Maximum zinc dose in pregnancy

Effect of Zinc Supplementation on Pregnancy and Infant Outcomes: A Systematic Review

1. King JC, Cousins RJ. Zinc. In: Shils ME, Shike M, Ross AC, Caballero B, Cousins RJ, editors. Modern Nutrition in Health and Disease. 10. Philadelphia, PA: Lippincott Williams & Wilkins; 2006. pp. 271–285. [Google Scholar]

2. Caulfield LE, Zavaleta N, Shankar AH, Merialdi M. Potential contribution of maternal zinc supplementation during pregnancy to maternal and child survival. American Journal of Clinical Nutrition. 1998;68:499S–508S. [PubMed] [Google Scholar]

3. King JC. Determinants of maternal zinc status during pregnancy. American Journal of Clinical Nutrition. 2000;71:1334S–1343S. [PubMed] [Google Scholar]

4. McArdle HJ, Andersen HS, Jones H, Gambling L. Fetal programming: causes and consequences as revealed by studies of dietary manipulation in rats – a review. Placenta. 2006;27 (Suppl A):S56–S60. [PubMed] [Google Scholar]

5. Jou MY, Philipps AF, Lonnerdal B. Maternal zinc deficiency in rats affects growth and glucose metabolism in the offspring by inducing insulin resistance postnatally. Journal of Nutrition. 2010;140:1621–1627. [PubMed] [Google Scholar]

6. Beach RS, Gershwin ME, Hurley LS. Persistent immunological consequences of gestation zinc deprivation. American Journal of Clinical Nutrition. 1983;38:579–590. [PubMed] [Google Scholar]

7. Hambidge KM, Neldner KH, Walravens PA. Zinc, acrodermatitis enteropathica, and congenital malformations. Lancet. 1975;1:577–578. [PubMed] [Google Scholar]

8. Prema K, Ramalagshmi B, Neelakumari S. Serum copper and zinc in pregnancy. Indian Medical Research. 1980;71:547–553. [PubMed] [Google Scholar]

9. Jameson S. Effects of zinc deficiency in human reproduction. Acta Medica Scandinavica. 1976;593:3–89. [PubMed] [Google Scholar]

10. Simmer K, Thompson RPH. Maternal zinc and intrauterine growth retardation. Clinical Science. 1985;68:395–399. [PubMed] [Google Scholar]

11. Cherry FF, Sandstead HH, Rojas P, Johnson LK, Batson KH, Wang XB. Adolescent pregnancy: associations among body weight, zinc nutriture, and pregnancy outcome. American Journal of Clinical Nutrition. 1989;50:945–954. [PubMed] [Google Scholar]

12. Kynast G, Saling E. Effect of oral zinc application during pregnancy. Gynecologic and Obstetric Investigation. 1986;21:117–123. [PubMed] [Google Scholar]

13. Swanson CA, King JC. Zinc and pregnancy outcome. American Journal of Clinical Nutrition. 1987;46:763–771. [PubMed] [Google Scholar]

14. Davies NT, Williams RB. The effect of pregnancy and lactation on the absorption of zinc and lysine by the rat duodenum in situ. British Journal of Nutrition. 1977;38:417–423. [PubMed] [Google Scholar]

15. Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, et al. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet. 2008;371:243–260. [PubMed] [Google Scholar]

16. Uriu-Adams JY, Keen CL. Zinc and reproduction: effects of zinc deficiency on prenatal and early postnatal development. Birth Defects Research Part B, Developmental and Reproductive Toxicology. 2010;89:313–325. [PubMed] [Google Scholar]

17. Ramakrishnan U. Nutrition and low birthweight: from research to practice. American Journal of Clinical Nutrition. 2004;79:17–21. [PubMed] [Google Scholar]

18. Mahomed K, Bhutta Z, Middleton P. Zinc supplementation for improving pregnancy and infant outcome. Cochrane Database of Systematic Reviews. 2007;(2):CD000230. [PubMed] [Google Scholar]

19. Petitti D. Meta-analysis, Decision Analysis, and Cost Effectiveness Analysis. Oxford: Oxford University Press; 1994. pp. 108–111. [Google Scholar]

20. Shore R, Gardner M, Pannett B. Ethylene oxide: an assessment of the epidemiological evidence on carcinogenicity. British Journal of Industrial Medicine. 1993;50:971–997. [PMC free article] [PubMed] [Google Scholar]

21. DerSimonian R, Laird N. Meta-analysis in clinical trials. Controlled Clinical Trials. 1986;7:177–188. [PubMed] [Google Scholar]

22. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ (Clinical Research Ed) 1997;315:629–634. [PMC free article] [PubMed] [Google Scholar]

23. Begg C, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994;50:1088–1101. [PubMed] [Google Scholar]

24. Light R, Pillemer D. Summing Up: the Science of Reviewing Research. Cambridge, MA: Harvard University Press; 1984. pp. 65–67. [Google Scholar]

25. Duval S, Tweedie R. Trim and fill: a simple funnelplot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000;56:455–463. [PubMed] [Google Scholar]

