Clinical Applications of Flavonoids in Pregnancy: Potential Therapeutic Strategies for Gestational Disorders—An Update

Gestational disorders, including pre-eclampsia, gestational diabetes mellitus, and fetal growth restriction, represent major maternal–fetal health challenges, with limited pharmacological options that can be used safely throughout pregnancy. Flavonoids, a diverse group of plant-derived polyphenols, exert antioxidant, anti-inflammatory, and vasoprotective effects in preclinical models. Translational evidence from these mechanistic studies has increased interest in their potential role in maternal–fetal health. This narrative review evaluates the clinical evidence regarding maternal flavonoid exposure across preconception care, pregnancy complications, postpartum recovery, and offspring health. A comprehensive literature search identified thirteen studies published within the past five years, comprising randomized controlled trials, meta-analyses, and evidence from major prospective birth cohorts. Available clinical evidence suggests that higher dietary intake of flavonoid-rich fruits, berries, and vegetables is associated with a lower risk of gestational diabetes, gestational hypertension, and small-for-gestational-age births. Clinical studies of targeted supplementation with specific compounds, including quercetin, epigallocatechin gallate, and botanical extracts, have reported potential benefits in selected clinical settings, including endocrine and reproductive outcomes in women with polycystic ovary syndrome, blood pressure management in pre-eclampsia, and postpartum or post-cesarean pain. Furthermore, maternal flavonoid exposure has been associated with differences in offspring immune development and a potentially lower incidence of food allergies in early childhood. Overall, current clinical evidence supports further investigation of dietary flavonoid intake and selected flavonoid-based interventions in maternal–fetal medicine. Overall, while current evidence strongly supports habitual consumption of a varied, plant-rich diet naturally high in flavonoids during pregnancy, clinical data remain insufficient to recommend routine high-dose isolated flavonoid supplementation in standard obstetric practice.