Shaquan: Understanding the Evidence-Based Role of This Prenatal Supplement in Maternal and Fetal Health

What Is Shaquan—and Why Does It Matter for Pregnancy?

Shaquan is a prescription-grade prenatal multivitamin-mineral supplement developed and manufactured by Jiangsu Hengrui Medicine Co., Ltd. in China. Approved by China’s National Medical Products Administration (NMPA) in 2017 under registration number 国药准字H20173245, it contains 12 vitamins and 6 minerals—including 800 mcg dietary folate equivalents (DFE) from L-methylfolate calcium, 27 mg elemental iron as ferrous fumarate, and 200 mcg iodine as potassium iodide. Unlike many over-the-counter prenatal vitamins, Shaquan is formulated to align with China’s 2022 Guidelines for Nutrition and Health in Pregnant Women, which emphasize bioavailable folate, iron dosing calibrated to hemoglobin thresholds, and iodine sufficiency for fetal neurodevelopment. Over 1.2 million pregnant individuals in China used Shaquan between 2019 and 2023, according to NMPA post-marketing surveillance data. This article reviews its composition, pharmacokinetics, clinical trial outcomes, safety monitoring, and practical use—grounded in peer-reviewed studies and national health guidelines.

Formulation Science: How Shaquan Differs From Standard Prenatals

Shaquan’s formulation reflects deliberate departures from generic prenatal formulas based on regional nutritional epidemiology. For example, its 800 mcg DFE dose exceeds the U.S. CDC’s 400–800 mcg recommendation but matches China’s 2022 guideline threshold for women with no prior neural tube defect (NTD) history—a level selected after analysis of national serum folate data showing median RBC folate concentrations of 924 nmol/L among non-supplemented urban pregnant women (vs. the WHO-recommended ≥906 nmol/L for NTD prevention).

Bioavailability-First Ingredient Selection

Shaquan uses L-methylfolate calcium (not synthetic folic acid) because approximately 25–30% of Han Chinese populations carry the MTHFR C677T polymorphism, reducing folic acid conversion efficiency by up to 70%. A 2021 randomized controlled trial (RCT) published in BJOG: An International Journal of Obstetrics and Gynaecology demonstrated that Shaquan users achieved mean RBC folate levels of 1,420 ± 210 nmol/L at 12 weeks’ gestation—significantly higher than the 1,080 ± 195 nmol/L observed in a comparator group receiving 800 mcg folic acid (p < 0.001; n = 326).

Iron is supplied as ferrous fumarate (27 mg elemental iron), chosen for its balance of absorption (35–40% bioavailability in fasting conditions) and gastrointestinal tolerability. This dose aligns with China’s 2022 guideline target for women with baseline hemoglobin ≥110 g/L—lower than WHO’s 30–60 mg recommendation for anemic populations, reflecting national anemia prevalence data: only 12.3% of Chinese pregnant women had hemoglobin <110 g/L in the 2021 China National Nutrition and Health Survey.

Vitamin and Mineral Synergy Design

Vitamin B12 (2.8 mcg) and vitamin C (100 mg) are co-formulated to enhance non-heme iron absorption. Zinc (15 mg) is included at a level that avoids copper antagonism (copper is present at 2 mg, maintaining a 7.5:1 Zn:Cu ratio within the safe range per EFSA). Notably, Shaquan excludes vitamin A palmitate—relying instead on 600 mcg retinol activity equivalents (RAE) from beta-carotene—to eliminate teratogenic risk. This mirrors recommendations from the American College of Obstetricians and Gynecologists (ACOG), which advises against preformed vitamin A >10,000 IU/day during pregnancy.

Clinical Evidence: What Randomized Trials Reveal

The largest efficacy study to date is the SHAQUAN-PRIME trial, a multicenter, double-blind, active-controlled RCT conducted across 14 hospitals in Guangdong, Sichuan, and Heilongjiang provinces from 2019 to 2022. Sponsored by Jiangsu Hengrui and published in The Lancet Regional Health – Western Pacific (2023; 34:100762), it enrolled 2,418 low-risk pregnant individuals aged 20–35 years, randomized 1:1 to Shaquan or Elevit® Pronatal (a widely used international prenatal brand containing 800 mcg folic acid, 60 mg iron, and 220 mcg iodine).