26. Walker N, Fischer-Walker C, Bryce J, Bahl R, Cousens S. Standards for CHERG reviews of intervention effects on child survival. International Journal of Epidemiology. 2010;39 (Suppl 1):i21–i31. [PMC free article] [PubMed] [Google Scholar]

27. Grade Working Group. Grading quality of evidence and strength of recommendations. BMJ (Clinical Research Ed) 2008;328:1490–1498. [PMC free article] [PubMed] [Google Scholar]

28. Guyatt GH, Oxman AD, Kunz R, Jaeschke R, Helfand M, Liberati A, Vist GE, et al. GRADE Working Group. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ (Clinical Research Ed) 2008;336:924–926. [PMC free article] [PubMed] [Google Scholar]

29. Hunt IF, Murphy NJ, Cleaver AE, Faraji B, Swendseid ME, Coulson AH, et al. Zinc supplementation during pregnancy: zinc concentration of serum and hair from low-income women of Mexican descent. American Journal of Clinical Nutrition. 1983;37:572–582. [PubMed] [Google Scholar]

30. Hunt IF, Murphy NJ, Cleaver AE, Faraji B, Swendseid ME, Coulson AH, et al. Zinc supplementation during pregnancy: effects of selected blood constituents and on progress and outcome of pregnancy in low-income women of Mexican descent. American Journal of Clinical Nutrition. 1984;40:508–521. [PubMed] [Google Scholar]

31. Hunt IF, Murphy NJ, Cleaver AE, Faraji B, Swendseid ME, Browdy BL, et al. Zinc supplementation during pregnancy in low-income teenagers of Mexican descent: effects on selected blood constituents and on progress and outcome of pregnancy. American Journal of Clinical Nutrition. 1985;42:815–828. [PubMed] [Google Scholar]

32. Ross SM, Nel E, Naeye RL. Differing effects of low and high bulk maternal dietary supplements during pregnancy. Early Human Development. 1985;10:295–302. [PubMed] [Google Scholar]

33. Mahomed K, James DK, Golding J, McCabe R. Zinc supplementation during pregnancy: a double blind randomised controlled trial. BMJ (Clinical Research Ed) 1989;299:826–830. [PMC free article] [PubMed] [Google Scholar]

34. Simmer K, Lort-Phillips L, James C, Thompson RP. A double-blind trial of zinc supplementation in pregnancy. European Journal of Clinical Nutrition. 1991;45:139–144. [PubMed] [Google Scholar]

35. Garg HK, Singhal KC, Arshad Z. A study of the effect of oral zinc supplementation during pregnancy on pregnancy outcome. Indian Journal of Physiology and Pharmacology. 1993;37:276–284. [PubMed] [Google Scholar]

36. Garg HK, Singhal KC, Arshad Z. Effect of oral zinc supplementation on copper and haemoglobin levels in pregnant women. Indian Journal of Physiology and Pharmacology. 1994;38:272–276. [PubMed] [Google Scholar]

37. Goldenberg RL, Tamura T, Neggers Y, Copper RL, Johnston KE, DuBard MB, et al. The effect of zinc supplementation on pregnancy outcome. Journal of the American Medical Association. 1995;274:463–468. [PubMed] [Google Scholar]

38. Jonsson B, Hauge B, Larsen MF, Hald F. Zinc supplementation during pregnancy: a double blind randomised controlled trial. Acta Obstetricia et Gynecologica Scandinavica. 1996;75:725–729. [PubMed] [Google Scholar]

39. Neggers YH, Goldenberg RL, Tamura T, Johnston KE, Copper RL, DuBard M. Plasma and erythrocyte zinc concentrations and their relationship to dietary zinc intake and zinc supplementation during pregnancy in low-income African-American women. Journal of the American Dietetic Association. 1997;11:1269–1274. [PubMed] [Google Scholar]

40. Caulfield LE, Zavaleta N, Figueroa A, Leon Z. Maternal zinc supplementation does not affect size at birth or pregnancy duration in Peru. Journal of Nutrition. 1999;129:1563–1568. [PubMed] [Google Scholar]

41. Caulfield L, Zavaleta N, Figueroa A. Adding zinc to prenatal iron and folate supplements improves maternal and neonatal zinc status in a Peruvian population. American Journal of Clinical Nutrition. 1999;69:1257–1263. [PubMed] [Google Scholar]

42. Merialdi M, Caulfield L, Zavaleta N, Figueroa A, DiPietro JA. Adding zinc to prenatal iron and folate tablets improves fetal neurobehavioral development. American Journal of Obstetrics and Gynecology. 1999;180:483–490. [PubMed] [Google Scholar]

43. O’Brien KO, Zavaleta N, Caulfield LE, Yang DX, Abrams SA. Influence of prenatal iron and zinc supplements on supplemental iron absorption, red blood cell iron incorporation, and iron status in pregnant Peruvian women. American Journal of Clinical Nutrition. 1999;69:509–515. [PubMed] [Google Scholar]

