By: Talking Nutrition Editors
Research has long shown the benefits multiple micronutrient supplementation has for women in the preconception stage in low- and middle-income countries, by demonstrating how nutrients such as folic acid, vitamin D and B12 promote health in children subsequently conceived.3 The World Health Organization (WHO) currently recommends prioritizing multiple micronutrient and vitamin D supplements during pregnancy based on evidence in favor of these interventions. To investigate how effective these interventions are, researchers at Southampton University assessed the nutrient status of women from the preconception stage up to six-months postpartum to determine the effects of maternal supplementation during pregnancy.1
The new research found that over 90% of women planning a pregnancy had marginal or low levels of at least one critical nutrient like folate, riboflavin, vitamin B12 and vitamin D prior to pregnancy.1 As many as half of the women were deficient in vitamin D before pregnancy and 1/3 were marginally deficient in folate, highlighting the need for nutrient supplementation prior to pregnancy. Researchers were surprised to find such high levels of folate deficiency as it is well known that adequate folate status prior to pregnancy prevents neural tube defects. Having adequate omega-3 status prior to pregnancy is also important as women with low DHA intake or status early in pregnancy are at an increased risk of preterm birth.4
Insights from our most recent Maternal Health, Attitude and Behaviors Report validated the hypothesis that the researchers from Southampton demonstrated; that there is a significant gap in both nutrient levels and awareness among women trying to conceive.
The report found that while there was relatively high awareness of certain key preconception nutrients, like folic acid (62%), vitamin D (66%), and calcium (71%) among women trying to conceive, actual intakes were often inadequate.2 For example, even though 66% of women recognized the importance of vitamin D, according to the consumer report, 85% of women had insufficient status according to the Southampton study, highlighting the need to do more to raise awareness of the value of supplementation at the preconception stage.
The report also uncovered concerning gaps in both awareness and intake of other critical prenatal nutrients. Only 54% of women were aware of the importance of vitamin B12 during preconception, and less than half (45%) knew about the role of riboflavin. This lack of knowledge likely contributes to the widespread deficiencies seen in the Southampton research. Omega-3 DHA was another notable nutrient gap. Only 28% of women in the preconception stage were aware of the ingredient and its benefit, validating earlier research that found 98% of women have inadequate DHA intake.5 Overall, the report indicates that much more needs to be done to educate and support women with optimal preconception nutrition across a range of essential nutrients.
With the Southampton study demonstrating that the vast majority of women have marginal or low-levels of at least one critical nutrient, there’s never been a more vital time to develop nutritional supplements that support healthy pregnancies. dsm-firmenich provides a range of solutions that aim to give moms and babies a healthy start. For example, our highly bioavailable form of folate, Metafolin® , increases blood folate levels to a greater extent than folic acid.6 Furthermore, our premix offering allows us to tailor solutions to meet the nutrient gaps of specific populations, by combining vitamin and minerals to preserve efficacy and stability. An example of this is a multiple micronutrient supplement (MMS) tablet that can be combined with a multivitamin (MV) softgel containing DHA, offering a comprehensive solution for expectant mothers.
Meanwhile, algal-sourced omega-3s like life’sDHA® are designed to address the high prevalence of DHA insufficiency and provide clinically-validated benefits that can help prepare the body for conception and a healthy pregnancy. Premature birth remains the leading cause of death in children under five.7 DHA has a vital role to play in helping to reduce premature birth risk and support fetal cognitive development. Few nutrients provide such far-reaching benefits during pregnancy as DHA.
And for today’s sustainability- and health-conscious mother, algal-based DHA provides the option to support a healthier future for themselves, their baby and the planet.
The new study reveals a key insight: there is a gap in adequate intake, even for nutrients such as folic acid and vitamin D, which are both recognized by consumers and found in most prenatal supplements. This presents an opportunity for brands to not only increase the number of women taking supplements at the preconception stage, predominantly to ‘lower the risk of genetic defects, preterm births and neural tube defects’ for their baby,1 but also to address nutrient gaps and include DHA, which is key to support healthy pregnancies.
