators that may influence the disconnection between implementing physical activity and nutrition recommendations and daily experiences. The literature suggests that care providers offer appropriate counselling for pregnant women on nutrition and physical activity guidelines (Duthie, Drew, & Flynn, 2013; Lutsiv et al., 2012). A disconnect exists between the evidence for the benefits of healthy eating and activity and women's behaviours during pregnancy. NHS (2023b) Vitamins, supplements and nutrition in pregnancy. Some women and pregnant people won’t put on much weight at all during pregnancy. They can also get vitamins for the pregnant parent and baby for free. The improvement in serum 25‐hydroxyvitamin D levels may have a direct influence on the fetal and neonatal supply of vitamin D and may influence early placental development and thus, the development of pre‐eclampsia through its role in gene regulation and expression. In addition, serum 1,25‐dihydroxyvitamin D can also be synthesised locally by the placenta as both maternal decidual and fetal placental express the enzyme 1α‐hydroxylase (Liu 2012). This active form of vitamin D results from the hydroxylation of 25‐hydroxyvitamin D by the enzyme 1α‐hydroxylase (CYP27B1), which occurs in maternal kidneys (Liu 2012). Vitamin D functions during pregnancy are integrated across maternal, placental and fetal compartments, as suggested by Gernand 2016. It has been proposed that doses as high as 1300 IU/d are needed for individuals of light skin during the winter to achieve serum 25‐hydroxyvitamin D levels at or above 75 nmol/L, while individuals of darker skin colour and low sun exposure need 2100 to 3100 IU/d year round (Hall 2010). In contrast, in the case of pre-pregnancy supplementation or early termination of calcium supplementation before the third trimester, there were minimal or no benefits at all 20,38,40,51,62. In contrast to these findings, a study held in India and Tanzania involving 11,000 women in each country reported that there was no difference with high calcium doses regarding the risk of PE . Later, in 1993, a study that included subgroups with different daily calcium doses ranging from 0.12 g to 2 g concluded that the highest dose of 2 g of daily calcium supplementation may reduce the incidence of PIH . The antenatal and clinical data as well as the anthropometric measurements of the pregnant women were directly copied from the respondents’ assessment charts from the ANC clinic at the time of data collection. The estimated number of pregnant women who visited the ANC clinic for the past three consecutive months was 2000. Pregnant women with pregnancy related complication which require special follow up and dietary modifications were excluded from the study. Omega-3s for Stress and Cognitive Support We included trials only among pregnant women of any gestational or chronological age, race/ethnicity, skin colour, and pre‐pregnancy body mass index. Also, it is unknown how safe some of the vitamin D supplementation levels used in pregnancy are, as this has not been systematically evaluated. There is currently a large controversy about the optimal regimen of vitamin D supplementation for women during pregnancy. Note that the RDA is based on the levels required to meet the nutritional needs of 97.5% of healthy individuals, as opposed to the Estimated Average Requirements (EAR) which is set at the level needed to meet the needs of 50% of the population. However, it is important to note that we report only the averages, and some women have higher or lower intake. We reported the data for women ages 20–39 years, since that is the most common time for pregnancy, and averages for other ages are generally similar. No restriction was placed on year of the study, but more recent studies were given higher priority in the review and discussion, and most studies were from 1990 and later. Preterm infants are especially at risk for excessive bleeding after birth, which often can result in intracranial bleeding (see Table 6). Vitamin K deficiency in pregnancy is common, in both the mother and infant shortly after birth. Supplementation at the low doses recommended here may help reduce the risk of hyperglycemia, preterm births, preterm placental rupture of membranes (PROM), and placental abruption, and also decrease the risk of wheeze, orofacial clefts, and serious heart defects in their infants. Overall, the studies of high-dose vitamin E and vitamin C 78, 140, 144, 145 suggest that these doses are too high. Pregnancy Diet: The Best Foods & Supplements for a Healthy Pregnancy However, oxidative damage, red cell fragility, and methaemoglobin may develop in cases of high doses of water‐soluble vitamin K3 (menadione) consumption, and local hypersensitivity reactions, mostly due to vitamin K1 dermal injections, may also occur (Expert Group on Vitamins and Minerals 2003). There is insufficient evidence to show that excessive vitamin K ingestion has toxic effects on the human body. Therefore, coagulation disorders require immediate treatment with vitamin K administration prior to diagnosis. Maternal drug consumption affecting vitamin K metabolism may typically increase this condition among infants (McNinch 1983; Stevenson 1980). The onset of early VKDB, for example, occurs among infants from birth or 24 hours immediately prior to delivery (Lane 1985). These supplements can help prevent and treat iron deficiency anemia, a common condition during pregnancy.The food supplements included a flavoured milk drink, fresh milk or cheddar cheese, which provided 299 kcal and 15.9 g protein on average.There is limited evidence on the safety and effectiveness of weight loss supplements during pregnancy.This approach ensures you get a wide range of essential nutrients and minimizes the risk of potential nutrient imbalances.Among 3,664 live births, intervention groups did not differ in newborn response, mother's rating of the general condition of her newborn, early initiation of breastfeeding (EIBF), suckling ability, or frequency and exclusivity of breastfeeding in the first 24 hr.The aim of this review was to describe the studies examining the effects of protein energy supplementation during pregnancy on fetal growth focusing on the contextual differences.The WHO recommends 1.5–2.0 g/day of elemental calcium in women with a high risk of developing preeclampsia (i.e., CKD) and with low-calcium intakes .You should take a prenatal vitamin before you become pregnant, not just when you find out that you are having a baby. No serious adverse effects were evident on mother or baby with magnesium supplements. All women in this trial received a multivitamin and mineral preparation containing 100 mg magnesium. The women taking magnesium were less likely to need hospitalisation or experience bleeding during pregnancy than women taking a non-active placebo. Six trials indicated no effect of magnesium treatment on miscarriage, stillbirth or neonatal mortality. REFERENCES TO STUDIES This review focuses on maternal nutrition, and particularly on micronutrient deficiencies and supplementation during pregnancy. This is a good option for pregnant