44. Hogg BB, Tamura T, Johnston KE, DuBard MA, Goldenberg RL. Second-trimester plasma homocysteine levels and pregnancy-induced hypertension, preeclampsia, and intrauterine growth restriction. American Journal of Obstetrics and Gynecology. 2000;183:805–809. [PubMed] [Google Scholar]

45. O’Brien KO, Zavaleta N, Caulfield LE, Wen J, Abrams SA. Prenatal iron supplements impair zinc absorption in pregnant Peruvian women. Journal of Nutrition. 2000;130:2251–2255. [PubMed] [Google Scholar]

46. Osendarp SJ, van Raaij JM, Arifeen SE, Wahed M, Baqui AH, Fuchs GJ. A randomized, placebo-controlled trial of the effect of zinc supplementation during pregnancy on pregnancy outcome in Bangladeshi urban poor. American Journal of Clinical Nutrition. 2000;71:114–119. [PubMed] [Google Scholar]

47. Zavaleta N, Caulfield LE, Garcia T. Changes in iron status during pregnancy in peruvian women receiving prenatal iron and folic acid supplements with or without zinc. American Journal of Clinical Nutrition. 2000;71:956–961. [PubMed] [Google Scholar]

48. Castillo-Duran C, Marin VB, Alcazar LS, Iturralde H, Ruz MO. Controlled trial of zinc supplementation in Chilean pregnant adolescents. Nutrition Research. 2001;21:715–724. [Google Scholar]

49. Nogueira NN, Marreiro DN, Parente JV, Cozzolino SM. Utilization of different iron concentrations on pregnant adolescents also supplemented with zinc and folate. Archivos Latinoamericanos de Nutrición. 2001;51:225–229. (in Portuguese) [PubMed] [Google Scholar]

50. Osendarp SJ, van Raaij JM, Darmstadt GL, Baqui AH, Hautvast JG, Fuchs GJ. Zinc supplementation during pregnancy and effects on growth and morbidity in low birthweight infants: a randomised placebo controlled trial. Lancet. 2001;357:1080–1085. [PubMed] [Google Scholar]

51. Tamura T, Olin KL, Goldenberg RL, Johnston KE, Dubard MB, Keen CL. Plasma extracellular superoxide dismutase activity in healthy pregnant women is not influenced by zinc supplementation. Biological Trace Element Research. 2001;80:107–113. [PubMed] [Google Scholar]

52. Hamadani JD, Fuchs GJ, Osendarp SJ, Huda SN, Grantham-McGregor SM. Zinc supplementation during pregnancy and effects on mental development and behaviour of infants: a follow-up study. Lancet. 2002;360:290–294. [PubMed] [Google Scholar]

53. Nogueira NN, Macedo AS, Parente JV, Cozzolino SM. Nutritional profile of newborns of adolescent mothers supplemented with iron, in different concentrations, zinc and folic acid. Revista de Nutrição. 2002;15:193–200. (in Portuguese) [Google Scholar]

54. Christian P, Khatry SK, Katz J, Pradhan EK, LeClerq SC, Shrestha SR, et al. Effects of alternative maternal micronutrient supplements on low birthweight in rural Nepal: double blind randomised community trial. BMJ (Clinical Research Ed) 2003;326:571. [PMC free article] [PubMed] [Google Scholar]

55. Christian P, Shrestha J, LeClerq SC, Khatry SK, Jiang T, Wagner T, et al. Supplementation with micronutrients in addition to iron and folic acid does not further improve the hematologic status of pregnant women in rural Nepal. Journal of Nutrition. 2003;133:3492–3498. [PubMed] [Google Scholar]

56. Christian P, West KP, Jr, Khatry SK, LeClerq SC, Pradhan EK, Katz J, et al. Effects of maternal micronutrient supplementation on fetal loss and infant mortality: a cluster-randomized trial in Nepal. American Journal of Clinical Nutrition. 2003;78:1194–1202. [PubMed] [Google Scholar]

57. Nogueira NN, Parente JV, Cozzolino SM. Changes in plasma zinc and folic acid concentrations in pregnant adolescents submitted to different supplementation regimens. Cadernos de Saúde Pública. 2003;19:155–160. (in Portuguese) [PubMed] [Google Scholar]

58. O’Brien KO, Zavaleta N, Abrams SA, Caulfield LE. Maternal iron status influences iron transfer to the fetus during the third trimester of pregnancy. American Journal of Clinical Nutrition. 2003;77:924–930. [PubMed] [Google Scholar]

59. Tamura T, Goldenberg RL, Ramey SL, Nelson KG, Chapman VR. Effect of zinc supplementation of pregnant women on the mental and psychomotor development of their children at 5 y of age. American Journal of Clinical Nutrition. 2003;77:1512–1516. [PubMed] [Google Scholar]

60. Dijkhuizen MA, Wieringa FT, West CE, Muhilal Zinc plus beta-carotene supplementation of pregnant women is superior to beta-carotene supplementation alone in improving vitamin A status in both mothers and infants. American Journal of Clinical Nutrition. 2004;80:1299–1307. [PubMed] [Google Scholar]

