Table 3. WHO-‐recommended quantities of minerals and vitamins per day during pregnancy
and lactation
Micronutrient
WHO recommendation
Vitamin A, µg
800.0 µg
Thiamine (vitamin B
1
), mg
1.4 mg
Riboflavin (vitamin B
2
), mg
1.4 mg
Niacin (vitamin B
3
), mg
18.0 mg
Vitamin B
6
, mg
1.9 mg
Vitamin B
12
, µg
2.6 µg
Vitamin C, mg
55.0 mg
Vitamin D, µg
5.0 µg
Vitamin E, mg
15.0 mg
Folic acid, µg
600.0 µg
Iron, mg
27.0 mg
Zinc, mg
10.0 mg
Copper, mg
1.15 mg
Selenium, µg
30.0 µg
Iodine, µg
250.0 µg
Calcium, g
1.5-‐2.0 g
5.6.1 Folic acid
Folic acid is required for maternal erythropoiesis, DNA synthesis, growth of the placenta and
the development of the fetal spinal cord during the first month of pregnancy. Notably, the
neural tube closes during weeks 3–4 of pregnancy when women are often unaware that they
are pregnant. In most cases, the required amounts of folates cannot be supplied from food
alone. (Folic acid and folates have a similar chemical structure; “folic acid” refers to synthetic
supplements, while food products contain “folates”.) An intake of 400 µg/day of folic acid
reduces the risk for neural tube defects; therefore, women of reproductive age should make
sure that their daily intake is at this level. Women who are planning pregnancy should start
taking folic acid supplements before pregnancy in order to reach a stable level by the time of
pregnancy, and they should continue supplementing their diet at least until the end of week 12
of gestation. It is recommended that the intake of women at high risk (a history of spina bifida,
diabetes mellitus, malabsorption syndrome, coeliac disease, use of anticonvulsants) should be
17
4 mg/day. Smokers, alcohol abusers and women who have regularly taken oral contraceptives
or triamterene and trimethoprim as diuretics are at higher risk for folic acid deficiency or deficit.
Women who take multi-‐vitamin supplements should check the folic acid content.
The foods eaten should be rich in folates. The main dietary sources of folic acid are green-‐leaf
vegetables (broccoli, spinach, Brussels sprouts, cabbage, salad leaves), bovine liver, legumes
(lentils, beans and peas), beetroot, oranges and tomatoes. Fresh, uncooked vegetables should
be eaten daily, as folic acid is unstable to heat.
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