Appropriate lab work throughout pregnancy plays a critical role in identifying nutrient deficiencies and addressing potential health concerns for both mother and baby. Many essential nutrients and health markers that significantly impact maternal and fetal well-being can be overlooked in standard lab testing. This lack of comprehensive testing can result in missed opportunities to provide targeted support, leaving gaps in maternal and fetal health needs. A functional medicine approach highlights the value of proactive and individualized lab assessments to better understand and meet the unique needs of each stage of pregnancy, postpartum, and while breastfeeding, ultimately optimizing health outcomes.
Pre-pregnancy testing and blood work
Preparing for pregnancy involves understanding your baseline health and addressing any imbalances before you get pregnant. Here are the top lab tests we recommend advocating for during preconception:
25-Hydroxy vitamin DÂ
Vitamin D is a powerhouse nutrient that influences immune function, thyroid health, and fetal skeletal development. Low levels have been linked to preeclampsia, gestational diabetes, and low birth weight. Few realize the synergistic role of vitamin D with magnesium and vitamin K2 for optimal absorption and utilization. Testing 25-Hydroxy Vitamin D levels periodically throughout pregnancy and lactation is critical to ensure sufficiency.
Thyroid hormones panel
Thyroid health is critical for fertility, fetal brain development, and maternal metabolism. Recent research highlights that even mild thyroid imbalances can increase the risk of complications, such as miscarriage or preterm birth. Functional medicine practitioners recommend a full thyroid panel for a comprehensive view. This is particularly important given the prevalence of subclinical hypothyroidism in pregnancy. A full thyroid panel includes:
- Thyroid Stimulating Hormone (TSH)
- Free T4 and Free T3
- Reverse T3
- Thyroid Peroxidase Antibodies (TPOAb)
- Thyroglobulin Antibodies (TgAb)
Regular thyroid monitoring is especially essential for individuals with a history of autoimmune thyroid disorders or those on thyroid medications. Micronutrients, such as selenium and iodine, have a key role in maintaining thyroid function and can be found in WeNatal for Her.
WeNatal For Her
Iron and oxygenation
Iron is essential for preventing maternal anemia and ensuring adequate oxygen delivery to both mother and baby. However, focusing solely on serum iron is insufficient, as it doesn’t provide a complete picture of iron status. A full iron panel should include:
- Serum Iron
- Serum Ferritin
- Transferrin
- TIBC (Total Iron-Binding Capacity)
- UIBC (Unsaturated Iron-Binding Capacity)
Research also emphasizes the importance of addressing inflammation, as elevated markers like C-reactive protein (CRP) can interfere with iron metabolism.Â
Insulin and blood sugar regulationÂ
While screening for gestational diabetes in the second trimester is standard, earlier and more comprehensive testing is helpful to identify insulin resistance. Elevated insulin levels, even in the absence of diabetes, can disrupt ovulation and increase pregnancy risks. Ask your doctor to check:
- Fasting Insulin
- Fasting Glucose
- Hemoglobin A1c (a three-month average of blood sugar levels)
Nutrients like inositol and chromium in supporting insulin sensitivity.
MTHFR Gene Analysis
Variations in the MTHFR gene can significantly impact how folate, B12, and choline are processed and absorbed in the body. These nutrients are critical for reducing the risk of neural tube defects and preeclampsia. New research links MTHFR variations to an increased need for activated forms of these nutrients, such as methylfolate and methylcobalamin. While this genetic analysis only needs to be done once, it provides valuable insights for personalized supplementation and preconception planning.
Additional considerations
Recent advances in functional nutrition emphasize the importance of omega-3 fatty acids, particularly DHA, for fetal brain development and maternal mental health. Testing for omega-3 index levels can guide supplementation. Emerging research also explores the role of microbiome diversity, emphasizing the gut-fertility connection. Testing for markers like zonulin and calprotectin can provide insights into gut integrity and inflammation.
First trimester pregnancy blood work
During early pregnancy, foundational testing focuses on assessing nutrient sufficiency and detecting any pre-existing or emerging issues. Recommended labs include:
- Thyroid Panel: Full panel as above
- Iron Panel: Full panel as above
- Vitamin D: 25-Hydroxy Vitamin D
- Blood Sugar Regulation:
-Fasting Insulin
-Fasting Glucose
-Hemoglobin A1c
- Early Pregnancy Markers:
-Progesterone
-hCG (Human Chorionic Gonadotropin)
- Inflammatory Markers: CRP (as mentioned above)
- Essential Nutrients:
-Vitamin B12
-Folate
-Choline
-Magnesium
Second trimester pregnancy blood work
The focus shifts to monitoring growth, detecting gestational diabetes risk, and supporting fetal development:
- Gestational Diabetes Screening:
-Fasting Insulin
-Fasting Glucose
-Hemoglobin A1c
-Oral Glucose Tolerance Test (OGTT), if indicated
- Thyroid Panel: Full panel as above
- Iron Panel: Full panel as above
- Vitamin D: 25-Hydroxy Vitamin D
- Omega-3 Index (to monitor DHA levels)
- Inflammatory Markers: CRP
- Electrolytes and Minerals: Magnesium, Calcium, Potassium
Third trimester pregnancy blood work
As delivery approaches, testing focuses on preparing for labor and postpartum recovery:
- Thyroid Panel: Full panel as above
- Iron Panel: Full panel as above
- Vitamin D: 25-Hydroxy Vitamin D
- Blood Sugar Monitoring: Fasting Glucose, Hemoglobin A1c
- Inflammatory Markers: CRP
- Omega-3 Index
- Group B Strep Screening: Standard in conventional and functional care
Postpartum blood work
After delivery, maternal health and recovery become the priority to replenish nutrient stores and prevent postnatal depletion. Testing focuses on hormonal balance, nutrient replenishment, and inflammation:
- Thyroid Panel: Full panel as above (postpartum thyroiditis screening)
- Iron Panel: Full panel as above (monitor for postpartum anemia)
- Vitamin D: 25-Hydroxy Vitamin D
- Inflammatory Markers: CRP
- Essential Nutrients:
-Vitamin B12
-Folate
-Magnesium
-Omega-3 Index
- Hormonal Testing:
- Progesterone
- Estrogen (Estradiol)
A note from WeNatal on pregnancy blood work
Comprehensive testing throughout preconception, pregnancy, and postpartum ensures individualized care and optimal outcomes for both mother and baby. Focusing on identifying and addressing imbalances early can significantly enhance maternal and fetal health. At WeNatal, we believe in empowering families with the tools and resources needed to thrive during this transformative journey.Â
Our mission is to bring hope and health to every stage of pregnancy by providing high-quality, targeted prenatal supplements for both women and men, designed to support optimal outcomes. With the right information and support, you can take charge of your health and confidently prepare for parenthood. WeNatal is here to stand by your side, offering science-backed solutions to help you and your baby flourish. If you are in need of a practitioner to help support you along the way be sure to check out our Practitioner Database.Â
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