Prenatal nutrient gaps show 90% of pregnant US women are deficient in choline

Pregnant women are experiencing deficiencies in crucial prenatal nutrients, including choline, folate, and the omega-3 fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). In the US, 90% of women are deficient in choline, a crucial nutrient for a baby’s development and pregnancy health. 

“Many pregnant women in the US face significant nutrient gaps, with over 30–90% falling short on key nutrients including iron, folate, choline, and omega-3 fatty acids (DHA/EPA) from diet alone,” Devyani Chaturvedi, senior nutrition scientist at SmartyPants Vitamins, tells Nutrition Insight.

Among these, she highlights choline as one of the most significant and persistent gaps.

“Despite its critical role in fetal brain and spinal cord development, fewer than 10% of pregnant women meet recommended intake levels. Current guidance suggests 450–550 mg/day during pregnancy, yet typical diets and many prenatal supplements often fail to deliver adequate amounts, making choline a particularly overlooked but essential nutrient during this critical window.”

Pregnancy and nutrition

During early pregnancy, nutrition plays an instrumental role in supporting the development and differentiation of fetal organs, as the rapidly growing embryo relies heavily on maternal nutrient stores to fuel this process, explains Chaturvedi.

“At the same time, inadequate intake of key nutrients, particularly choline, alongside well-established essentials like folate and iron, remains common, contributing to unmet nutritional needs during a highly sensitive window of development.”

During early pregnancy, nutrition plays an instrumental role in supporting the development and differentiation of fetal organs.Choline may play an underappreciated role in regulating inflammation during pregnancy, according to a recent study. It found that higher recent dietary choline intake was associated with lower levels of inflammation in the third trimester.

Meanwhile, choline has also been shown in prior clinical trials to deliver long-term benefits for the baby’s cognitive health from supplementation in pregnancy. 

“Folate, choline, and iron are especially critical at this stage, given their roles in neural tube formation, brain and spinal cord development, and oxygen transport. These considerations align with a growing body of evidence highlighting the critical phase for neurodevelopment and the foundational role of nutrition during the first 1,000 days,” says Chaturvedi.

SmartyPants Vitamin’s formulation approach is informed by this integrative perspective, prioritizing clinically relevant nutrient levels and bioavailable forms such as folate as methylfolate and iron as Ferrochel to help address meaningful gaps.

“The goal is to deliver nutrients in forms and amounts that are not only effective, but also well tolerated for consistent, everyday use,” says Chaturvedi.

Women’s life stages

Women go through multiple hormonal shifts during life, which creates a need for different nutritional approaches.

Nutrition Insight recently sat down with Alisa Vitti, the creator of the Cycle Syncing Method, to discuss how menstrual health can be optimized through nutrition. She detailed how adapting nutrients and diet plans can optimize health for each phase, while underscoring the health benefits of prioritizing overall nutrition over pharmaceuticals to balance women’s infradian rhythms.

Chaturvedi says SmartyPants Vitamins also takes a life‑stage approach to women’s health: “Formulations are built around evidence‑based nutrient needs for each stage, with priority on bioavailable forms, tolerability, and practicality to support daily adherence.”

“In the prenatal stage, that translates to higher, clinically informed choline, methylated B‑vitamins, and tummy‑friendly iron in a two‑capsule format. The same development philosophy (science‑informed levels, forms the body prefers, third‑party testing) guides how we approach women’s products across other stages as well.”

Although geographical differences in nutrient gaps can vary depending on regional dietary patterns, the choline shortfall in the US is particularly well‑documented, says Chaturvedi.

“While other regions may differ based on local cuisine and available foods, our formulation strategy responds directly to the US landscape, where choline intake remains low. Designing Prenatal Plus Multivitamin Capsules around evidence‑based nutrient needs — starting with choline — ensures that the product aligns with the deficiencies most prominent in the population we serve.”

Prenatal nutrition growth

As prenatal nutrient guidance continues to evolve, choline has become increasingly recognized as a critical nutrient for early pregnancy.

The choline shortfall in the US is particularly well‑documented, says Chaturvedi.Transformations in prenatal nutrition are being driven by advancements in ingredient technology, innovative product formats, and a growing understanding of the nuanced needs of expecting parents. From formulation advances around essential vitamins to specialized ingredients, the industry is recalibrating to offer more targeted and personalized support.

“SmartyPants designed Prenatal Plus Multivitamin Capsules to directly address this gap, providing 480 mg of choline in a formula co‑developed with a board‑certified OB‑GYN and complemented by key nutrients like methylated folate, methylcobalamin, and gentle‑on‑the‑stomach Ferrochel iron,” details Chaturvedi.

Looking forward, Chaturvedi says SmartyPants’ Vitamins prenatal portfolio has long included the science‑backed Prenatal Multi and Omegas, and the company is continuing to expand within the category.

“Later this year, we will introduce a prenatal omega‑3 DHA gummy, offering additional targeted support during this critical life stage. This continued investment reflects our longstanding commitment to supporting families from the very beginning of life onward, consistent with the life‑stage mission that has defined SmartyPants since its founding,” she concludes.