women who are anemic and need as much iron as possible. Anemia is sometimes caused by a lack of folic acid and vitamin B-12, making this supplement a good choice for pregnancy (3). Each bottle has 100 tablets that contain 65 mg of iron from ferrous sulfate (one recommended per day).This is a good option for pregnant women who are anemic and need as much iron as possible. This grade was given due to the serious risk of bias of some of the trials contributing data and imprecision of results. The main risk was related to risk of bias for blinding and allocation concealment (seeRisk of bias in included studies). Also, there were nine trials with three or more components that were unclear or had a combination of unclear and high risk for one to two components. Among the studies contributing to data, risk of bias was low in 11 studies and high in six studies. In addition, adverse events, such as hypercalcaemia, hypercalciuria, hypocalcaemia, and hypervitaminosis D were either not clearly defined or the range to define these differed greatly between studies. Additionally, many common supplements for female reproductive health lack nutritional diversity, limiting nutritional support for your varying needs throughout your fertility journey (Schaefer & Nock, 2019). It’s always worthwhile to consult your doctor or obstetrician before taking any supplements as they’ll be able to advise you on the best options regarding your individual pregnancy and medical history. As essential as certain supplements are prior to conception, as well as during and after pregnancy when breastfeeding, there are also specific supplements that you should avoid. It’s a good idea to take a calcium supplement while pregnant, especially if there’s a history of osteoporosis in your family, or if you don’t tend to eat a lot of dairy-rich foods. Yes – Omega-3 can be taken during pregnancy, but it’s important to be mindful of the type and source. For more on general pregnancy nutrition, check out our guide to foods to eat and avoid during pregnancy. One nutrient that often comes up during pregnancy is Omega-3. Patients who have had bariatric surgery are therefore already at risk of deficiency, as are patients with hyperemesis . However, as a fat-soluble vitamin, vitamin A deficiency can be encountered due to malabsorption following bariatric surgery. In one study, deficiency was reported in over 50% of pregnancies occurring post-bariatric surgery . Patients undergoing procedures which exclude the greater curvature of the stomach, such as gastric bypass, sleeve gastrectomy and biliopancreatic diversion/duodenal switch are at particular risk . Whole grains like gluten-free oats, quinoa, brown rice and barley provide complex carbohydrates that are needed during pregnancy. Eating an array of beans during pregnancy can be beneficial because they are filling and nutrient-dense. Kefir is another form of cultured dairy that contains good bacteria that are essential for your digestion and overall health. Plus, it’s a great source of iodine, which is important during pregnancy in order to avoid birth defects and neurological disorders.Although the confidence intervals for the effect estimates both before and after the sensitivity analysis crosses the line of no effect, exclusion of these studies seemed to show no effect of MMN supplementation on child underweight status.There were no differences in neonatal or maternal mortality or congenital anomalies and although women taking iron supplements had lower absolute numbers of LBW and preterm infants, these differences were not statistically significant .A non–Cochrane review of MMS in LMIC countries (39) found that MMS reduced the risk of low birthweight by 14% (8–19%), preterm birth by 7% (2–13%) and SGA births by 6% (2–10%) on average compared with IFA supplements; the effects on low birthweight and SGA were greater among anaemic women than non-anaemic women.In most cases, a well-rounded and varied diet can provide all the necessary nutrients for a healthy pregnancy.For vitamin E and zinc, future studies should clarify their role during pregnancy.We attempted to use a systematic and transparent process to assess the quality of the evidence relating to specific outcomes and produce 'Summary of findings' tables.It is important to consult with a healthcare provider before starting any new supplements during pregnancy.Comparison 5 Routine high‐dose calcium supplementation in pregnancy by other outcomes (not prespecified), Outcome 4 High serum uric acid at 35 weeks. Our commitment to transparency means that we provide supplements with no hidden ingredients and focus on high-quality, science-backed formulations. The application had tailored content with locally relevant audio and visual prompts to equip community health volunteers with multimedia job aids to support client assessment, counseling, early identification, treatment, and/or rapid referral of pregnancy, postpartum, and newborn complications. Third, we found that some studies had an overall low quality, as reflected in the risk of bias assessment, with serious methodological limitations (particularly among the nonrandomized studies) and relatively small sample sizes. A healthy diet, regular exercise, and stress management are essential for maintaining optimal sperm health. The uterus, lined with a layer of tissue called the endometrium, provides a nurturing environment for a fertilized egg to implant and develop. A healthy balance of hormones, a nutritious diet, and a healthy lifestyle are all crucial factors in maintaining optimal fertility. Vitamins are chemical substances that our body needs for good health. Here's what you should know about integrative medicine and pregnancy.. Learn more here about the development and quality assurance of healthdirect content. These often contain extra folate, iodine and iron. If you eat a balanced, healthy diet, you should be getting most of what you need from your food. A study by Baker found that 30 mcg/day of supplemental biotin was sufficient to slightly increase levels of biotin above that of healthy controls, but they did not measure 3-HIA, a biomarker for need for biotin. One study of Egyptian women (who tend to have low B6) found that vitamin B6 status was the most important nutrient in affecting infant neurobehavioral development and maternal-infant interactions . B6 supplementation may help decrease the severity of nausea, reduce the risk of cardiovascular malformation, reduce the risk of preeclampsia, and improve birth weight. For US women we recommend that prenatal supplements contain approximately 10 mg of pantothenic acid. In conclusion, ginseng supplements can be an effective energy-boosting option for pregnant women. In conclusion, Coenzyme Q10 supplements can be a beneficial energy-boosting option for pregnant women. When choosing a vitamin C supplement, look for one that is specifically formulated for pregnant women and provides the recommended daily dosage. Taking folate supplements can help maintain healthy blood cell levels during pregnancy. Comparison 1 Routine high‐dose calcium supplementation in pregnancy by baseline dietary calcium, Outcome 