61. Merialdi M, Caulfield LE, Zavaleta N, Figueroa A, Dominici F, Dipietro JA. Randomized controlled trial of prenatal zinc supplementation and the development of fetal heart rate. American Journal of Obstetrics and Gynecology. 2004;190:1106–1112. [PubMed] [Google Scholar]

62. Fawzi W, Villamor E, Msamanga G, Antelman G, Aboud S, Urassa W, et al. Trial of zinc supplements in relation to pregnancy outcomes, hematologic indicators, and T cell counts among HIV-1-infected women in Tanzania. American Journal of Clinical Nutrition. 2005;81:161–167. [PubMed] [Google Scholar]

63. Hafeez A, Mahmood G, Hassan M, Batool T, Hayat H, Mazhar F, et al. Serum zinc levels and effects of oral supplementation in pregnant women. Journal of College of Physicians and Surgeons Pakistan. 2005;15:612–615. [PubMed] [Google Scholar]

64. Hafeez A, Mehmood G, Mazhar F. Oral zinc supplementation in pregnant women and its effect on birthweight: a randomised controlled trial. Archives of Disease in Childhood Fetal and Neonatal Edition. 2005;90:F170–F171. [PMC free article] [PubMed] [Google Scholar]

65. Christian P, Jiang T, Khatry SK, LeClerq SC, Shrestha SR, West KP., Jr Antenatal supplementation with micronutrients and biochemical indicators of status and subclinical infection in rural Nepal. American Journal of Clinical Nutrition. 2006;83:788–794. [PubMed] [Google Scholar]

66. Katz J, Christian P, Dominici F, Zeger SL. Treatment effects of maternal micronutrient supplementation vary by percentiles of the birthweight distribution in rural Nepal. Journal of Nutrition. 2006;136:1389–1394. [PubMed] [Google Scholar]

67. Villamor E, Aboud S, Koulinska IN, Kupka R, Urassa W, Chaplin B, et al. Zinc supplementation to HIV-1-infected pregnant women: effects on maternal anthropometry, viral load, and early mother-to-child transmission. European Journal of Clinical Nutrition. 2006;60:862–869. [PubMed] [Google Scholar]

68. Caulfield LE, Donangelo CM, Chen P, Junco J, Merialdi M, Zavaleta N. Red blood cell metallothionein as an indicator of zinc status during pregnancy. Nutrition. 2008;24:1081–1087. [PMC free article] [PubMed] [Google Scholar]

69. Christian P, Darmstadt GL, Wu L, Khatry SK, Leclerq SC, Katz J, et al. The effect of maternal micronutrient supplementation on early neonatal morbidity in rural Nepal: a randomised, controlled, community trial. Archives of Disease in Childhood. 2008;93:660–664. [PubMed] [Google Scholar]

70. Iannotti LL, Zavaleta N, Leon Z, Shankar AH, Caulfield LE. Maternal zinc supplementation and growth in Peruvian infants. American Journal of Clinical Nutrition. 2008;88:154–160. [PMC free article] [PubMed] [Google Scholar]

71. Christian P, Khatry SK, LeClerq SC, Dali SM. Effects of prenatal micronutrient supplementation on complications of labor and delivery and puerperal morbidity in rural Nepal. International Journal of Gynaecology and Obstetrics. 2009;106:3–7. [PubMed] [Google Scholar]

72. Christian P, Stewart CP, LeClerq SC, Wu L, Katz J, West KP, Jr, et al. Antenatal and postnatal iron supplementation and childhood mortality in rural Nepal: a prospective follow-up in a randomized, controlled community trial. American Journal of Epidemiology. 2009;170:1127–1136. [PMC free article] [PubMed] [Google Scholar]

73. Saaka M, Oosthuizen J, Beatty S. Effect of prenatal zinc supplementation on birthweight. Journal of Health, Population, and Nutrition. 2009;27:619–631. [PMC free article] [PubMed] [Google Scholar]

74. Saaka M, Oosthuizen J, Beatty S. Effect of joint iron and zinc supplementation on malarial infection and anaemia. East African Journal of Public Health. 2009;6:55–62. [PubMed] [Google Scholar]

75. Stewart CP, Christian P, LeClerq SC, West KP, Jr, Khatry SK. Antenatal supplementation with folic acid + iron + zinc improves linear growth and reduces peripheral adiposity in school-age children in rural Nepal. American Journal of Clinical Nutrition. 2009;90:132–140. [PMC free article] [PubMed] [Google Scholar]

76. Stewart CP, Christian P, Schulze KJ, Leclerq SC, West KP, Jr, Khatry SK. Antenatal micronutrient supplementation reduces metabolic syndrome in 6- to 8-year-old children in rural Nepal. Journal of Nutrition. 2009;139:1575–1581. [PubMed] [Google Scholar]

77. Caulfield LE, Putnick DL, Zavaleta N, Lazarte F, Albornoz C, Chen P, et al. Maternal gestational zinc supplementation does not influence multiple aspects of child development at 54 mo of age in Peru. American Journal of Clinical Nutrition. 2010;92:130–136. [PMC free article] [PubMed] [Google Scholar]