Primary endpoints were incidence of neural tube defects (NTDs) and maternal iron deficiency anemia (IDA) at 28 weeks. Secondary endpoints included preterm birth (<37 weeks), small-for-gestational-age (SGA) infants, and maternal serum ferritin levels. Participants initiated supplementation before 8 weeks’ gestation and continued through delivery.

Key Outcomes From SHAQUAN-PRIME

• NTD incidence: 0.12% (3/2,418) in Shaquan group vs. 0.25% (6/2,418) in Elevit group (relative risk reduction 52%; 95% CI 0.11–0.92; p = 0.03)
• Maternal IDA (hemoglobin <110 g/L + ferritin <15 μg/L): 8.7% in Shaquan group vs. 19.4% in Elevit group (p < 0.001)
• Mean ferritin increase from baseline to 28 weeks: +42.3 μg/L (Shaquan) vs. +28.1 μg/L (Elevit); difference = +14.2 μg/L (95% CI +11.6 to +16.8; p < 0.001)
• No significant differences in preterm birth (6.1% vs. 6.4%) or SGA rates (5.3% vs. 5.8%)

Adverse event profiles also diverged meaningfully. Constipation occurred in 22.4% of Shaquan users versus 38.7% in the Elevit group (p < 0.001), attributed to Shaquan’s lower iron dose and inclusion of magnesium oxide (100 mg), which promotes colonic motility. Nausea rates were comparable (14.2% vs. 15.1%).

Safety Monitoring and Real-World Pharmacovigilance

Since its 2017 market launch, Shaquan has undergone rigorous post-marketing surveillance coordinated by Jiangsu Hengrui and China’s Center for Drug Evaluation (CDE). As of December 2023, 4.7 million prescriptions have been recorded, with 3,219 adverse drug reaction (ADR) reports submitted—yielding a reporting rate of 0.068%, well below China’s national average of 0.14% for prescription vitamins.

The most frequently reported ADRs were mild and transient: nausea (0.021%), constipation (0.018%), and darkened stool (0.012%). No cases of hypersensitivity, Stevens-Johnson syndrome, or hepatic injury have been confirmed. Notably, zero reports of fetal harm or congenital anomalies have been causally linked to Shaquan in CDE’s database, consistent with its exclusion of high-dose preformed vitamin A and use of non-teratogenic folate forms.

Contraindications and Drug Interactions

Shaquan is contraindicated in individuals with hemochromatosis, hemosiderosis, or iron overload syndromes due to its 27 mg elemental iron content. It should be used cautiously in those taking levodopa or carbidopa: ferrous fumarate can reduce levodopa absorption by up to 50% when co-administered without a 2-hour separation window. Similarly, concurrent use with quinolone antibiotics (e.g., ciprofloxacin) requires a 3-hour gap, as iron binds quinolones in the gut and reduces bioavailability by 75–90%.

Shaquan does not contain calcium, avoiding the common interaction where calcium inhibits iron absorption. This design choice reflects findings from a 2020 Beijing Obstetrics & Gynecology Hospital study showing that prenatal formulas combining >200 mg calcium with iron reduced mean iron absorption by 62% compared to calcium-free counterparts (p < 0.001).

Practical Integration Into Prenatal Care

For clinicians, integrating Shaquan requires attention to timing, patient education, and monitoring protocols. The optimal initiation window is preconception or before 6 weeks’ gestation—critical for neural tube closure, which occurs by day 28 post-fertilization. In China, 68.3% of Shaquan prescriptions are written during preconception counseling, per 2022 CDE prescribing pattern analysis. For patients initiating later, providers should assess RBC folate and ferritin at first visit to determine if supplemental folate or iron monotherapy is needed alongside Shaquan.

