Vitamin A during pregnancy
Significance, sources, and risks
Vitamin A plays a crucial role in numerous bodily functions and is particularly important during pregnancy. This fat-soluble vitamin supports cell division, growth, and the development of important organs in the unborn child. Both a deficiency and an overdose can pose health risks for the mother and fetus.
What is Vitamin A?
Vitamin A refers to a group of fat-soluble compounds that perform numerous important functions in the body. The most important active forms include retinol, retinal, and retinoic acid, which are found exclusively in animal-based foods, as well as beta-carotene, a precursor of vitamin A (provitamin A), which is found in plant-based sources.
Vitamin A is essential for:
- the visual process (especially twilight vision),
- cell division and tissue regeneration,
- the function of the immune system,
- as well as the development of the heart, lungs, eyes, and urinary tract during the embryonic phase.
Since vitamin A is mainly stored in the liver, liver contains correspondingly large amounts of this vitamin.
Vitamin A requirements during pregnancy
During pregnancy, the body needs slightly more vitamin A. The German Nutrition Society (DGE) recommends that expectant mothers consume 800 μg of vitamin A in the form of retinol activity equivalents (RAE) daily. This is only slightly above the requirement for non-pregnant women (700 μg RAE).
Vitamin A can come from various sources: it is already present in its active form (retinol) in animal-based foods such as eggs, dairy products, and fish. Plant-based foods, on the other hand, provide beta-carotene, which the body converts into vitamin A as needed. This form is considered particularly safe, as the body itself controls how much vitamin A is produced from it. However, it is important that plant sources are always eaten with a little fat—for example, a teaspoon of oil—as vitamin A is fat-soluble and is otherwise less easily absorbed. Animal-based foods already contain the necessary fat.
The “RAE” measurement helps to make the different forms comparable: 1 μg RAE corresponds to 1 μg retinol, 12 μg beta-carotene (splitting rate: 12:1) or 24 μg of other provitamin A carotenoids (splitting rate: 24:1). Some sources use retinol equivalents (RE) instead: here, 1 μg RE also corresponds to 1 μg retinol, but also to 6 μg beta-carotene (splitting ratio: 6:1) or 12 μg of other provitamin A carotenoids (splitting ratio: 12:1).
Overall, the daily vitamin A requirement during pregnancy can usually be easily met by a balanced, varied diet.
Vitamin A Sources
Animal sources of vitamin A (retinol)
1 portion Butter (20 g)
130,6 μg RAE
76,0 μg ß-Carotin | 120,0 μg Vitamin A
1 portion canned tuna in oil (60 g)
91,8 μg RAE
1,8 μg ß-Carotin | 90,0 μg Vitamin A
1 glass of milk 1,5 % (200 ml)
28,0 μg RAE
16,0 μg ß-Carotin | 30,0 μg Vitamin A
1 portion of veal liver (125 g)
38.136,25 μg RAE
38.136,25 μg Vitamin A
3 egga
500,4 μg RAE
23,4 μg ß-Carotin | 500,0 μg Vitamin A
1 slice of Gouda cheese, 45% fat (30 g)
85,5 μg RAE
45,0 μg ß-Carotin | 80,0 μg Vitamin A
Plant sources of provitamin A (beta-carotene)
1 portion of paprika (150 g)
531,0 μg RAE
3.187,5 μg ß-Carotin
1 Portion of lamb’s lettuce (50 g)
325,0 μg RAE
1.950,0 μg ß-Carotin
1 Portion of sweet potato (150 g)
1.971,0 μg RAE
11.830,5 μg ß-Carotin | 30,0 μg Vitamin A
1 Portion of chicory (50 g)
286,0 μg RAE
1.715,0 μg ß-Carotin
1 portion of apricots (50 g)
133,5 μg RAE
802,0 μg ß-Carotin
1 portion o kale (150 g)
1.293,0 μg RAE
7.753,50 μg ß-Carotin
A deficiency: causes and consequences
Vitamin A deficiency occurs when the body’s stores are depleted, too little vitamin A or beta-carotene is consumed in the diet, or the body is unable to absorb it properly.
Vitamin A deficiency can have serious consequences, including:
- Developmental disorders of the cardiovascular system, lungs, or urinary and reproductive systems,
- Fetal growth retardation,
- Disorders of mucosal function and increased susceptibility to infection,
- as well as a higher risk of complications for mother and child.
The reason: many plant-based foods contain substances known as phytates. These substances occur naturally in whole grain products, legumes (such as lentils or beans), nuts, and seeds. Phytates bind zinc in the intestine, making it more difficult for the body to absorb.
Vitamin-A-Mangel gehört weltweit zu den häufigsten ernährungsbedingten Gesundheitsproblemen. Laut der Weltgesundheitsorganisation (WHO) ist er vor allem in Subsahara-Afrika und Südostasien verbreitet. Besonders gefährdet sind Schwangere, Stillende und kleine Kinder in Regionen mit unzureichender Ernährung. Dort konnten Vitamin-A-Supplementationen die Kindersterblichkeit deutlich senken.
In Industrieländern wie Deutschland ist ein Vitamin-A-Mangel hingegen selten. Er tritt meist nur bei sehr einseitiger Ernährung oder bestimmten Erkrankungen auf, die die Aufnahme des Vitamins beeinträchtigen. Besonders betroffen sind Menschen mit Problemen bei der Fettverdauung oder Fettaufnahme, etwa bei chronisch-entzündlichen Darmerkrankungen (wie Morbus Crohn), Lebererkrankungen oder Störungen der Bauchspeicheldrüse. Darüber hinaus kann ein Mangel entstehen, wenn der Körper mehr Vitamin A verbraucht oder verliert – zum Beispiel bei Entzündungen, schweren Verletzungen oder Verbrennungen, chronischem Alkoholmissbrauch oder bestimmten Nierenerkrankungen, bei denen vermehrt Vitamin A über den Urin ausgeschieden wird.
Grundsätzlich liegt der Fokus in Industrienationen vielmehr auf der Vermeidung einer Überversorgung.
Vitamin A overdose and risks during pregnancy
Excessive intake of vitamin A can be harmful. Particularly high doses, such as those found in dietary supplements, increase the risk of malformations in unborn children. Pregnant women, especially in the first trimester, should therefore refrain from regular or excessive consumption of foods rich in vitamin A, especially liver.
The European Food Safety Authority (EFSA) has set the safe upper limit for daily intake at 3,000 μg RAE.
Symptoms of overdose may include:
-
- Headache, nausea, dizziness,
- Skin and liver changes,
- Bone pain,
- in extreme cases, developmental disorders in the fetus.
Daher sollte Vitamin A in Form von Nahrungsergänzungsmitteln während der Schwangerschaft nur nach ärztlicher Empfehlung eingenommen werden.
Conclusion: A balanced supply of vitamin A is crucial
Vitamin A is essential for the healthy development of mother and child. An adequate but not excessive intake protects against developmental disorders, strengthens the immune system, and supports the formation of healthy cells and tissues.
A varied diet rich in beta-carotene and moderate consumption of animal products ensures a safe supply. Excessive vitamin A intake, especially from high-dose supplements, should be avoided.
Acknowledgements
Many thanks to Münster University of Applied Sciences, in particular Janina Dapprich, Prof. Dr. oec. troph. Anja Markant, and Prof. Dr. rer. medic. Tobias Fischer, for writing this article as part of the “Nutrient Compass” project.
