Most people think a prenatal vitamin and mineral supplement is an important part of a healthy pregnancy, providing necessary nutrients to meet the increased demands of fetal growth and development. Although taking a prenatal supplement during pregnancy is important, there are also reasons to consider a “prenatal” before and after pregnancy.

Most women think of ovulation as the release of an egg that developed after the most recent menstrual cycle, but … did you know that each egg released by the ovary was selected for development nearly a year earlier?

Although a woman is born with egg cells (oocytes) in her ovaries, the oocytes exist within premature follicles – groups of cells that contain a developing oocyte within them. For the ovary to release a mature egg, these follicles must go through several stages of development: initiation, growth, selection, and maturation.

The initiation stage, during which a premature follicle becomes a primary and then a secondary follicle, takes approximately 290 days, or approximately 10 menstrual cycles. The growth stage, which occurs next, takes place over 60 days. At any given time, several follicles are developing during these stages, and during each menstrual cycle a dominant follicle is selected. The dominant follicle continues to mature and reaches ovulation approximately 20 days later.1

So, although an oocyte released during a monthly cycle doesn’t fully develop until that current cycle, by the time it’s released it has been maturing within its primordial follicle for almost a year. As the follicle and egg are developing, antioxidants, including vitamins C and E, and B vitamins like folate, protect against oxidative stress and contribute to healthy oocyte development.*2

The fetal brain, spinal cord, heart, and other organs begin to develop before most women know they are pregnant.

Preparing your body during preconception can also have benefits for early pregnancy. By the third week of development following conception, nervous system tissues are beginning to form, and by the end of the fourth week, the neural tube, which is the developing brain and spinal cord, is beginning to close. 

Neural tube defects, like spina bifida, occur when the neural tube does not close properly. Folate plays a primary role in proper neural tube development.*3 Because neural tube development happens so early in pregnancy, many women don’t yet know they are pregnant when this process is occurring. Taking a prenatal supplement before conception can ensure that folate is available to the developing neural tube.*

Along with folate, choline is another important nutrient for fetal brain and nervous system development.* Recent research indicates that most U.S. women take in far less dietary choline daily than is recommended, and during pregnancy, particularly in the third trimester, demand for choline in the body increases significantly. Phosphatidylcholine, a component of cell membranes, and acetylcholine, a neurotransmitter involved in cognitive function and memory, are both made in the body from choline.* Choline can also be converted to betaine, which is an optimal source of methyl groups for DNA modulation.*4

During the fourth week after conception, other organs, such as the heart, are also beginning to form; and during weeks four and five the heart begins to beat. B vitamins, like folate, riboflavin, niacin, and B12, and minerals including iron, contribute to fetal heart development.*6

Nutrient status during pregnancy is also important later in life.

Studies have also explored the relationship between choline levels during pregnancy and cognitive function later in childhood. In both animal and human studies, maternal dietary choline intake is associated with memory in offspring.* In one study, higher maternal choline levels in the second trimester promoted visual memory in 7-year-old children.*5

DHA, an omega-3 fatty acid, is an essential nutrient for brain, nerve, and eye development.* DHA accumulates in a baby’s developing brain primarily during the third trimester of pregnancy and throughout the first two years of life.* After that, DHA levels are largely maintained by dietary intake but don’t necessarily increase.

Importance of specific nutrients in a prenatal supplement

Here are some of the nutrients commonly found in a prenatal supplement and the roles they play in fetal development:

  1. Vitamin A – skin, bones, and eyesight*
  2. Vitamin B6 – red blood cell formation*
  3. Vitamin B12 – nervous system and red blood cell formation*
  4. Folate (vitamin B9) – brain and spinal cord, nervous system, and red blood cell formation*
  5. Vitamin C – gums, teeth, and bones*
  6. Choline – brain and nervous system, cognitive function, and cellular health*
  7. Vitamin D – bones, teeth, skin, and eyesight*
  8. Calcium – bones and teeth*
  9. Iron – red blood cells*
  10. DHA – brain, nerves, cognitive function, and eyes*

The American College of Gynecology recommends taking a prenatal supplement before and during pregnancy to help manage nausea and vomiting during pregnancy.

More than 70 percent of pregnant women experience nausea and vomiting, particularly during early pregnancy. Whether experienced as morning sickness or throughout the day, nausea and vomiting can make it difficult to obtain adequate nutrition. A prenatal supplement can fill in nutritional gaps by providing vitamins and minerals needed for healthy development.* In addition, vitamins B6, C, and K have been shown to ameliorate morning sickness.*

Anemia during pregnancy occurs in approximately 38 percent of pregnancies worldwide, with 25 percent of pregnant U.S. women experiencing anemia.7 Blood volume increases during pregnancy so adequate oxygen and nutrients can be supplied to the developing baby. As blood volume increases, the number of red blood cells must also increase. Anemia occurs when there are too few red blood cells.

