Evidence-based recommendations for dietary supplementation during pregnancy

Background - Micronutrient deficiencies in pregnant women are linked to serious health issues, including conception difficulties, spontaneous abortions, preterm births, low birth weight, birth defects and long-term metabolic disorders. Despite the recognized importance of dietary supplementation during pregnancy, rigorous research and supplementation monitoring remain limited. Objective - This study aimed to review the evidence on the impact of dietary supplementation on maternal and infant outcomes and to provide evidence-based recommendations for dietary supplementation during pregnancy. Methods - A systematic search, analysis, and synthesis of randomized controlled trials (RCTs) were conducted between October and January 2022. Databases searched included PubMed, CINAHL with Full Text, Google Scholar and CrossRef. The study adhered to PRISMA guidelines and applied inclusion and exclusion criteria to identify relevant studies. A total of 51 RCTs were included and assessed for quality, categorizing articles as moderate or high quality. Results - Of the 51 RCTs analyzed, 47 (92.16%) were of moderate quality, and 4 (7.84%) were of high quality. Findings revealed that recommended dietary supplementation doses for pregnant women are often set well below safety thresholds. Evidence supporting the efficacy of certain vitamins and minerals in pregnancy remains inconclusive. The study highlighted a dose–response conundrum, with an emphasis on identifying effective and safe doses. Conclusion - Micronutrient deficiencies in pregnant women pose significant risks to maternal and infant health. Current dietary supplementation recommendations require enhancement and alignment with the latest and most robust evidence. This study provides a comprehensive overview of state-of-the-art evidence and underscores the importance of bridging gaps in supplementation guidelines to optimize maternal and infant health outcomes.