A healthy diet and lifestyle is a pre requisite to a healthy pregnancy, however this is often not the case. Many pregnant women are overweight or clinically obese and this has been shown to increase their risk of major complications of pregnancy such a preeclampsia, intrauterine growth retardation, preterm birth and gestational diabetes. An adequate and balanced diet is important, as is the balance between macronutrients such as carbohydrates, fats and protein and the vitamins and essential trace elements needed to support metabolism. In this review, we look at the use of micronutrient supplements during pregnancy and examine the recommendations currently in place to guide the use of these products. We also present evidence that broad-spectrum micronutrients may have a beneficial effect in pregnancy and lower the incidence of preeclampsia and preterm labour, especially in overweight and obese women. Finally we focus on the essential trace element Selenium and present a strong case for its importance in maintaining mitochondrial function during oxidative stress which is generated in the placentae of women experiencing these complications of pregnancy. It can no longer be assumed that women are consuming an adequate and well balanced diet during pregnancy and the use of micronutrient supplements may potentially have positive effects on a healthy start to life. Globally, millions of women are currently taking these products each year and an opportunity exists to systematically determine their beneficial effect.