There are more than 400 types of anemia.

The most common types of anemia during pregnancy are iron deficiency anemia, folate deficiency anemia, and vitamin B12 deficiency anemia. In the United States, anemia in pregnancy is usually due to insufficient intake of the vitamins and minerals necessary to produce healthy red blood cells. Vitamins B6, B12, folate, C, and A, along with iron, contribute to healthy red blood cell formation.*

Whether by natural birth or cesarean section, childbirth can result in tissue damage, oxidative stress, and loss of blood and other fluids. In addition to possible anemia, a woman can experience increased nutrient demands for healing and tissue repair. Women who experience anemia during pregnancy are at higher risk for developing postpartum anemia. Vitamins C and E provide antioxidant support; iron, vitamin C, and B vitamins are needed to make red blood cells; and vitamin C and zinc support the healing of wounded tissues.*

Breastfeeding women need 450-500 additional calories per day to meet nutritional demands.

A prenatal supplement can also be helpful when you are breastfeeding. Nutrient intake needs increase during lactation because the mother is sharing nutrition with her baby. Vitamin D and calcium are important for a baby’s growing bones and teeth, while vitamin C and iron support healthy blood and cardiovascular development.* DHA supports healthy development of the brain, nerves, and eyes.* 

Most women need 450-500 additional calories per day when breastfeeding.8 Caring for an infant while resuming work and other lifestyle commitments can make it difficult to eat a perfect diet. While a prenatal supplement doesn’t take the place of food, in helps supply the nutrients missed if eating is done on the run.

As you can see, a prenatal supplement plays an important role before, during, and after pregnancy. Even for a woman who is striving to eat a healthy diet, a modern lifestyle can make it difficult to consistently obtain all the nutrition she needs. Including a high-quality prenatal supplement can bridge most nutritional gaps and supply the nutrients for healthy fetal development, even before trying to conceive.

Thorne’s Basic Prenatal provides multi-vitamin/mineral support with choline, active forms of folate and other B vitamins, and well-absorbed amino-acid chelated minerals. The formula is gentle on the stomach with its well-tolerated and highly absorbable forms of nutrients, including iron bisglycinate. Pair it with Thorne’s Prenatal DHA for a full slate of nutrients that support mom and baby from pre-conception through breastfeeding.*

References

  1. Williams CJ, Erickson GF. Morphology and physiology of the ovary. In: Feingold KR, Anawalt B, Boyce A, et al., eds. Endotext MDText.com, Inc.; 2000. Accessed July 27, 2020. http://www.ncbi.nlm.nih.gov/books/NBK278951/
  2. Silvestris E, Lovero D, Palmirotta R. Nutrition and female fertility: an interdependent correlation. Front Endocrinol 2019;10. doi:10.3389/fendo.2019.00346
  3. Wilson RD, Wilson RD, Audibert F, et al. Pre-conception folic acid and multivitamin supplementation for the primary and secondary prevention of neural tube defects and other folic acid-sensitive congenital anomalies. J Obstet Gynaecol Canada 2015;37(6):534-549. doi:10.1016/S1701-2163(15)30230-9
  4. Adams JB, Kirby JK, Sorensen JC, et al. Evidence based recommendations for an optimal prenatal supplement for women in the US: vitamins and related nutrients. Matern Health, Neonatol and Perinatol 2022;8(1):4. doi:10.1186/s40748-022-00139-9
  5. Boeke CE, Gillman MW, Hughes MD, et al. Choline intake during pregnancy and child cognition at age 7 years. Am J Epidemiol 2013;177(12):1338-1347. doi:10.1093/aje/kws395
  6. Yang J, Kang Y, Cheng Y, et al. Maternal dietary patterns during pregnancy and congenital heart defects: a case-control study. Int J Environ Res Pub Health 2019;16(16). doi:10.3390/ijerph16162957
  7. World Health Organization, ed. WHO Recommendations on Antenatal Care for a Positive Pregnancy Experience. World Health Organization; 2016.
  8. CDC. Diet considerations for breastfeeding mothers. Centers for Disease Control and Prevention. Published February 10, 2020. https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/diet-and-micronutrients/maternal-diet.html  [Accessed August 5, 2020.