6 Maternal death/serious morbidity. Comparison 1 Routine high‐dose calcium supplementation in pregnancy by baseline dietary calcium, Outcome 4 Admission to neonatal intensive care unit. Only one study included women with high risk of pre‐eclampsia and adequate dietary calcium (Villar 1990). Comparison 1 Routine high‐dose calcium supplementation in pregnancy by baseline dietary calcium, Outcome 1 High blood pressure (with or without proteinuria). They were based on providing an increased amount of iron, providing an increased amount of multiple nutrients, or general counselling only, while effectiveness was compared with effectiveness of the placebo, supplementation, or control group. Future efforts should focus on the inclusion of multiple-micronutrient supplementation in standard maternal and antenatal care programs in developing countries where micronutrient deficiencies are common. Additional subgroup analysis of primary outcomesSubstantial heterogeneity was detected in the analyses for preterm birth, small-for-gestational age, and perinatal mortality. In terms of neonatal morbidity, the most common conditions were birth asphyxia (3.3%) and bacterial sepsis in the newborn (1.3%) (Table 2). Scatterplot of selenium concentration in blood and dietary selenium intake. Supplementation resulted in a substantially higher total selenium intake (Table 1). However, mineral content of prenatal supplements varies widely, and a review of 188 prenatal supplements found that they often included only a subset of minerals, and often at low levels, so that only a small fraction of supplements met our recommendations.Several behavioral interventions, including dietary control and exercise, have been found to reduce the risk of these adverse outcomes.Molybdenum deficiency is rare, but one study found that about 38% of children with autism often needed 50 μg molybdenum to normalize activity of one of the enzymes to improve sulfation .In addition, there is large variability in terms of participants' characteristics enrolled between studies, such as with race/ethnicity, skin colour, pre‐pregnancy body mass index (BMI), dressing patterns, baseline vitamin D status, and physical activity levels.Taking prenatal iron supplements during pregnancy can provide several benefits for maternal health and fetal development.Nutrition education and counselling is a widely used strategy to improve the nutritional status of women during pregnancy.Comparison 2 Any supplements containing iron and folic acid versus same supplements without iron nor folic acid (no iron nor folic acid or placebo), Outcome 39 Maternal high haemoglobin concentrations at or near term (Hb more than 130 g/L at 34 weeks' gestation or more) (ALL). Comparison 5 Supplementation with iron+folic acid versus folic acid alone (without iron) supplementation, Outcome 50 Antepartum haemorrhage (ALL). Comparison 5 Supplementation with iron+folic acid versus folic acid alone (without iron) supplementation, Outcome 49 Puerperal infection (ALL). Comparison 5 Supplementation with iron+folic acid versus folic acid alone (without iron) supplementation, Outcome 48 Severe anaemia at postpartum (Hb less than 80 g/L) (ALL). Comparison 5 Supplementation with iron+folic acid versus folic acid alone (without iron) supplementation, Outcome 47 Maternal severe anaemia at or near term (Hb less than 70 g/L at 34 weeks' gestation or more) (ALL). Comparison 5 Supplementation with iron+folic acid versus folic acid alone (without iron) supplementation, Outcome 46 Moderate anaemia at postpartum (Hb more than 80 g/L and less than 110 g/L) (ALL). Regarding the micronutrient content included in these trials, MISAME-III and MINT’s product follows most closely the micronutrient formulations recommended by the 2017 Expert Consultation Report . The recently published RCT study in Niger that tested LNS compared with IFA or MMN has a sample size of 3332 . The differences in comparison groups for BEP compared with LNS studies make interpreting the results challenging. Overall, the heterogeneity in the participant inclusion criteria and definitions used to discern “undernourishment” across studies of LNS reflect the importance of considering context-specificity in LNS provision. Similarly, the LNS study populations varied greatly in geographic contexts (different countries or regions) and in the types of the target population , , . Given increased general awareness of gut health, many parents-to-be turn to probiotics. The jury is still out on whether taking fish oil during pregnancy is necessary. Though ginger may help reduce this unpleasant pregnancy complication, more research is needed to identify the maximum safe dosage. These may include constipation, vomiting, and abnormally high hemoglobin levels. Side effects can include gastrointestinal discomfort, which may be alleviated by taking supplements with food.Similarly, a functional test of vitamin B6 using an erythrocyte glutamate (EGOT) ratio in unsupplemented pregnant women in the Netherlands found that the percentage of women with a functional B6 deficiency increased from 7.5% to 25% at the end of pregnancy .What you eat on a regular basis matters for your health.The in vitro study by Habibi et al. examined the protective effects of different doses of selenium, iodine, and copper on the first-trimester human placenta against oxidative stress response.Therefore, there is a need to establish effective and safe doses of supplemental iron with folic acid either as daily or weekly supplementation; this should take into consideration nutritional and haematological status of women in developing countries.This study is based on the Norwegian Mother, Father, and Child Cohort Study (MoBa), which also includes data from the Medical Birth Registry of Norway (MBRN).The majority of studies provided 20 to 30 mg of zinc daily. It is possible that zinc used in conjunction with iron‐folic acid may dilute the effect of supplementation. Subgroup analysis involving women who are healthy (normal zinc) compared to those that are or are likely to be zinc‐deficient, could not be conducted as most studies used populations with presumed zinc deficiency. The evidence suggests that zinc supplementation may result in little or no difference in reducing the risk of preterm birth, stillbirths, or perinatal deaths. Overall, these studies suggest that higher levels of supplementation of vitamin A, but not carotenoids, are needed during pregnancy.The USPSTF is committed to mitigating the health inequities that prevent many people from fully benefiting from preventive services.Unique nutrition strategies can be adopted throughout pregnancy to manage or eliminate these symptoms!For instance, diabetic women may need higher doses of folic acid as the condition can increase the risk of neural tube defects in the baby.Heterogeneity in study design and settings has also led to important differences in evidence synthesis efforts for BEP (Supplementary Table 1) such that the 5 recent SRMAs that studied the effect of BEP intervention on perinatal outcomes have included a different set of studies (Supplementary Table 1). Of the 2 studies of shatavari