Not all prenatal vitamins are built the same. Folic acid gets the spotlight, but a handful of other important nutrients are often missing or low. Here's the short list, with the data behind it.
Written by Vita Globe Editorial Team | Reviewed against NIH Office of Dietary Supplements fact sheets and USPSTF/CDC guidance
What are most prenatal vitamins missing?
The usual gaps are choline, iodine, DHA and sometimes iron. The NIH says prenatal supplements typically contain little if any choline[1]. Of 59 best-selling prenatal multivitamins studied, only 34 contained iodine[2]. Whether DHA and iron are included varies by product[3]. Pregnancy needs are 450 mg of choline, 220 mcg of iodine and 27 mg of iron daily[1][2][3].
Caveat: "Missing from the pill" doesn't always mean missing from your diet. Eggs, dairy, seafood and iodized salt can cover some gaps, so review your whole diet with your OB or midwife.
Sources: NIH ODS (choline) · NIH ODS (iodine) · NIH ODS (iron) · NIH ODS (omega-3) · Verified 2026-09-27
In this article
Why is choline so often missing?
Choline is a nutrient involved in the baby's developing brain and spinal cord, and needs go up in pregnancy. The Adequate Intake is 450 mg a day in pregnancy and 550 mg a day while breastfeeding[1].
Yet the NIH says it plainly: prenatal dietary supplements typically contain little if any choline[1]. One likely reason is bulk. Choline is needed in hundreds of milligrams, which is hard to fit into a small tablet or gummy.
Food helps a lot here. One large hard-boiled egg has about 147 mg of choline[1]. Meat, fish, dairy and beans also contribute.
How many prenatals leave out iodine?
Iodine is needed to make thyroid hormones, which are important for the baby's brain development. The RDA rises to 220 mcg a day in pregnancy and 290 mcg while breastfeeding[2].
The American Thyroid Association recommends that people who are pregnant, planning pregnancy or breastfeeding take a supplement with 150 mcg of iodine a day, and the American Academy of Pediatrics advises at least 150 mcg plus iodized salt[2].
Even so, an analysis of 59 best-selling prenatal multivitamins from 2016–2017 found only 34 contained iodine, about 58%[2]. If your label has no iodine line, ask your provider whether you need a separate source.
Does your prenatal include DHA?
Some do, some don't, and some brands sell it as a separate add-on. DHA is an omega-3 fat concentrated in the brain and retina, and it builds up fastest in the third trimester[4]. An expert consensus suggests at least 200 mg of DHA a day during pregnancy and breastfeeding[5].
If your prenatal doesn't include DHA, you can get it from 8 to 12 ounces a week of lower-mercury fish[7] or a separate fish oil or algal oil supplement. See Do You Really Need DHA During Pregnancy? for the research.
What about iron?
Iron needs jump in pregnancy to an RDA of 27 mg a day[3]. The NIH reports that about 18% of pregnant women in the U.S. had iron deficiency in national survey data, rising to nearly 30% in the third trimester[3]. ACOG recommends low-dose iron supplementation starting in the first trimester[3].
Iron content varies from product to product, and some prenatals leave it out entirely. That isn't automatically wrong, since some people get iron separately on their provider's advice, but you should know which kind you have. Our post on prenatal gummies vs. pills goes deeper.
What about folic acid?
Folic acid is the nutrient prenatals are best known for, and it's the one with the strongest evidence. The USPSTF recommends 400 to 800 mcg of folic acid daily for people planning or able to become pregnant to help prevent neural tube defects[6]. It's still worth confirming the amount on your label.
The honest summary
- Choline is typically missing or very low[1].
- About four in ten top-selling prenatals studied had no iodine[2].
- DHA and iron vary a lot by product.
- Folic acid matters most early, so confirm the amount[6].
Here's a simple checklist to take to your next appointment:
| Nutrient | Daily target in pregnancy | Check your label for |
|---|---|---|
| Folic acid | 400–800 mcg supplement | Listed amount in mcg |
| Iodine | 220 mcg total (150 mcg supplement advised) | Is it listed at all? |
| Choline | 450 mg | Often absent or low |
| Iron | 27 mg | Present or not, and how much |
| DHA | At least 200 mg (expert consensus) | Included or separate |
For a broader label guide, see What to Look For in a Prenatal Gummy Vitamin.
Our option
Vita Globe Prenatal Fish Oil Gummies
Our Prenatal Fish Oil Gummies pair omega fatty acids from fish oil with vitamins that include folic acid (vitamin B9), in a raspberry and lemon chewable gummy. Suggested use is 2 gummies once daily; they're gluten-free, non-GMO and made without artificial colors or flavors. It includes omega fatty acids, which not every prenatal does, but it isn't a complete answer to every gap on this list. The exact DHA, EPA and folic acid amounts are on the Supplement Facts panel on the product page, so bring it to your OB or midwife. It contains fish, and it isn't a substitute for a prenatal vitamin your provider has recommended.
Frequently asked questions
Do I need a separate choline supplement?
Not necessarily. Eggs and other foods can cover a good share of the 450 mg target[1]. Ask your provider whether your diet is enough.
Is iodized salt enough iodine in pregnancy?
The AAP suggests both a supplement with at least 150 mcg of iodine and iodized salt[2]. Check whether your prenatal includes iodine.
Should my prenatal have iron?
Many people benefit from iron in pregnancy, and ACOG recommends low-dose iron supplementation[3]. Your provider can check your levels and tell you how much you need.
Are prescription prenatals better than over-the-counter ones?
Not automatically. What matters is what's in the formula. Compare labels with your provider rather than assuming one type is complete.
Is methylfolate better than folic acid?
Folic acid is the form behind the neural tube defect recommendation[6]. Talk with your provider if you've been told you need a different form.
Sources
- NIH Office of Dietary Supplements. Choline: Fact Sheet for Health Professionals. Updated June 2, 2022. ods.od.nih.gov
- NIH Office of Dietary Supplements. Iodine: Fact Sheet for Health Professionals. Updated November 5, 2024. ods.od.nih.gov
- NIH Office of Dietary Supplements. Iron: Fact Sheet for Health Professionals. Updated September 4, 2025. ods.od.nih.gov
- NIH Office of Dietary Supplements. Omega-3 Fatty Acids: Fact Sheet for Health Professionals. Updated September 20, 2026. ods.od.nih.gov
- Koletzko B, Lien E, Agostoni C, Böhles H, Campoy C, et al. The roles of long-chain polyunsaturated fatty acids in pregnancy, lactation and infancy: review of current knowledge and consensus recommendations. J Perinat Med. 2008;36(1):5-14. doi:10.1515/JPM.2008.001
- US Preventive Services Task Force. Folic acid supplementation to prevent neural tube defects: US Preventive Services Task Force reaffirmation recommendation statement. JAMA. 2023;330(5):454. doi:10.1001/jama.2023.12876
- U.S. Food and Drug Administration and U.S. Environmental Protection Agency. Advice about Eating Fish: For Those Who Might Become or Are Pregnant or Breastfeeding and Children Ages 1–11 Years. Updated March 5, 2024. fda.gov
About the Vita Globe Editorial Team
The Vita Globe Editorial Team researches and writes our wellness content, working from peer-reviewed research, systematic reviews and guidance from bodies such as the NIH and the FDA. We cite our sources inline and update articles when the evidence changes.
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. This article is for informational purposes only and is not a substitute for medical advice. Talk to your healthcare provider before starting any new supplement, particularly if you are pregnant, nursing, taking medication, or caring for a child.
