Nutrient Needs During Pregnancy

Vitamins

For the most part, requirements for vitamins during pregnancy are not different from requirements for non-pregnant women of the same age. It is still important to evaluate whether or not an individual’s intake meets recommendations, however. Some key vitamins are discussed below.

vitamin A
folate
vitamin B12
vitamin D

Vitamin A
Vitamin A is needed for growth and maintenance of the fetus, fetal stores, maternal tissue growth. The RDA for vitamin A during pregnancy is slightly higher than the RDA for non-pregnant women.

Preformed vitamin A in excessive amounts can be teratogenic. During the first trimester, toxicity is associated with central nervous system abnormalities, craniofacial malformations, and cardiac defects. The 2000 DRIs set an upper limit for preformed vitamin A (including during pregnancy): 2800 µg per day for 14-18 year olds and 3000 µg per day for 19-50 year olds.

Folate
In addition to folate early in pregnancy, related to prevention of some neural tube defects, folate is needed throughout pregnancy to prevent megaloblastic anemia.

A fortification policy implemented by the US Food and Drug Administration in 1998 mandated that enriched grain products be fortified with folic acid. It was expected that this would increase individuals’ folic acid intakes by about 100 µg per day, with 50% of women of childbearing age receiving at least 400 µg per day. A recent study indicates that although folic acid intakes of women of childbearing age have increased since 1998, only 22.8% (2007-2010) are reaching the 400 µg goal. (Healthy People 2020) In addition, the recommended intake level for women of childbearing age was increased to 600 µg per day in 1998. (IOM 1998)

Vitamin B12
Maternal intake of vitamin B12 seems to have more of an influence on fetal B12 concentrations than maternal stores of the vitamin. The RDA for B12 during pregnancy is increased above recommendations for women who are not pregnant.

Vitamin D
The recommended intake for vitamin D during pregnancy is not increased over that for non-pregnant women. Women who receive regular exposure to sunlight do not need vitamin D supplementation, but those who are at high latitudes during winter months (such as those in Washington State) may be at risk for vitamin D deficiency. The IOM does suggest that an intake of 15 µg (600 IU)/day (the amount supplied by prenatal vitamin supplements), would not be excessive. Primary food sources for vitamin D are eggs, meat, oily fish (such as salmon and tuna), and fortified milk and dairy products.

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KNOWLEDGE CHECK

For a pregnant woman that has not been taking a prenatal vitamin and mineral, would you be concerned about adequate intake of any vitamins and minerals? If so which ones?

Answer: For a woman that has a well rounded diet and was meeting all of her needs prior to pregnancy, most would not be concerned about any deficiencies and inadequate intakes. However for a woman that might not have met her vitamin and mineral recommendations prior to pregnancy, iron, folate and vitamin D may be of concern.