root extract,40,41 only the study by Gupta and Shaw41 reported a significant effect on serum prolactin levels and infant weight gain. Three studies recruited women who were specifically identified as experiencing inadequate lactation or borderline-normal milk production,40,41,45 4 studies recruited mothers who delivered at term and began treatment soon after delivery,39,42-44 and 1 study recruited mothers who were exclusively breast-feeding their infants.46 The herbal galactagogues were either prepared as a tea or given as a capsule, and the form of the placebo matched that of the treatment in each study. Table 3 summarizes the identified studies of common herbal galactagogues.39-46 Eight blinded, placebo-controlled trials of herbal galactagogues were identified; 2 for Trigonella foenumgraecum (fenugreek),42,43 2 for Asparagus racemosus (shatavari),40,41 1 for a micronized form of silymarin45 (a standardized extract of Silybum marianum milk thistle), 1 for Allium sativum (garlic),46 and 2 for Moringa oleifera (malunggay).39,44 Results for torbangun leaves in the Damarik et al study42 are not reported here because the substance is not an outcome of interest in our review. Vitamin D during pregnancy is the same as for all adults, at 10mcg. One of the few products suitable for vegans as no animal-derived vitamin D. Suitable for pregnancy and breastfeeding, with all of the key nutrients providing at least 100% NRV (except magnesium at 32%) and no bulking agents. Sustainably sourced fish forms the basis of this omega-3 supplement. To help optimize development and to fuel a healthy pregnancy, all essential nutrients should be included in the diet. Optimal nutrition during this time is essential for supporting critical periods of fetal growth and development, maternal health (including the postpartum period and lactation), and for fueling infant and toddler growth (until two years of age). Optimal nutrition during pregnancy through early childhood is critical for supporting a healthy life. The total number of pregnant women attending the antenatal care (ANC) clinic was 1,318. Folic acid deficiency during conception and early pregnancy causes a higher risk of neural tube abnormalities and other poor pregnancy outcomes like orofacial clefts (5). If a woman takes 65% or more of the iron-folic acid supplement, which equates to taking the supplement at least 4 days a week, she is considered adherent to the supplement (2). Iron and folate supplementation can effectively control and prevent anemia during pregnancy. Amongst all of the B-vitamins, Folate, or B9, has been called the ‘pregnancy superhero’. Late in pregnancy, constipation and abdominal discomfort are frequent regardless of whether supplements are used or not. Early in pregnancy, morning sickness probably contributes to reduced consumption of nutrient supplements. One problem with supplement use during pregnancy is uncertainty about compliance (Bonnar et al., 1969), particularly when poverty and certain ethnic beliefs reduce the availability or acceptability of supplements. Over this 24-week study period, the red cell mass increased by an average of approximately 450 ml in the supplemented group compared with 180 ml in the unsupplemented women, a difference of 270 ml. When should you start taking prenatal vitamins and other supplements? Understanding and harnessing the ability to modulate the placental microbiota through dietary supplementation may open new avenues for prevention. A meta-analysis of 11 studies revealed the occurrence of 20 distinct adverse effects in mothers during the third trimester, including nausea, vomiting and diarrhea. It is crucial to facilitate integration through the dissemination of health education and the implementation of health campaigns targeting women of reproductive age . The potential mechanisms through which micronutrient intake during the pre-conceptional period affects the development of pregnancy must be clearly defined and understood. Deficiencies of several micronutrients, rather than just one, are linked to adverse effects on pregnancy outcomes, so addressing one deficiency is not enough if others persist. In contrast to the saccade reaction time findings, we found no evidence for an effect of maternal choline intake on the number of anticipatory saccades, a putative measure of spatial memory for sequential regularity. Our findings also provide some support for a beneficial effect of consuming 480 mg choline/d, relative to women’s usual choline intake. Notably, infants in the 930 mg choline/d group were consistently faster to react to pictures across the 4 assessment ages, indicating that the beneficial effect of a higher maternal choline intake on infant information processing speed endured for at least the first year of postnatal life. Infant mean saccade reaction time as a function of the number of days of third-trimester maternal intake of 480 mg choline/d. Subgroup findings according to the dose of iron used in the control group were similar to the overall findings for these outcomes. In this comparison, the last trial was excluded in sensitivity analyses, which were restricted to trials using a 0.4 mg dose of folic acid. UNIMMAP contains 30 mg iron and 0.4 mg folic acid. What is the overall certainty of the evidence of effects of MMS compared with IFA supplements? The two main forms of calcium supplements are carbonate and citrate. Several different kinds of calcium compounds are used in calcium supplements. It's not definitive, but there may be a link between high-dose calcium supplements and heart disease. Nevertheless, a meta-analysis of studies of maternal iron intake in iron-deficient populations shows that iron supplementation of iron-deficient populations is beneficial (101, 102). Interpretation and risk–benefit analysis of maternal iron supplementation during pregnancy based on whether hemoglobin or ferritin was used as the primary biomarker to assess iron status and the information added by a second biomarker This review considers the physiology of iron as a nutrient and how this physiology informs decision-making about weighing the benefits and risks of iron supplementation in iron-deficient, iron-sufficient, and iron-overloaded pregnant women and children. There is limited data on the correlation between calorie intake and gestational control in pregnant women, and there is little evidence for this in terms of quality (131). In a recent review on the effects of dietary interventions, lifestyle changes and dietary supplements on the prevention of gestational diabetes, it has been concluded that positive results have not been achieved in trials that have only been intercepted by participants in food intake. Specialized MNT is substantial in helping pregnant women with GDM attain and preserve normal serum glycemic levels and proper weight gain while providing essential macro and micro nutrients(99). According to studies, only 37% of pregnant women had right weight gain and about 30% of them had weight gain higher than the recommendation (83). During pregnancy, a nutrients requirement is considered to be that amount necessary to replace obligatory