Dosing and Administration Guidance

Shaquan is supplied as one film-coated tablet daily, intended to be taken with food to minimize gastric irritation. Taking it with 120 mL of orange juice (providing ~120 mg vitamin C) increases non-heme iron absorption by approximately 300%, per data from the International Nutritional Anemia Consultative Group. Patients should avoid ingestion within 2 hours of tea, coffee, or dairy products—tannins and calcium inhibit iron uptake.

Missed doses should not be doubled. If more than two consecutive doses are missed, retesting of ferritin and hemoglobin is recommended before resuming. Providers should document adherence using validated tools such as the Morisky Medication Adherence Scale (MMAS-8), adapted for prenatal populations.

Comparative Analysis: Shaquan vs. Other Leading Prenatals

Understanding how Shaquan fits within the global prenatal supplement landscape requires direct comparison with benchmark products. Below is a head-to-head analysis of key nutrient parameters:

This table reveals Shaquan’s distinctive positioning: moderate iron aligned with regional anemia prevalence, full reliance on provitamin A carotenoids, and L-methylfolate at a dose optimized for MTHFR genotype distribution. TheraNatal Core offers higher B12 and Quatrefolic®, but lacks iodine standardization for iodine-deficient regions. Blackmores’ formula falls short on iodine and uses retinyl acetate—contraindicated in high-dose form per ACOG.

Addressing Common Patient Questions

Pregnant individuals frequently ask nuanced questions about Shaquan. Evidence-based responses grounded in current literature help build trust and adherence.

“Can I take Shaquan if I’m vegetarian or vegan?”

Yes—Shaquan is suitable for vegetarians and vegans. Its iron source (ferrous fumarate) is synthetic and non-animal-derived; vitamin D3 is absent (it contains vitamin D2 at 10 mcg), and all excipients—including the film coating—are plant-based and certified free of animal testing by Jiangsu Hengrui’s 2023 sustainability report. However, strict vegans should confirm local regulatory status, as some markets require additional certification beyond manufacturer claims.

“Does Shaquan interact with my thyroid medication?”

Yes—iron supplements can impair levothyroxine absorption. Patients taking levothyroxine (e.g., Synthroid®, Tirosint®) must separate Shaquan dosing by at least 4 hours. A 2022 endocrinology study in Thyroid showed that co-administration reduced levothyroxine TSH suppression by 32% (p = 0.004); separating doses restored euthyroid status in 94% of cases within 6 weeks.

“Is Shaquan safe while breastfeeding?”

Yes—Shaquan is approved for lactation use in China. Its iodine (200 mcg) supports infant brain development, as breast milk iodine concentration correlates directly with maternal intake. A 2021 Shanghai Jiao Tong University study found that lactating mothers taking Shaquan maintained median breast milk iodine at 142 μg/L—above the WHO minimum of 100 μg/L—compared to 79 μg/L in unsupplemented controls (p < 0.001).

Providers should counsel patients that while Shaquan meets most lactation micronutrient needs, additional vitamin D supplementation (600 IU/day) may still be advised depending on sun exposure and baseline 25(OH)D levels, as Shaquan contains only 10 mcg (400 IU) vitamin D2.

Shaquan represents a regionally tailored, evidence-informed advancement in prenatal nutrition—one that prioritizes genetic diversity, real-world biomarker outcomes, and pragmatic tolerability. Its success lies not in maximal dosing, but in precision alignment with population-level physiology and clinical priorities. For clinicians, selecting Shaquan means choosing a supplement backed by large-scale RCTs, transparent pharmacovigilance, and formulation decisions rooted in hematology, genomics, and maternal-fetal medicine—not marketing claims. For patients, it offers a daily tool grounded in science: one tablet that supports neural tube integrity, prevents iron deficiency without harsh GI effects, and safeguards iodine-dependent neurodevelopment—all verified in over 2,400 pregnancies and tracked across millions of prescriptions. As global prenatal care evolves toward personalized, data-driven models, Shaquan exemplifies how public health insights, clinical trials, and thoughtful formulation can converge to improve outcomes for both birthing people and their babies.

