Micronutrient requirements during pregnancy

During pregnancy, the requirements for certain vitamins and minerals increase. These additional requirements can largely be met by a balanced and varied nutrition. However, pregnant women should pay particular attention to certain micronutrients. These include, for example, the vitamin folate and the trace element iodine.

According to data from the External Link:German Health Interview and Examination Survey for Adults (only available in German, „Studie zur Gesundheit Erwachsener in Deutschland”, DEGS1), the majority of the adult population in Germany is well supplied with folate. However, women of child-bearing age fall far short of the folate concentrations that the World Health Organisation (WHO) recommends as needed for reduction of the risk of neural tube defects (NTDs, also known as spina bifida or “open spine”) in children. These are malformations resulting from incomplete closure of the neural tube during embryonic development.

To reduce the risk of neural tube defects, it is recommended that women who are planning to become pregnant or who could become pregnant, and pregnant women in the first trimester of pregnancy, supplement their diet with folic acid (400 micrograms per day). Regardless of this, it is important to ensure a folate-rich diet, especially during pregnancy, but also during breastfeeding. This is because pregnant and breastfeeding women have an increased need for this vitamin. External Link:Reference values for folate intake (in German) can be found at the German Nutrition Society’s website (DGE).
 

Iodine is one of the essential trace elements that must be obtained from food. It is needed to produce thyroid hormones, which play a central role in regulating important metabolic processes and are essential for the growth and healthy development of a child's internal organs, the nervous system, circulatory organs and muscles – even before birth. The DGE recommends an iodine intake of 220 micrograms per day for pregnant women (compared to 150 micrograms per day for other adults).

In Germany, iodine supply has improved since the mid-1980s. However, recent data from the Robert Koch Institute (RKI) show that the iodine status is still not optimal and has even been declining again for several years. Pregnant women and breastfeeding mothers have increased iodine requirements due to their special metabolic situation. After consulting their gynaecologist, they should take iodine at a dose of 100 to 150 micrograms per day as a supplement in addition to a diet rich in natural iodine, processed foods containing iodised salt and the use of iodised salt in the household. All this contributes to reducing the risk of an iodine deficiency and possible health consequences for mother and child. 
 

Iron requirements increase during pregnancy because this mineral is needed for blood formation, the placenta and the growth of the unborn child. For pregnant women, the External Link:DGE recommends an iron intake (in German) of 27 milligrams per day (compared to 16 milligrams per day for non-pregnant women). Iron deficiency increases the risk of premature birth and low birth weight. However, there is no general recommendation for taking iron supplements during pregnancy, as additional iron intake in pregnant women who are already well supplied can also pose health risks for mother and child. For this reason, laboratory tests are carried out during prenatal check-ups to determine on an individual basis whether iron supplementation is necessary.

Polyunsaturated fatty acids, which include docosahexaenoic acid (DHA) but also eicosapentaenoic acid (EPA) and α-linolenic acid (ALA), are important for the development of the child. While DHA is mainly found in fatty sea fish, ALA is found in certain vegetable oils (e.g., rapeseed oil, linseed oil), nuts, and seeds. The DGE therefore recommends that pregnant women consume at least 200 milligrams of DHA per day. This can be achieved by eating 1-2 portions of fatty sea fish such as mackerel, herring or salmon per week. However, in some fish species, especially predatory fish (e.g. tuna, swordfish, monkfish, halibut, perch or hake), methylmercury (the organic form of mercury) can accumulate via the marine food chain. Pregnant women should thus avoid these types of fish. DHA can also be produced in the body from ALA; however, endogenous synthesis is too low to ensure sufficient DHA supply during pregnancy. Pregnant women who eat little or no oily fish should therefore take a DHA supplement in consultation with their doctor.

The unborn child needs vitamin D for healthy development. It receives this vitamin from the mother, who must ensure she has is sufficient vitamin D – especially through the body's own synthesis. Pregnant women do not have a higher vitamin D requirement than the rest of the population. During the summer months, the requirement can be met by spending time outdoors regularly and exercising in the fresh air when there is sufficient sunlight. To achieve this, it is recommended to expose about a quarter of the body surface (face, hands and parts of arms and legs) to the sun several times a week for 5 to 25 minutes, depending on the skin type and the season, without covering up or using sunscreen. Sunburn should always be avoided. During the winter months, the body's own synthesis is insufficient; however, the body stores vitamin D in fat and muscle tissue and can release it again through physical activity to supply the body during winter. The benefits of general vitamin D supplementation during pregnancy have not been scientifically proven.

The current data available for Germany indicate that the population, including pregnant and breastfeeding women, has an adequate supply of vitamin A. Compared to non-pregnant women, pregnant women have only a slightly higher requirement for vitamin A, while the requirement – and thus also the External Link:intake recommended by the DGE (in German) – increases more significantly during breastfeeding. On the other hand, excessive vitamin A intake, especially via food supplements and particularly in the first few months of pregnancy, is associated with an increased risk of malformations in the unborn child. For this reason, pregnant women are advised to avoid eating liver, especially pork liver, as it can contain very high amounts of vitamin A. Pregnant women (and young children) should also be very cautious about consuming products containing liver. Moreover, during pregnancy, vitamin A supplements should only be taken after consulting a doctor.

Pregnant women should be even more cautious than other consumers with taking food supplements. Any additional intake of food supplements should be preceded by medical advice or recommendation. Pregnant women in particular should refrain from taking food supplements, over-the-counter medicines or seemingly harmless natural preparations on their own. In most cases, the requirements for important micronutrients can be met with a varied, healthy diet. Many food supplements also contain relatively unknown, sometimes exotic ingredients whose effects have often not been well studied, especially with regard to pregnant women and the unborn child. More information on this topic can be found under “other substances”.

Status: 21/01/2026