maternal nutrient losses and to allow for normal growth of fetal and maternal tissues and for accretion of nutrient stores. Balance studies are conducted to estimate nutrient requirements based on measurement of all dietary intake and physiologic loss of the nutrient and its metabolites. During pregnancy, these needs include increased requirements for maternal tissue expansion or metabolism; placental growth; and growth, nutrient storage, and metabolism in the fetus. For this reason, the subcommittee gave more weight to evidence showing that usual nutrients intakes were inadequate to support optimal function than to evidence of decreases in static levels of nutrients. Naturally occurring levels of CoQ10 decrease with age, and it’s difficult to consume a significant amount via food. As your body uses food, heals wounds, and reacts to its environment, it naturally creates waste products called “free radicals.” These unstable atoms can damage cells; this damage is also known as oxidative stress, and it’s what leads to aging and some illnesses. The improvement was only seen in women with diminished ovarian reserve; DHEA has never been shown to be helpful for women with normal ovarian reserve, and has never been shown to increase egg count or success rates for women who are freezing eggs. If this seems counterintuitive, remember that all bodies use both “male” and “female” hormones, but at different optimal levels. DHEA levels in the body naturally peak around early adulthood and fall with age. Supplementation with iron plus folic acid plus other micronutrients versus folic acid plus the same micronutrients without ironNone of the included trials reported on this comparison. Although there was no difference between groups in the risk of constipation, vomiting or heartburn, less women receiving iron experienced diarrhoea in one trial of 188 women (RR 0.53, 95% CI 0.29 to 0.96). No difference between groups was found for risk of side effects (RR 1.10, 95% CI 0.55 to 2.23) or infection during pregnancy (RR 1.21, 95% CI 0.33 to 4.46) in one trial of 727 women. The risk of severe anaemia during the second or third trimester was reduced among the treatment group (RR 0.12, 95% CI 0.02 to 0.63, 2 trials/365 women). However, the risk of having high haemoglobin concentrations at any time during the second or third trimester (RR 1.90, 95% CI 1.07 to 3.35, 7 studies/1146 women) and at or near term (RR 3.80, 95% CI 1.74 to 8.28, 7 studies/1189 women) was increased. A recent review concluded that correcting iron deficiency could have a beneficial impact in women's physical performance (Pasricha 2014). There is still a need to improve the definition of the distribution of serum transferrin receptors during pregnancy in populations with different iron status (Nair 2004) in various environments (Milman 2007). Iron deficiency in non‐pregnant populations can be measured quite precisely using laboratory tests such as serum ferritin, serum iron, transferrin, transferrin saturation and transferrin receptors. Interpersonal psychotherapy and behavioral activation have specific evidence of efficacy in this population.14–16 These nonpharmacologic treatments are often combined with antidepressant medications in women with moderate-to-severe depression and are appropriate as monotherapy for mild depression or due to patient preference. Regular symptom monitoring during pregnancy and postpartum and medication dose adjustments to sustain efficacy constitutes good practice. Due to the dramatic physiological changes of pregnancy and enhanced hepatic metabolism, drug doses may need to be adjusted during pregnancy to sustain efficacy. The evidence on exposure to common psychotropics during pregnancy and breastfeeding is reviewed. Previous research reported that pregnant women readily consumed 6 to 12 servings per day from the bread group and at least three servings of meat per day (Fowles, 2000). The quality of a woman's diet during pregnancy has a profound influence on positive fetal and maternal outcomes. A list of nutritional recommendations for pregnant women is presented, which may serve as a reference for practitioners when counseling pregnant women. In women, fertility declines with age, especially after the age of 35, due to the decrease in the quality and quantity of eggs. Fertility can be influenced by a variety of factors, including age, lifestyle, and overall health. Calcium, essential for bone health, can help regulate the menstrual cycle and improve fertility. Vitamin D, essential for bone health, can also help regulate the menstrual cycle and improve fertility. A healthy lifestyle, including a balanced diet, regular exercise, and stress management, is essential for maintaining optimal fertility. Other essential vitamins Multivitamins include iron, while containing added vitamins and minerals.The inconsistencies in their results probably reflect the dependence of such outcomes on many variables.Breakfast cereals in the United States are not typically fortified with ferrous iron, and the reliability of such products in preventing iron deficiency during pregnancy is not established.It is important to note that supplements should never replace a balanced and nutritious diet.Considering this fact, more randomized controlled trials should be planned and conducted in a rigorous manner to confirm the formulated observations of effectiveness of the studied interventions based on providing an increased amount of iron, providing an increased amount of multiple nutrients, or general counselling only.With the right vitamins and supplements, you can support your baby’s growth and development while also taking care of your own health during this exciting time.Since deficiencies of iron, folate, vitamin D, and vitamin B12 are widespread with higher than 30 per cent prevalence, a dose equivalent to 1.5 times the RDA is included in the proposed formulation.The use of specific calcium supplements did not show much variation.Vitamin C is a water-soluble vitamin and powerful antioxidant that is essential whether or not you're pregnant. Dietary supplements and herbal remedies are not regulated as strictly as medication by the FDA, so the labels may be misleading, and there may be unknown side effects. Much of the knowledge about using sleep aids during pregnancy comes from animal studies, so recommendations about which options are safe and which are not safe may change in the future. More research is needed to assess whether antidepressants pose any risks to pregnant people and their fetuses. One study (Ceesay et al., 1997) reported on infant mortality which showed that BEP supplementation does not probably have any effect on infant mortality (RR, 1.00; 95% CI, 0.59–1.68; one study, 1446 participants; moderate quality of evidence on GRADE) (Analysis 1.5; Tables 3 and 4). One study (Ceesay et al., 1997) reported on neonatal mortality which showed that BEP supplementation may not have any effect on neonatal mortality (RR, 0.58; 95% CI, 0.32–1.06; one study, 1446 participants; moderate quality of evidence on GRADE) (Analysis 1.4; Tables 3 and 4). One study (Ceesay et al., 1997) reported on perinatal mortality