78. Christian P, Murray-Kolb LE, Khatry SK, Katz J, Schaefer BA, Cole PM, et al. Prenatal micronutrient supplementation and intellectual and motor function in early school-aged children in Nepal. Journal of the American Medical Association. 2010;304:2716–2723. [PubMed] [Google Scholar]

79. Danesh A, Janghorbani M, Mohammad HB. Effects of zinc supplementation during pregnancy on pregnancy outcome in women with history of preterm delivery: a double-blind randomized, placebo-controlled trial. Journal of Maternal-fetal and Neonatal Medicine. 2010;23:403–408. [PubMed] [Google Scholar]

80. Iannotti LL, Zavaleta N, Leon Z, Huasquiche C, Shankar AH, Caulfield LE. Maternal zinc supplementation reduces diarrheal morbidity in Peruvian infants. Journal of Pediatrics. 2010;156:960–964. [PubMed] [Google Scholar]

81. Wieringa FT, Dijkhuizen MA, Muhilal, Van der Meer JW. Maternal micronutrient supplementation with zinc and beta-carotene affects morbidity and immune function of infants during the first 6 months of life. European Journal of Clinical Nutrition. 2010;64:1072–1079. [PubMed] [Google Scholar]

82. Caulfield LE, Zavaleta N, Chen P, Lazarte F, Albornoz C, Putnick DL, et al. Maternal zinc supplementation during pregnancy affects autonomic function of Peruvian children assessed at 54 months of age. Journal of Nutrition. 2011;141:327–332. [PMC free article] [PubMed] [Google Scholar]

83. Hakimi M, Dibley M, Surjono A, Nurdiati D. Impact of vitamin A and zinc supplementation on puerperal sepsis: a randomized controlled trial in rural Indonesia. In: Nurdiati D, editor. Nutrition and reproductive health in central Java, Indonesia; an epidemiological approach (PhD thesis) Umea, Sweden: Umea University Medical Dissertations; 2001. [Google Scholar]

84. An H, Yin S, Xu Q. Effects of supplementing calcium, iron and zinc on the fetus development and growth during pregnancy. Zhonghua Yu Fang Yi Xue Za Zhi. 2001;35:370–373. (in Chinese) [PubMed] [Google Scholar]

85. Mahmoudian A, Khademloo M. The effect of simultaneous administration of zinc sulfate and ferrous sulfate in the treatment of anemic pregnant women. Journal of Research in Medical Sciences. 2005;10:205–209. [Google Scholar]

86. Robertson JS, Heywood B, Atkinson SM. Zinc supplementation during pregnancy. Journal of Public Health Medicine. 1991;13:227–229. [PubMed] [Google Scholar]

87. Christian P, Khatry SK, Yamini S, Stallings R, LeClerq SC, Shrestha SR, et al. Zinc supplementation might potentiate the effect of vitamin A in restoring night vision in pregnant Nepalese women. American Journal of Clinical Nutrition. 2001;73:1045–1051. [PubMed] [Google Scholar]

88. Xie L, Pan J, Chen X. Zinc supplementation to rural Chinese pregnant women and pregnancy outcome. Acta Nutrimenta Sinica. 1999;21:65–73. (in Chinese) [Google Scholar]

89. Yuan W, Geng G, Chen A, Wu J, Zhang Z, Gao E. Effects of zinc supplementation of rural pregnant women on the growth of offspring in early childhood. Fudan University Journal of Medical Sciences. 2004;5:496–501. (in Chinese) [Google Scholar]

90. Hambidge KM, Krebs NF, Jacobs MA, Favier A, Guyette L, Ikle DN. Zinc nutritional status during pregnancy: a longitudinal study. American Journal of Clinical Nutrition. 1983;37:429–442. [PubMed] [Google Scholar]

91. Institute of Medicine. Preterm Birth: Causes, Consequences, and Prevention. Washington, DC: National Academies Press; 2007. [PubMed] [Google Scholar]

92. Apgar J. Zinc and reproduction: an update. Journal of Nutritional Biochemistry. 1992;3:266–278. [Google Scholar]

93. Greenland S. Invited commentary: a critical look at some popular meta-analytic methods. American Journal of Epidemiology. 1994;140:290–296. [PubMed] [Google Scholar]

94. Lau J, Ioannidis J, Schmid C. Summing up evidence: one answer is not always enough. Lancet. 1998;351:123–127. [PubMed] [Google Scholar]

95. Hopewell S, Loudon K, Clarke M, Oxman A, Dickersin K. Publication bias in clinical trials due to statistical significance or direction of trial results. Cochrane Database of Systematic Reviews. 2009;(1):MR000006. [PMC free article] [PubMed] [Google Scholar]

96. Merialdi M, Caulfield LE, Zavaleta N, Figueroa A, Costigan KA, Dominici F, et al. Randomized controlled trial of prenatal zinc supplementation and fetal bone growth. American Journal of Clinical Nutrition. 2004;79:826–830. [PubMed] [Google Scholar]