To achieve this, brands can develop targeted and effective supplements that fill nutritional voids. Specific formulation strategies for preconception include featuring folic acid at optimal neural tube prevention doses of 400-800 mcg,8 along with including at least 250mg/day of DHA from marine or algal sources.4 Delivery formats like gummies and jellies may also help overcome barriers around taste and convenience that impact adherence among preconception women.
Furthermore, brands can invest in educational initiatives to raise awareness about the importance of adequate nutrient intake during the preconception stage. By providing clear, science-backed information and guidance, brands can empower women to make informed decisions about their nutritional needs and encourage them to start taking supplements early on in their pregnancy journey.
Developing high-quality, insight-driven, innovative preconception supplements takes more than ingredients. It takes a partner.
Partner with us to leverage our maternal health insights, expert services, customized solutions and science-backed products to develop supplements that promote fertility, reduce risk of defects and establish the foundation for a healthy pregnancy. We’ll be there to reliably support you, from concept to consumer.
02 April 2024
8 min read
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1 Godfrey, K. M., Titcombe, P., El‐Heis, S., Albert, B. B., Tham, E. H., Barton, S. J., Kenealy, T., Chong, M. F., Nield, H., Chong, Y. S., Chan, S., & Cutfield, W. S. (2023). Maternal B-vitamin and vitamin D status before, during, and after pregnancy and the influence of supplementation preconception and during pregnancy: Prespecified secondary analysis of the NiPPeR double-blind randomized controlled trial. PLOS Medicine, 20(12), e1004260.
2 dsm-firmenich. Maternal Health, Attitude and Behaviour Report. 2023.
3 D’souza, Naomi, et al. Pre-conceptional Maternal Vitamin B12 Supplementation Improves Offspring Neurodevelopment at 2 Years of Age: PRIYA Trial. Front. Pediatric. Vol 9. 2021.
4 Cetin I, Carlson SE, Burden C, da Fonseca EB, di Renzo GC, Hadjipanayis A, Harris WS, Kumar KR, Olsen SF, Mader S, McAuliffe FM, Muhlhausler B, Oken E, Poon LC, Poston L, Ramakrishnan U, Roehr CC, Savona-Ventura C, Smuts CM, Sotiriadis A, Su KP, Tribe RM, Vannice G, Koletzko B; Clinical Practice Guideline on behalf of Asia Pacific Health Association (Pediatric-Neonatology Branch), Child Health Foundation (Stiftung Kindergesundheit), European Academy of Paediatrics, European Board & College of Obstetrics and Gynaecology, European Foundation for the Care of Newborn Infants, European Society for Paediatric Research, and International Society for Developmental Origins of Health and Disease. Omega-3 fatty acid supply in pregnancy for risk reduction of preterm and early preterm birth. Am J Obstet Gynecol MFM. 2024 Feb;6(2).
5 Zhang Z, Fulgoni VL, Kris-Etherton PM, Mitmesser SH. Dietary Intakes of EPA and DHA Omega-3 Fatty Acids among US Childbearing-Age and Pregnant Women: An Analysis of NHANES 2001-2014. Nutrients. 2018 Mar 28;10(4):416. doi: 10.3390/nu10040416. PMID: 29597261; PMCID: PMC5946201.
6 Henderson AM, Aleliunas RE, Loh SP, Khor GL, Harvey-Leeson S, Glier MB, Kitts DD, Green TJ, Devlin AM. l-5-Methyltetrahydrofolate Supplementation Increases Blood Folate Concentrations to a Greater Extent than Folic Acid Supplementation in Malaysian Women. J Nutr. 2018 Jun 1;148(6):885-890. doi: 10.1093/jn/nxy057. PMID: 29878267.
7 World Health Organization, ‘Preterm birth’, Preterm birth (who.int), 2023.
8 Folic Acid Supplementation to Prevent Neural Tube Defects, US Preventive Services Task Force Reaffirmation Recommendation Statement, US Preventive Services Task Force, August 2023.