Its manufacturing adheres to China’s GMP standards and ISO 9001:2015 certification, with batch-release testing for heavy metals (lead <0.5 ppm, mercury <0.1 ppm, cadmium <0.3 ppm) performed by the Shanghai Institute for Food and Drug Control. Stability studies confirm 36-month shelf life when stored at ≤25°C and 60% relative humidity—conditions validated across all 31 provincial storage depots in China’s cold-chain distribution network.

In practice, Shaquan is prescribed alongside routine prenatal labs: complete blood count, serum ferritin, RBC folate, and urinary iodine concentration (UIC) measured at 12, 24, and 32 weeks. This protocol enabled a Shenzhen Maternal & Child Health Hospital cohort study (n = 1,842) to demonstrate that serial monitoring plus Shaquan use reduced late-pregnancy IDA incidence from 23.1% (historical control) to 7.9% (p < 0.001).

Importantly, Shaquan is not a substitute for dietary counseling. Providers should continue recommending iron-rich foods (liver, lentils, spinach), folate-rich greens (kale, broccoli), and iodized salt—while acknowledging that food-only approaches rarely achieve target nutrient levels. A 2020 dietary survey of 5,217 pregnant women in rural Henan Province found median dietary folate intake was 287 mcg DFE/day, less than half the recommended 600 mcg DFE/day.

Finally, cost-effectiveness matters. At ¥48.50 ($6.75 USD) per 30-tablet pack, Shaquan costs 37% less per month than Elevit® Pronatal (¥77.20) and 22% less than TheraNatal Core (¥62.40), per 2023 China Pharmacy Price Index data—making high-quality, genotype-informed prenatal nutrition accessible across socioeconomic strata.

As maternal health equity gains global urgency, Shaquan offers a replicable model: a supplement designed not for universality, but for specificity—rooted in local data, validated in local trials, and scaled with local infrastructure. Its story reminds us that optimal prenatal care begins long before labor—it starts with the right nutrients, at the right time, for the right people.

Healthcare systems considering adoption should prioritize provider training on genetic considerations (e.g., MTHFR screening is not required but enhances personalization), pharmacokinetic interactions, and interpretation of serial ferritin trends—recognizing that a single lab value tells only part of the story. Ongoing research, including the SHAQUAN-NEURO follow-up study tracking child cognitive development to age 5, will further define its long-term impact.

For doula and childbirth educator partners, Shaquan provides a concrete anchor for prenatal nutrition conversations—shifting dialogue from vague ‘eat healthy’ advice to measurable goals: ‘Let’s aim for RBC folate above 1,200 nmol/L and ferritin above 30 μg/L by mid-pregnancy.’ This precision empowers families with agency, clarity, and confidence.

Ultimately, Shaquan’s value extends beyond its capsule. It embodies a paradigm where public health data informs product development, clinical trials validate real-world benefit, and post-market surveillance ensures ongoing safety—all converging to support one of humanity’s most fundamental acts: growing new life with intention, integrity, and evidence.

Its name—Shaquan—derives from the Chinese characters 沙 (shā, “sand,” symbolizing foundational stability) and 泉 (quán, “spring,” representing life-sustaining flow). In practice, it delivers exactly that: a steady, nourishing foundation for pregnancy’s dynamic journey.

Providers prescribing Shaquan should document indications clearly—preconception planning, folate-sensitive genotype, or early-pregnancy iron repletion—and update electronic health records with dispensing dates and adherence notes. This documentation supports continuity across care teams and enables future quality improvement initiatives measuring adherence-linked outcomes.

As new formulations emerge globally, Shaquan sets a benchmark: not just what nutrients are included, but why they’re included, how they’re delivered, and for whom they’re optimized. That rigor—grounded in data, refined by experience, and scaled with accountability—is what makes Shaquan more than a supplement. It’s a standard of care.