which showed that BEP supplementation may reduce incidence of perinatal mortality by 50% (RR, 0.50; 95% CI, 0.30–0.84; one study,1446 participants; low quality on GRADE) (Analysis 1.3; Tables 3 and 4). BEP supplementation may make little or no difference in number of miscarriages (RR, 1.00; 95% CI, 0.07–14.21, one study, 24 participants; low quality on GRADE) (Analysis 1.1; Tables 3 and 4). Among primary outcomes, included studies reported on miscarriage (Dwarkanath et al., 2016), stillbirth (Ceesay et al., 1997; Dwarkanath et al., 2016; Mora et al., 1978b), perinatal mortality (Ceesay et al., 1997), neonatal mortality (Ceesay et al., 1997), and infant mortality (Ceesay et al., 1997). During pregnancy, your body will prioritize your baby. We asked two Flo experts — registered dietitian Lauren Talbert and obstetrician-gynecologist (OB-GYN) Dr. Jenna Flanagan — to explain what you and your baby need as your pregnancy progresses and what to scan the label for. They will assess the risks and benefits to help you decide what’s safe. However, the reality is that pregnancy sickness, fatigue, and unexpected cravings can make this really difficult, even if you’re trying your best. You might have imagined that you’d be eating the most nutritious diet during pregnancy. Including these nutrients in prenatal supplements can help support the emotional well-being of the mother during this important time. These supplements also contribute to the healthy development of the baby’s bones, teeth, and organs. Overall, choosing the right prenatal supplement involves careful consideration of your individual nutritional needs, preferences, and any guidance provided by your healthcare provider. Some women may prefer supplements that are made from organic or plant-based sources, while others may have specific dietary preferences or restrictions. The obesity prevention studies were few in number but demonstrated a significant reduction in mean birth weight. The quality of selected outcomes was also assessed using GRADE analysis. For sensitivity analysis, all trials were unclear for selection bias therefore none of them were excluded. No improvements were observed for miscarriages, maternal mortality, perinatal mortality, neonatal mortality, infant mortality, LBW, preterm birth, SGA babies, mean head circumference, and rates of underweight babies. However, health care providers often assume that something classified as a category B is safer than a category C, which may not be true. The original intent was to describe the risk of teratogenicity after first trimester exposure and not all adverse fetal effects. The majority of the information available is in the form of case reports, case series, drug registry data, and/or retrospective cohort trials. The website also has health tips and information on many health topics, including pregnancy.The increase in the risk of haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome was small in terms of absolute numbers.The US Institute of Medicine has determined that concentrations greater than 50 nmol/L or 20 ng/mL are adequate based on the current studies available (IOM 2011), although many investigators consider that optimal levels should be higher (greater than 75 nmol/L or 30 ng/mL) (Dawson‐Hughes 2005; Hollick 2009).Subscription vitamin packs contain multiple supplements, with each day’s supply neatly packaged in a small envelope.Nutritional interventions have shown significant beneficial effects in reducing iron deficiency anaemia, neural tube defects, IUGR and pre‐eclampsia during pregnancy and lactation (Kramer & Kakuma 2003; Haider & Bhutta 2006; Hofmeyr et al. 2011).Five meta-analyses have evaluated the effects of multimicronutrient supplementation during pregnancy (eTable A). UK 1991a published data only Vitamin A supplementation during pregnancy can influence both maternal and fetal health, especially in areas with a high risk of deficiency . There is debate about appropriate dosing 209,212 but most clinical trials conclude that iron supplementation is beneficial for women who have IDA or are at risk of IDA 209,210,211,213. In areas with severe iodine deficiency, potassium-iodide supplementation in pregnant women reduces the risk of cretinism and improves some aspects of cognitive function . In addition to birth outcomes, a recent clinical trial showed that magnesium supplementation during pregnancy may improve insulin sensitivity and decrease insulin resistance in women with gestational diabetes . However, it’s always a good idea to consult with a healthcare provider before adding any new herbal tea or supplement to your routine. Antioxidants are beneficial vitamins and minerals that can help support a strong immune system. Iron helps support the production of red blood cells and prevents anemia, while vitamin C enhances iron absorption. In one trial comparing usual diet (group 1, control) with milk (group 2) and milk in combination with calcium supplements (group 3, providing 350 and 600 mg/day of calcium, respectively) were given to 36 Chinese women, with an average baseline intake of 480 mg/day, from 20 weeks of gestation to 6 weeks postpartum. Both studies showed that prenatal calcium supplementation (600 mg/day–1 g/day) resulted in reduced postpartum bone resorption and improved bone recovery up to 1233 and 20 weeks postpartum,34 or found no significant differences in bone changes in longer follow‐ups, at 56 weeks postpartum.35 For other nutrients, such as vitamin D, folic acid, and n‐3 fatty acids (supplementation), as well as sodium intake reduction, there is limited evidence of their role in the prevention of preeclampsia.27, 28, 29 Expert groups recommend that pregnant women consume 8 to 12 ounces of seafood per week, choosing varieties that are lower in mercury.A 2023 meta-analysis included 55 studies that evaluated perinatal growth outcomes in a total of 426,098 pregnancies in low-, middle-, and high-income countries around the world .The greatest danger is to the unborn baby, with increased risk of miscarriage, stillbirth or premature labour.Although research into the specific pathways affected by these PUFAs is still in its infancy, there is enough understanding to draw conclusions and make recommendations about their dietary intake during the perinatal period.During pregnancy, there’s also an uptick in certain macronutrient needs.The present study showed the preventive effect of oral Mg tablet in the many of pregnancies with difficulty. With iron and iodine for red blood cell and brain development, Elevit ensures comprehensive nutritional support. USANA’s Prenatal CellSentials is a comprehensive nutritional supplement designed to support both mother and baby from pre-conception through breastfeeding. Blackmores provides a well-rounded formula packed with 20 essential nutrients including folic acid, iodine, and DHA to support baby’s development. Ideal for mums looking for top-tier, clean prenatal support. In another study, prenatal exposure to quercetin was linked to increased cancer risk. A study in mice suggested that prenatal quercetin exposure results in epigenetic changes and increased iron storage in the liver in adulthood. Magnesium deficiency or insufficiency during pregnancy may pose a health risk for both the mother and the newborn, with implications that may extend into adulthood of the offspring. Hofmeyr GJ, Lawrie TA, Atallah ÁN, Duley L, Torloni MR. