Micronutrient needs and supplementation strategies during pregnancy

Abstract

Introduction. Micronutrient deficiencies during pregnancy remain a major global public health concern, with implications for maternal health, fetal development, and long-term child outcomes. International organizations such as the WHO and FIGO have issued evidence-based guidelines on micronutrient supplementation, which are increasingly being adapted into national protocols. Material and methods. This narrative review was based on literature searches in PubMed, Scopus, Web of Science, and Google Scholar, covering January 2000 to May 2025. Peer-reviewed studies, systematic reviews, and clinical guidelines from WHO, FIGO, and the Moldovan Ministry of Health were included. The review focused on iron, folic acid, iodine, calcium, vitamin D, and selected trace elements. Results. Iron and folic acid emerged as the most consistently recommended supplements across guidelines, with proven efficacy in reducing maternal anemia and neural tube defects. Iodine and calcium are also emphasized, particularly in regions with documented dietary insufficiency. Moldova’s antenatal care protocol largely aligns with WHO and FIGO recommendations, prioritizing targeted over universal supplementation for nutrients beyond iron and folate. Evidence on routine supplementation with multivitamin complexes remains inconclusive. Conclusions. Evidence-based micronutrient supplementation is essential to optimizing pregnancy outcomes. Universal iron and folic acid supplementation remain the cornerstone of antenatal nutrition strategies. Conte