Dietary Supplements in the Perinatal Period.

The physiologic changes of pregnancy, in addition to the nutritional needs of the growing fetus, require supplementation and dietary changes during pregnancy. Additional macronutrient needs include protein and polyunsaturated fatty acids. Micronutrients also have important roles in supporting maternal health and fetal development, including vitamins A, D, C, B 6 , B 12 , and K, in addition to iodine, iron, choline, zinc, calcium, and folate. The most common form of supplementation in pregnancy is oral prenatal vitamins, although these can vary in their composition and inclusion of certain micronutrients. Nutrient supplementation also varies according to prepregnancy medical conditions and diagnoses made during pregnancy. Examples of some conditions that require modified supplementation include anemia, multiple gestation, history of bariatric or gastrointestinal surgery, and a personal history or pregnancy history of neural tube defects. Finally, significant socioeconomic drivers of health shape access to adequate prepregnancy and perinatal nutrition, and targeted interventions, including supplementation, may be necessary to address these disparities.