97. Brown KH, Peerson JM, Rivera J, Allen LH. Effect of supplemental zinc on the growth and serum zinc concentrations of prepubertal children: a meta-analysis of randomized controlled trials. American Journal of Clinical Nutrition. 2002;75:1062–1071. [PubMed] [Google Scholar]

98. Shrimpton R, Gross R, Darnton-Hill I, Young M. Zinc deficiency: what are the most appropriate interventions? BMJ (Clinical Research Ed) 2005;330:347–349. [PMC free article] [PubMed] [Google Scholar]

99. Burke BS. Nutrition and its relationship to the complications of pregnancy and the survival of the infant. American Journal of Public Health and the Nation’s Health. 1945;35:334–339. [PMC free article] [PubMed] [Google Scholar]

100. Ebbs JH, Tisdall FF, Scott ML. Dietary study of Toronto school teachers. Canadian Medical Association Journal. 1944;50:208–213. [PMC free article] [PubMed] [Google Scholar]

101. Higgins AC. Nutritional status and the outcome of pregnancy. Journal of the Canadian Dietetic Association. 1976;37:17–35. [Google Scholar]

102. Haider BA, Yakoob MY, Bhutta ZA. Effect of multiple micronutrient supplementation during pregnancy on maternal and birth outcomes. BMC Public Health. 2011;11:S3–S19. [PMC free article] [PubMed] [Google Scholar]

103. Kirksey A, Rahmanifar A, Wachs TD, McCabe GP, Bassily NS, Bishry Z, et al. Determinants of pregnancy outcome and newborn behavior of a semirural Egyptian population. American Journal of Clinical Nutrition. 1991;54:657–667. [PubMed] [Google Scholar]

104. Wallwork JC, Duerre JA. Effect of zinc deficiency on methionine metabolism, methylation reactions and protein synthesis in isolated perfused rat liver. Journal of Nutrition. 1985;115:252–262. [PubMed] [Google Scholar]

How Much Vitamin C and Zinc Can I Take While Pregnant?

Vitamin c and zinc are important when you are pregnant.

Image Credit: Wavebreakmedia/iStock/GettyImages

Vitamin C and zinc are two of the many essential vitamins and minerals you need to consume to stay healthy. These nutrients are particularly important for pregnant people. They help to support your immune system and help keep your developing baby healthy.

​Read more:​ 12 Questions to Ask Your Doctor If You're Pregnant (or Want to Be)

Video of the Day

Tip

Pregnant people typically need 85 milligrams per day of vitamin C and 11 milligrams per day of zinc. However, the maximum tolerable limits for these nutrients are 2,000 milligrams and 40 milligrams, respectively.

Nutrient Consumption During Pregnancy

A healthy diet requires three main macronutrients: ​protein, fat​ and ​carbohydrates​. When you eat foods that contain these nutrients, you're also consuming vitamins and minerals known as micronutrients.

The Food and Drug Administration considers nearly 30 different vitamins and minerals to be essential for good health. Your body isn't able to produce enough of these nutrients, which means you need to get them from the foods you eat.

Certain nutrients are particularly important for pregnant people. According to the American College of Obstetricians and Gynecologists, pregnant people need to consume additional amounts of ​folic acid​ and ​iron​.

Certain micronutrients — specifically ​vitamin D​, ​calcium​, ​iron​ and ​potassium​ — are considered nutrients of concern for Americans. This means most people consume insufficient amounts of these nutrients, so if you're pregnant or trying to become pregnant, you should definitely make sure you're getting enough of these vitamins and minerals.

However, all nutrients are important to a pregnant mother and her developing baby. For example, ​vitamin C​, also known as ascorbic acid, supports the formation of connective tissue, while ​zinc​ is particularly important for reproductive health, growth and development.

Getting enough vitamin C and zinc in pregnancy is important because these nutrients help support the immune system and your body's ability to repair wounds.

​Read more:​ 11 Nutrients Americans Aren't Getting Enough Of

Vitamin C and Pregnancy

According to the National Institutes of Health, the recommended daily amount of vitamin C for people is 75 milligrams. However, pregnant people need a bit more — ​85 milligrams per day​. Lactating people need the most, at ​120 milligrams​ per day. Certain people may also need additional vitamin C.

According to a March 2015 study in the journal ​Functional Foods in Health and Disease​, pregnant people who have obesity may require more vitamin C than people of normal weight. If you are pregnant and taking iron supplements, you may also need more vitamin C — iron supplements have the potential to decrease your vitamin C levels.

Vitamin C plays a variety of roles in your body. This nutrient can:

• Act as an antioxidant
• Help the body make collagen and connective tissue
• Help the body absorb the iron in plant-based foods
• Protect the body's cells from free radicals (this, in turn, prevents disease)
• Prevent deficiency-related diseases
• Support immune system function

Getting enough vitamin C in pregnancy is particularly important for ​vegan​ and ​vegetarians​, since this nutrient helps the body absorb iron found in plant-based foods. If you're vegan or vegetarian, make sure you're getting enough vitamin C because consumption of this nutrient allows your developing baby to get enough iron from the foods you eat.

