Episode Details

Episode 111: Pregnancy FAQ  

Dr. Urso answers commonly asked questions during pregnancy.  

You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.

Written by Carmen Urso, MD. Edited by Hector Arreaza, MD.

Pregnancy is one of the most exciting moments of a woman’s life, but at the same time, it could be a little scary because whatever the mother does may affect the baby. This is why it is so important to make sure about general recommendations during pregnancy. The information I present here is evidence-based. 

1. Should I take prenatal vitamins?

The goal of prenatal supplements is to provide the vitamins and minerals needed to promote normal fetal development. Some studies have shown that in high-income countries where the food is vitamin-fortified, and typically people are well-nourished, vitamin supplementation has not proved to improve maternal and neonatal outcomes. However, a Cochrane review of randomized trials in low- and middle-income countries with vitamin and mineral diet deficiency found that supplementation reduces the risk of low birth weight and small for gestational age. Because you don’t always know the nutritional status of a patient, it is advised to use a standard prenatal vitamin. 

What are the most important vitamins in the prenatal period? 

The 2 most important elements are folic acid and iron, which can be found in regular prenatal vitamins. The American College of Obstetrics and Gynecology (ACOG) recommends multivitamins with: 

-Folic acid: 400mcg to 800mcg daily to reduce the risk of neural tube defects. It is recommended to start before pregnancy until the end of the first trimester (12 weeks). Patients with a history of fetal neural tubal defect should take 4000 mcg (4mg) daily. The USPSTF recommends (Grade A, 2017) to supplement with folic acid for all women of childbearing before pregnancy. Supplementation should start at least one month before pregnancy, according to CDC. 

-Iron: 30 mg/day to prevent maternal anemia. The formulation should contain 15-30 mg/dl. Most prenatal contain about 30 mg, which is considered a “low” dose, and 65 mg of elemental iron is equivalent to 325 mg of ferrous sulfate, which is a common supplement given to patients in our clinics. So, patients could take one tablet of 325 mg of ferrous sulfate daily and have enough for their pregnancy, or take it every other day if they are intolerant to iron]

-Vitamin D: Vitamin D deficiency is associated with preterm birth and preeclampsia. 200-600 international units are recommended. ACOG does not recommend screening for vitamin D deficiency before or during pregnancy. The USPSTF concluded there is insufficient evidence to recommend for or against Vitamin D deficiency screening in asymptomatic adults. This is a Grade I recommendation.

-Calcium: Supplements should contain 1000 mg/dL. Most multivitamins have 200-300mg; the rest of the daily calcium should come from dietary sources. Foods rich in calcium include dairy products such as milk, yogurt, cheese, soybeans, seeds, beans, lentils, and dark-green leafy vegetables like kale, spinach, and collard greens. Another source of vitamin D is sun exposure. We do not recommend sun exposure as a source of vitamin D, but there are benefits to sun exposure for other reasons, for example, mood.

2. Should I be eating for 2 while I am pregnant?

It is a misconception. Pregnant women do not have to eat for 2. Caloric intake will depend on the number of fetuses (single or multiple), the trimester, and the pre