Nitrate-rich dietary supplementation during pregnancy: The pros and cons

•There is an increasing public interest and health claims regarding beneficial effects of NO3-rich supplements in pregnancy.•NO3-rich supplement is regarded as a tempting administration with fewer off-target effects in NO-deficient pregnant women.•NO3-rich supplements during pregnancy may be accompanied with a wide range of unexpected maternal and fatal adverse outcomes.•Using dietary inorganic NO3 as a common supplement during pregnancy is currently on a long way from bench to bedside. Inorganic nitrate (NO3) due to its potential endogenous conversion to nitric oxide (NO), is suggested as a compensatory fuel for disrupted NO pathways in the case of pathological stats during pregnancy. Dietary NO3-rich supplement in the NO-deficient pregnant women is now suggested as a more appealing choice with fewer off-target effects which can attenuate hypertension and preeclampsia, improve placental blood flow and subsequently enhance maternal and neonatal health. There is also an increasing public interest and common health claims regarding beneficial effects of NO3-rich dietary supplements like beetroot byproducts in pregnant women. Conversely, NO3-rich dietary supplementation during pregnancy may be accompanied with a wide range of unexpected maternal and fatal adverse outcomes such as methemoglobinemia, alteration in embryonic cells and malignant transformation, as well as thyroid disorders. In conclusion, use of dietary inorganic NO3 as a common supplement during pregnancy is currently on a long way from bench to bedside.