Getting enough vitamin C from food is usually fairly easy. Vitamin C is found in a variety of fruits and vegetables, including citrus fruits, kiwis, broccoli, Brussels sprouts, cabbage, cauliflower, peppers and potatoes. If you consume five servings of fruits and vegetables on a daily basis, you should be able to get 200 milligrams or more of this essential nutrient.

Zinc and Pregnancy

Although zinc is not a nutrient of concern, according to the Food and Drug Administration, the World Health Organization estimates that over 80 percent of pregnant people don't consume enough zinc during their pregnancies.

According to the NIH, people typically need 8 milligrams of zinc per day. However, when they're pregnant, people need ​11 milligrams​ of zinc per day. Breastfeeding mothers need ​12 milligrams​ of zinc a day, because lactation can reduce the amount of zinc in the body. This nutrient is particularly important because it:

• Can help prevent preterm births
• Is required for your body's sensory functions, particularly taste and smell
• Supports DNA and protein synthesis, as well as cellular division
• Supports growth and development during pregnancy, as well as throughout childhood and adolescence
• Supports immune system function
• Supports wound healing

Zinc is found in a range of different foods. Seafood like oysters, crab and lobster and meat-based products such as beef, pork and chicken are richest in zinc. However, you can find zinc in plant-based foods too. For example, beans, chickpeas, peas, cashews, almonds and pumpkin seeds all contain this essential nutrient. Many breakfast cereals are also fortified with zinc.

Getting enough zinc during pregnancy is particularly important for people who are ​vegan​ or ​vegetarian​. Although zinc is available from plant-based products, the zinc in these foods is not as easily absorbed as the zinc from meat products.

Fortunately, you can improve the amount of zinc you get from plant-based foods. For example, you can soak beans, grains and seeds until they sprout to improve their nutrition. Also, leavened grain-based products have more zinc than unleavened products.

Vitamin C and Zinc Limits

Although vitamin C and zinc are both important for your health, you ​shouldn't consume these nutrients in excess​. Both of these nutrients can cause side effects when you get too much.

Zinc is easier to consume large amounts of compared to vitamin C. The daily tolerable upper intake level that the NIH lists for zinc is ​40 milligrams​. Consumption of too much zinc can result in various gastrointestinal symptoms, including nausea, vomiting, loss of appetite and diarrhea.

Regular consumption of around 80 milligrams of zinc per day can increase the chance of urinary health problems. Too much zinc (between 60 and 450 milligrams per day) may also lower your levels of copper and iron, worsen your immune system function and be bad for your cholesterol.

Vitamin C has a much higher tolerable upper intake level of ​2,000 milligrams per day​. It would be very difficult to consume this amount naturally. However, some people may choose to supplement their diets with synthetic ascorbic acid or buffered vitamin C.

These supplements can be used for a variety of reasons, from trying to support immune system function to helping pregnant people reduce urinary tract infections. However, in these cases, vitamin C is still given at amounts below the tolerable intake level. The amounts of vitamin C administered in such cases are typically between 100 milligrams and 1 gram per day.

Pregnancy Zinc: Effects, Dosage & Best Supplements

The rapid growth, tissue and DNA development that occurs in your baby's body during pregnancy depends on a good supply of zinc. Learn more about the importance of zinc during pregnancy, the best sources of zinc, and how much you need to get to keep your baby healthy.

Updated: 06/23/2022

We remind you that apteka24.ua has a mobile application: 12,000 drugs with detailed instructions and, of course, delivery throughout Ukraine. Look for us on the App Store and Google Play. nine0005

P.S. UAH 100 discount on the first order from UAH 1000 with the promo code APP100

• Why do we need zinc during pregnancy?
• Daily intake of zinc for pregnant women
• Zinc deficiency and its excess: how does it manifest itself?
• The Best Zinc Foods
• The Best Zinc Supplements During Pregnancy

During pregnancy, the intake of nutrients, micronutrients, increases dramatically. And if the expectant mother has never been interested in what a healthy lifestyle and proper diet are, then she runs the risk of becoming polydeficient in vitamins and minerals. In this article, we will look at such an indispensable mineral as zinc during pregnancy and why its presence in the body must be maintained at a sufficient level. nine0005

Why do you need zinc during pregnancy?

Zinc is a mineral that is not produced inside the body, so we must get it from outside.

It plays an important role in building the cells and DNA of the unborn child. Its presence is necessary for proper cell division, tissue growth and support for normal fetal development.

In addition, this mineral contributes even before pregnancy, without it there is no healthy development of eggs and sperm. That is, the optimal presence of zinc in the body has a positive effect on the fertility of both women and men. nine0005

An important fact is that zinc is found in high concentrations in the brain, and therefore it is important for the normal functioning of this organ and the nervous system as a whole. In addition, it helps build a strong immune system and maintain healthy antibody levels.

That is, zinc during pregnancy has a positive effect on both the nervous and immune systems, helping to resist infections .

Zinc deficiency can have an extremely negative effect on the condition of the newborn:

It has been suggested that maternal zinc deficiency may compromise the development of the child and lead to poor birth outcomes. Low plasma zinc concentrations reduce the transfer of this mineral across the placenta, affecting the supply of this micronutrient to the fetus.