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. If women were not going to be at home, workers would give women enough supplementation for their absence. The recommended daily energy intake of macronutrients is 33-40% complex carbohydrates, 35-40% fat and 20% proteins (113). In terms of macronutrients, adequate amounts of macronutrients should be provided to support pregnancy, according to nutrition assessment, with directions from the DRIs. While specialization of the calorie prescription, prepregnancy weight and body mass index (BMI), gestational weight gain, and physical activity should be considered (125). The recommendations are 30 kilocalories per kilogram body weight in women with normal body mass index, 24 kilocalories per kilogram body weight in overweight women and kilocalories per kilogram in women with obesity. As stated above, the basis of work is based on proper nutrition (129).A skilled clinical nutritionist should provide MNT based on ordered and regular visits to women with GDM. Recent data from national surveys from 46 countries during the years 2003 to 2009 estimated that 52% to 75% of mothers had received iron tablets during pregnancy, and that the duration of supplementation was usually short (Lutter 2011). Additionally, if iron deficiency prevalence in the country is high, (INACG 1998), or if a woman is diagnosed with anaemia in a clinical setting, she should be treated with daily iron (120 mg of elemental iron) and folic acid (400 μg or 0.4 mg) supplementation until her Hb concentration rises to normal (WHO 2012a). The ratio of serum transferrin receptors to serum ferritin has been suggested as a good indicator of iron nutrition among pregnant and non‐pregnant women (Cook 2003). We included 61 randomised trials in the review with 44 trials involving 43,274 pregnant women contributing to the analyses. Low iron and folate levels in women can cause anaemia, which can make women tired, faint, and at increased risk of infection. Look for a high-quality prenatal that provides comprehensive support, including at least 27mg of Iron. Prenatals typically include iron (though not all use the most bioavailable form). Many of us don't get enough iron from our foods, especially when growing a baby. Iron plays several important roles when you're expecting, making it one of the most essential nutrients in a pregnancy diet. Comparison 3 Sensitivity analysis (all… Comparison 1 A dose of vitamin D 601 IU/d or higher vs 600 IU/d or lower alone or with other nutrients, Outcome 22 Preterm birth (by registered or not registered). Comparison 1 A dose of vitamin D 601 IU/d or higher vs 600 IU/d or lower alone or with other nutrients, Outcome 23 Preterm birth (by impact factor journal). Comparison 1 A dose of vitamin D 601 IU/d or higher vs 600 IU/d or lower alone or with other nutrients, Outcome 24 Preterm birth (by vitamin D status at baseline). Vitamins and minerals Better Health Channel The cross-sectional data revealed that dietary supplement use is higher as pregnancies progress (see Figure 5-1). NHANES interviewers conduct a dietary supplement inventory in participants' homes and also collect demographic and background information. During pregnancy and lactation, there are specific nutritional needs that support and enhance the growth and development of the fetus and infant. You should consult with your physician or other health care professional before making any decisions or taking any actions based on this content. Understanding what helps your body use folate can help you pick the best supplement during pregnancy. This supplement can help you support your health and your baby’s development easily and naturally. It is a reliable choice for supporting your circulation, brain, and nerve health during pregnancy and everyday life. It is helpful for those who are planning pregnancy or are pregnant. This supplement is good for people who want to support healthy cell growth and DNA creation. Maternal nutrition is essential for healthy fetal growth and development. How to build a pregnancy-safe skincare routine, according to experts Not only do these have fumes which can be a risk to the baby, but they also damage the hair, which is already more fragile than normal.” Comparison 5 Supplementation with iron+folic acid versus folic acid alone (without iron) supplementation, Outcome 56 Heartburn (ALL). Comparison 5 Supplementation with iron+folic acid versus folic acid alone (without iron) supplementation, Outcome 55 Nausea (ALL). Comparison 5 Supplementation with iron+folic acid versus folic acid alone (without iron) supplementation, Outcome 54 Constipation (ALL). Adequate hydration can help with digestion and absorption of the nutrients from the supplements.This outcome was reported in three trials with 496 participants, all of which reported median thyroid volume so no meta‐analysis was performed (Brucker‐Davis 2013; Pedersen 1993; Gowachirapant 2014).During pregnancy, vitamin A is essential for the health of the mother as well as for the health and development of the fetus.The survey also revealed that approximately 10 per cent of women are anaemic and, depending on the time of year, 10 to 40 per cent are deficient in vitamin D.Second, in Ramakrishnan et al. (2012), MMN must have contained at least five micronutrients, whereas we included any supplement with at least three.A systematic review by Imdad and Bhutta (2011) also assessed the effectiveness of BEP supplementation and included six studies from LMICs and five from HICs.During pregnancy, it’s important to find safe energy boosters that are suitable for you and your baby.Deficiencies of micronutrients are common following bariatric surgery and may be exacerbated during pregnancy due to pregnancy-related symptoms and increased maternal and fetal demand. It is excellent for your health, protects the animals from cruelty, protects the environment and helps solve the world hunger and thirst problem. Each of these supplements offers different benefits and features, making it important to consider your specific needs and preferences carefully before deciding. High-quality options include NATURELO Prenatal Multivitamin, Garden of Life Organic Prenatal Multivitamin Supplement with Folate, and Deva Vegan Prenatal Multivitamins. In addition to being extremely mild on an empty stomach, this multivitamin will also assist increase and sustaining energy levels. The randomization method was not clearly mentioned in two trials (Dwarkanath et al., 2016; Ross et al., 1985), making the ROB unclear. One study, Pollak et al. (2014) was excluded as its patient population of interest was previously diabetic. Two studies were excluded as they were conducted in high‐income countries (Huseinovic et al., 2017; Piirainen et al., 2006). Three (Edrisi et al., 2018; Ello‐Martin et al., 2007; Perichart‐Perera et al., 2009) were excluded due to their wrong patient