Aim. Pregnant women require different nutritional intake such as folic acid, iron and cholecalciferol, and specific vaccination to prevent fetal abnormalities and improve outcomes.. This study aims to analyze usage trends for these recommended drugs over the last decade, and to identify maternal factors associated with their use. Methods. The nationwide cross-sectional study is based on data from the French national administrative health database, including pregnancies from 2012 to 2022. Folic acid, iron, cholecalciferol, and influenza vaccination use were analyzed according to the relevant periods based on WHO and French guidelines. Multivariable logistic regression assessed maternal characteristics associated with drug use. Results. Analyzing 8,979,173 pregnancies, the study found that 46.0% of pregnancies used folic acid during the periconceptional period, rising from 33.8% in 2012 to 52.6% in 2022. Women with chronic disease and higher financial resources were more likely to use it. 64.1% used iron during pregnancy with exposure increasing with age. 35.5% used cholecalciferol, with higher socioeconomic status associated with increased use. Only 5.1% were vaccinated against influenza, with the rate increasing until 2020, before declining. Vaccination was positively associated with maternal age, the presence of a chronic disease, and higher financial resources. Conclusion. This study revealed increasing trends of use in recommended drugs during pregnancy over the last decade, although overall prevalence remains not optimal, and concerning for influenza vaccination. The identified risk factors for non-use include young maternal age, low income, and deprived areas, emphasizing the need for targeted interventions to improve maternal health outcomes.