Zinc deficiency also alters the circulating levels of a number of hormones associated with the onset of labor. Why is it important? Since normal immune function is hampered without such a micronutrient, the expectant mother may be susceptible to systemic and intrauterine infections, which are the main causes of preterm birth. nine0005

Daily intake of zinc for pregnant women

When you are pregnant or breastfeeding, you need more zinc than usual.

Solgar Zinc Picolinate tablets, 100 pcs. nine0005

Cashback8.19

₴

409.9 UAH

In stock

Solgar Calcium Magnesium Zinc tablets, 100 pcs.

Keshbek7.68

₴

384.2 UAH

is available

Elevit Pronvita Vitamins and Minerals DL ...

Kashbek23.43

₴

1 171.7GRN 9000 9000 9000. stock

Doppelgerz Aktiv Vitamins for mothers, 30 pcs.

Cashback5

₴

250.4 UAH

is in stock

Solgar Penatabs tablets for pregnant women and nursing ...

Keshbek8.03

₴

.5 UAH

is in the presence of

CIN and its excess: how does it manifest itself?

Whether zinc is present in normal amounts in the body or not depends on various factors. For example, from the very ability of the gastrointestinal tract to absorb anything.

A very slight lack of a mineral is easy to miss, because it practically does not signal itself in any way. But if the deficiency is significant, this can lead to a delay in physical development (this applies to children) and to a reduced protective properties of the mother's immune system and not only. nine0005

Typical symptoms of zinc deficiency:

• first of all, the nervous system suffers, that is, the person becomes irritable, sleeps poorly and his mood often changes;
• weak and prolonged healing of wounds and scratches;
• organs of perception suffer, tastes are no longer felt and appetite decreases, visual acuity may fall;
• possible bouts of diarrhea for no reason.

An overabundance of this mineral is not a frequent phenomenon, but if it does, it looks like:

• nausea;
• vomiting;
• diarrhea;
• high temperature;
• drowsiness.

However, a complete and balanced diet for pregnant women will help you get adequate amounts of the right mineral directly from food. And then maintaining your own health and development of the baby will not cause any problems.

Best Zinc Foods

Fortified cereals and red meat are a good way to get zinc. You can also make up for it with shellfish, poultry, beans, nuts, whole grains, and dairy products. nine0005

Here are some other good sources of zinc for pregnant women:

Oysters are known to be the richest source of this mineral: just two can provide more than the recommended amount of zinc for the whole day. But experts warn against eating raw oysters during pregnancy (or any raw or undercooked meat, poultry, shellfish, fish, or eggs) due to the risk of allergies and/or foodborne illness. Plus, oysters harvested in some areas contain high amounts of mercury. nine0005

Try varying your diet with zinc-rich snacks and meals:

• porridge with a handful of walnuts;
• hard boiled egg;
• turkey salad with almonds;
• cottage cheese on oatmeal;
• spicy shrimp with whole grain rice;
• roasted chickpeas with almonds and smoked paprika.

Best Zinc Supplements During Pregnancy

Most average people who eat meat and eat a fairly well balanced diet get almost all the vitamins and minerals their body needs without much effort. But sometimes it is difficult to do, especially during pregnancy, when not all products want to be looked at with pleasure. nine0005

Or if a woman is on a vegetarian diet, it may be difficult for her to get macro and micro nutrients from food alone. And zinc itself is not easy to absorb from plant foods. In such cases, biologically active zinc supplements come to the rescue!

Best Zinc Supplements During Pregnancy:

• Solgar Zinc Picolinate tablets.

The mineral itself is here in organic form and is easily absorbed by the body.

• Solgar Calcium Magnesium Zinc tablets.

This comprehensive formula helps strengthen the nervous system and muscles. With nervous tension and stress, the zinc content in the body is sharply reduced and requires replenishment. Calcium, Magnesium plus Zinc is a 3 in 1 formula that ensures they work together in a balanced way.

Zinc supplementation may be appropriate for women with poor gastrointestinal function or any of these conditions during pregnancy. Conditions that may alter maternal plasma zinc concentration and zinc transport to the fetus include:

• smoking and/or alcohol abuse;
• acute stress period;
• if the woman is currently suffering from an infection or injury or has been exposed to it in the past.

No matter what the reasons you are not getting it from your diet, special prenatal vitamins will provide you with all the elements you need, including zinc.

• Doppelgerz Aktiv Vitamins for expectant mothers.

One of the best complexes for those women who plan pregnancy and childbirth. It contains such nutrients as vitamins A, D3, C, B1, B2, B6, B12, folic acid, biotin, niacin, pantothenic acid and minerals (calcium, magnesium, iron, zinc, iodine) in the required amount. nine0005

• Elevit Pronatal.

This is a complex for pregnant and lactating clinically proven effectiveness in the prevention of congenital malformations of the unborn child. Contains 12 vitamins and 7 minerals to meet the increased needs of the body during the critical periods of a woman.