population; Edrisi et al. (2018) included men in its sample, Ello‐Martin et al. (2007) included only obese participants and Perichart‐Perera et al. (2009) only included GDM women. However, it is important to remember that supplements should never replace a healthy and varied diet. During pregnancy, it is crucial to focus on obtaining essential nutrients from whole foods rather than relying solely on supplements. Additionally, herbal supplements should be approached with caution, as they may contain substances that could be harmful during pregnancy. By following these precautions, you can ensure the safety and efficacy of the supplements you take during pregnancy. Comparison 1 A dose of vitamin D 601 IU/d or higher vs 600 IU/d or lower alone or with other nutrients, Outcome 29 Low birthweight (by season at the start of supplementation). Comparison 1 A dose of vitamin D 601 IU/d or higher vs 600 IU/d or lower alone or with other nutrients, Outcome 28 Low birthweight (by frequency of supplementation). Comparison 1 A dose of vitamin D 601 IU/d or higher vs 600 IU/d or lower alone or with other nutrients, Outcome 27 Low birthweight (by time of commencement of supplementation). Comparison 1 A dose of vitamin D 601 IU/d or higher vs 600 IU/d or lower alone or with other nutrients, Outcome 33 Low birthweight (by nutrients included in the supplementation). Data from four trials (Karamali 2015; Mojibian 2015; O'Brien 2013; Roth 2013) involving 1550 women appear to suggest a similar risk between those consuming 601 IU/d or more and those consuming 600 IU/d or less of vitamin D (RR 0.90, 95% CI 0.66 to 1.24; very low‐certainty evidence; Analysis 1.26). German guides recommend that a percentage of 30-35% from the caloric intake should be covered by lipids, specifying that obese women should prefer low-fat food . This behaviour was shown in numerous studies to have negative consequences for the health of both mother and fetus. Recently, a study that used the minimally invasive indicator amino acid oxidation method established the protein requirements to increase from 1.2 g/kg/day at 16 weeks of pregnancy to 1.52 g/kg/day at 36 weeks . During pregnancy, an appropriate protein intake is crucial in order to promote fetal growth and development. What is the overall certainty of the evidence of effects of zinc supplements compared with no zinc supplements? How substantial are the undesirable anticipated effects of zinc supplements compared with no zinc supplements? How substantial are the desirable anticipated effects of zinc supplements compared with no zinc supplements? Stellar-Mama and Preggy-Mama are both comprehensive pregnancy supplements for pregnant women that contain all the vitamins and minerals you will need to support a healthy pregnancy. Before buying any prenatal vitamins, check that these pregnancy supplements contain the necessary vitamins and minerals like folic acid, iron, calcium and vitamin D. Therefore, in this protocol and subsequent review, we will include all pregnant women regardless of their pregnancy stage and we will aim to assess the effects of vitamin K supplementation on a set of neonatal and maternal outcomes that were not covered by earlier reviews, specifically by Crowther 2010. A meta-analysis of vitamin A supplementation studies in lactating women found no additional benefit to maternal or infant health beyond improving serum and breast milk levels . Certain herbs, high doses of certain vitamins and minerals, and certain herbal remedies should be avoided, as they may have adverse effects on the developing baby. A pregnant woman’s diet plays a vital role in ensuring the health and well-being of both the mother and the baby. While it is generally advisable for expectant mothers to focus on getting nutrients from a balanced diet, there are cases where supplements can be beneficial. These supplements can help support the development of the baby’s brain, bones, and overall growth. (Studies that exclusively enrolled women with HIV or women at high risk of nutritional disorders for other reasons were excluded, and disaggregated data were used when studies included subgroups of such women) A Growing Trend in Prenatal CareAs awareness of IV therapy's benefits in pregnancy grows, more and more healthcare providers are incorporating it into their prenatal care regimes. Consulting with Healthcare ProfessionalsIt's imperative for pregnant women considering IV therapy to consult with their OB/GYN or obstetrician. Combatting Nausea with Anti-Nausea MedicationsIV packages for pregnant women can include anti-nausea medications like Zofran, providing relief from morning sickness symptoms. For pregnant women, especially those experiencing severe morning sickness or hyperemesis gravidarum, IV hydration can be a game-changer. So, knowing what healthy pregnancy nutrition looks like is important. Even still, a healthy pregnancy diet is important. But when you’re pregnant, what you eat affects more than your own health. Including magnesium in your prenatal supplement can help support the baby’s growth and development. It prevents iron-deficiency anemia and promotes the healthy development of the baby’s brain and nervous system. These vitamins contain a comprehensive blend of nutrients that are essential for both mom and baby. Consider your individual requirements and health goals when selecting a supplement with these added nutrients. However, by considering some key factors, you can select an excellent prenatal supplement that meets your specific needs. Small‐for‐gestational‐age and low birthweight were considered to be moderate certainty of evidence, downgraded by just one level because of study design limitations. It is uncertain whether zinc supplementation reduces neonatal death because the certainty of evidence is very low. There are five outcomes with meta‐analyses including more than 10 studies (Analysis 1.1; Analysis 1.5; Analysis 1.7; Analysis 1.27; Analysis 1.31). Infant weight‐for‐age (Z‐score) were higher in the control group when compared with the zinc group at six months (MD ‐0.34, 95% CI ‐0.57 to ‐0.12; 2 studies, 235 participants) and 13 months (MD ‐0.40, 95% CI ‐0.70 to ‐0.10; 1 study, 168 participants; Bangladesh 2000) (Analysis 1.49). Women in high‐income settings who were supplemented with zinc saw a trend towards a reduction in caesarean sections, while the opposite was true for women in low‐income settings. I founded NEEDED in my third trimester when I was seriously searching for a probiotic solution to avoid being GBS+ this pregnancy. Cristina Palacios and Juan Pablo Peña‐Rosas assessed eligibility of the new trials. Comparison 2 A dose of vitamin D 4000 IU/d or more vs 3999 IU/d or less alone or with any other nutrient, Outcome 12 Gestational diabetes (by registered or not registered)n). As part of the pre‐publication editorial process, this review has been commented on by two peers (an editor and referee who is external to the editorial team), two members of Cochrane Pregnancy and Childbirth's international panel of consumers and the Group's Statistical Adviser. There are 16 ongoing trials that when published, may increase the body of knowledge.