A fresh life develops within the body during pregnancy, requiring increased nutrients and vitamins. Folic acid, or folate, is particularly crucial during this time, leading many expectant mothers to supplement their intake. Here’s an overview of the increased daily requirements for various vitamins. Which vitamins does the German Nutrition Society (DGE) recommend supplementing?
Pregnancy Vitamins: Why the Body Needs Certain Vitamins
Vitamin needs significantly increase during pregnancy, and it can be difficult to meet these needs through diet alone, making supplementation vital. Pregnant individuals are advised to take folic acid and iodine. Iron supplementation is also often recommended, depending on the mother’s iron levels, as the developing fetus has high iron requirements. Blood iron levels should be checked during prenatal care. These vitamins and nutrients are needed for the following functions during pregnancy:
- Calcium: Bone structure development
- Folic Acid: Maternal tissue growth, nervous system development
- Docosahexaenoic Acid (DHA): Brain, nerve, and eye development
- Iodine: Thyroid hormone development, growth, and healthy organ development
- Iron: Important for fetal brain development
In addition to folic acid, all other B vitamins play a central role in a pregnant person’s body and for the developing fetus. Vitamins B1 through B5 are essential for energy metabolism and support normal cognitive function. Vitamin B7 is needed for maintaining healthy skin and hair, and vitamin B12 is crucial for cell division and a normal immune system function. Magnesium may help prevent cramps and premature labor during pregnancy, and vitamin D is needed for bone development. Docosahexaenoic acid is an unsaturated fatty acid that may positively influence memory and is primarily obtained through fish products.
Vitamin Supplementation During Pregnancy: When is it Beneficial?
Though Germany generally doesn’t experience widespread vitamin and nutrient deficiencies due to balanced diets, some nutrients are more commonly lacking in the population. These deficiencies are common in Germany.
According to the Robert Koch Institute, 29.7% of women in Germany are deficient in vitamin D. The Techniker Krankenkasse reports that 86% of women have insufficient folic acid levels. As the Federal Ministry of Food and Agriculture states, 30% of women in Germany do not meet the average daily iodine requirement.
Self-diagnosis and self-treatment with supplements should be avoided during pregnancy, and generally. Only blood tests and consultation with a doctor can determine if a deficiency exists. The idea that “more is better” does not apply here. The water-soluble B vitamins and vitamin C are usually excreted in the urine if taken in excess, but caution is advised with an overdose of fat-soluble vitamins like vitamin D.
Pregnancy Vitamins: Why Should Pregnant Individuals Take Folic Acid?
The nervous system develops in the fetus during the first few weeks of pregnancy. The body needs sufficient folate, or folic acid, for cell growth to prevent birth defects. 86% of women in Germany have a mild folic acid deficiency, which is why the DGE recommends taking folic acid even when planning a pregnancy. In addition to a folate-rich diet, 400 micrograms of folic acid per day should be taken as a supplement. According to the Federal Institute for Risk Assessment, this can reduce the risk of neural tube defects. It’s important to note that “folic acid” refers to the synthetically produced form of folate, which the body absorbs differently than naturally occurring food folate. The daily requirement is also indicated in folate equivalents.
Why Should Individuals Take Iodine During Pregnancy?
Iodine is an essential trace element for the body. It enters the food chain through the soil, but the iodine content in German soil is generally low. Iodized salt is used to ensure adequate intake. From the 12th week of pregnancy onwards, iodine prophylaxis is recommended due to the increased maternal basal metabolic rate, as reported by the Ärzte Zeitung (German Medical Journal). Since the average iodine intake from food is about 120 micrograms per day, the gap should be covered with iodine tablets. According to the Ärzte Zeitung, the intake should be 100 micrograms per day. Supplementation should always be discussed with a doctor.
Iodine deficiency during pregnancy increases the risk of miscarriage and stillbirth. Infants also require sufficient iodine for thyroid hormone formation. According to the MSD Manual, prolonged iodine deficiency during pregnancy can cause birth defects in affected babies, including deafness, muteness, or stunted growth.
Vitamin Deficiency During Pregnancy: What Can Happen?
Iodine deficiency during pregnancy increases the risk of:
- Miscarriage and stillbirth
- Intellectual disability
- Birth defects in the baby
Folate deficiency during pregnancy increases the risk of:
- Congenital malformations affecting the brain or spinal cord, known as neural tube defects.
- Spina bifida, commonly known as “open spine,” is the most common.
Other deficiency symptoms:
- A calcium deficiency can manifest as dental developmental problems in children.
- Vitamin B6 deficiency can cause seizures in infants.
A vitamin B12 deficiency can cause the following symptoms in infants:
- Developmental delays
- Low blood pressure
- Tremors or seizures
Vitamin Needs During Pregnancy: Which Vitamins Have Increased Daily Requirements?
According to the DGE, pregnant and breastfeeding individuals have increased daily requirements for almost all vitamins – except vitamin D and vitamin K. The daily requirements for pantothenic acid (vitamin B5) do not increase during pregnancy, but breastfeeding individuals should consume 7 mg instead of 5 mg per day. The same applies to biotin (vitamin B7), where the requirement only increases slightly from 40 micrograms to 45 micrograms during breastfeeding. Here’s an overview:
- Pregnant: 800 µg-activity equivalent per day
- Breastfeeding: 1300 µg-activity equivalent per day
- Regular daily requirement for adults: 700 µg-activity equivalent per day
- Pregnant: 13 mg-equivalent per day
- Breastfeeding: 17 mg-equivalent per day
- Regular daily requirement for adults up to 65 years: 12 mg-equivalent per day
- Pregnant: 2nd trimester: 1.2 mg per day; 3rd trimester: 1.3 mg per day
- Breastfeeding: 1.3 mg per day
- Regular daily requirement for adults: 1.0 mg per day
- Pregnant: 2nd trimester: 1.3 mg per day; 3rd trimester: 1.4 mg per day
- Breastfeeding: 1.4 mg per day
- Regular daily requirement for adults up to 51 years: 1.1 mg per day
- Pregnant: 2nd trimester: 14 mg-equivalents per day; 3rd trimester: 16 mg-equivalents per day
- Breastfeeding: 16 mg-equivalents per day
- Regular daily requirement for adults up to 25 years: 13 mg-equivalents per day; up to 51 years: 12 mg-equivalents per day
- Pregnant: 1st trimester: 1.5 mg per day; 2nd and 3rd trimesters: 1.8 mg per day
- Breastfeeding: 1.6 mg per day
- Regular daily requirement for adults: 1.4 mg per day
- Pregnant: 550 µg-equivalent per day
- Breastfeeding: 450 µg-equivalent per day
- Regular daily requirement for adults: 300 µg-equivalent per day
- Pregnant: 4.5 µg per day
- Breastfeeding: 5.5 µg per day
- Regular daily requirement for adults: 4.0 µg per day
- Pregnant (after 4th month): 105 mg per day
- Breastfeeding: 125 mg per day
- Regular daily requirement for adults: 95 mg per day
Which Minerals Are Needed During Pregnancy?
The daily requirement for minerals also increases for pregnant and breastfeeding individuals, but only for potassium, phosphorus, iron, iodine, zinc, and selenium. The following values only increase for breastfeeding individuals:
- Selenium: 75 µg per day (regular 60)
- Potassium: 4400 mg per day (regular 4000)
The following are the increased requirements for these micronutrients during pregnancy and breastfeeding:
