Symptoms of vitamin deficiency during pregnancy

Section 1: Vitamin D deficiency during pregnancy: risks and manifestations

Pregnancy is a period of increased need for vitamins and minerals necessary for the healthy development of the fetus and maintaining the health of the mother. Vitamin D, being fat -soluble vitamin, plays a key role in the absorption of calcium, regulation of the immune system and the development of bone tissue in both the mother and the child. Vitamin D deficiency during pregnancy is a common phenomenon, especially in regions with limited sunlight or in women with dark skin, obesity or observing a vegetarian diet.

1.1 The role of vitamin D in pregnancy:

Vitamin D, also known as calciferol, is not a vitamin in the classical sense. This is a runner, which the body is able to synthesize under the influence of ultraviolet radiation (UVB) in the skin. In small quantities, vitamin D comes with food, especially from oily fish, egg yolks and enriched products. However, sunlight remains the main source of vitamin D for most people.

During pregnancy, vitamin D performs a number of important functions:

• Regulation of calcium metabolism: Vitamin D promotes the absorption of calcium in the intestines and maintaining its level in the blood, which is necessary for the formation of the bones and teeth of the fetus, as well as to prevent the development of osteoporosis in the mother.
• Support for the immune system: Vitamin D plays a role in the modulation of the immune response, which helps to reduce the risk of infections during pregnancy and after childbirth. The deficiency of vitamin D can increase susceptibility to bacterial and viral infections.
• Development of the nervous system of the fetus: Vitamin D is involved in the development of the brain and the nervous system of the fetus, which can affect the cognitive functions and behavior of the child in the future.
• Glucose level regulation: Studies show that vitamin D can improve insulin sensitivity and reduce the risk of gestational diabetes.
• Reduction of the risk of preeclampsia: Some studies associate the deficiency of vitamin D with an increased risk of developing preeclampsia, a dangerous complication of pregnancy characterized by high blood pressure and proteinuria.

1.2 Risk factors for the development of vitamin D deficiency during pregnancy:

Some factors increase the likelihood of developing vitamin D during pregnancy:

• Geographical position: Accommodation in regions with low insolation, especially in the winter months, limits the synthesis of vitamin D in the skin.
• Skin color: Dark skin contains more melanin, which blocks UVB ray and reduces the production of vitamin D.
• Obesity: Vitamin D is fat -soluble, therefore, in women with overweight it can accumulate in adipose tissue, reducing its accessibility for the body.
• Insufficient consumption of vitamin D with food: A vegetarian or vegan diet, as well as limited consumption of fatty fish, eggs and enriched products can lead to a deficiency of vitamin D.
• Using sunscreen creams: Sunscreen creams block UVB ray and reduce the synthesis of vitamin D in the skin.
• Diseases affecting fat absorption: Some diseases, such as cystic fibrosis or Crohn’s disease, may disrupt the absorption of fat and vitamin D in the intestines.
• Pregnancy in adolescence: Teenagers, being pregnant, have an increased need for vitamin D for their own growth and development, as well as for the development of the fetus.
• Multiple pregnancy: With multiple pregnancy, the need for vitamin D increases, increasing the risk of deficiency.

1.3 Symptoms of vitamin D deficiency during pregnancy:

Symptoms of vitamin D deficiency can be non -specific and often go unnoticed. However, with a progressive deficiency, the following signs may appear:

• Fatigue and weakness: General weakness and increased fatigue are common symptoms of vitamin D. deficiency
• Bone pain and muscles: The disadvantage of vitamin D can lead to pain in the bones and muscles, especially in the back of the back, pelvis and legs.
• Reduced immunity: Frequent colds and infections may indicate a decrease in immunity associated with vitamin D. deficiency.
• Depression and anxiety: Vitamin D plays a role in the regulation of mood, and its deficiency can contribute to the development of depression and anxiety.
• Hair loss: The deficiency of vitamin D can lead to hair loss.
• Slow wound healing: Vitamin D deficiency can slow down the healing process of wounds.

In severe cases, vitamin D deficiency can lead to more serious complications, such as:

• Osteomulation: Softening of bones, which increases the risk of fractures.
• Muscle weakness: Pronounced muscle weakness that impedes movement.
• Precomports: Increased risk of preeclampsia.
• Gestational diabetes: Increased risk of developing gestational diabetes.
• Premature birth: Increased risk of premature birth.
• Low birth weight: An increased risk of a child with low weight.
• Rachite in a child: Vitamin D deficiency in the mother can lead to rickets in a child characterized by a violation of bone formation.

1.4 Diagnosis of vitamin D deficiency during pregnancy:

Diagnosis of vitamin D deficiency is based on determining the level of 25-hydroxyvitamin D [25(OH)D] In the blood. The optimal level of 25 (OH) D for pregnant women is 30-60 ng/ml (75-150 nmol/l).

• Deficiency: Level 25 (OH) D less than 20 ng/ml (50 nmol/l).
• Failure: Level 25 (OH) D 20-29 ng/ml (50-72.5 nmol/l).
• Optimal level: Level 25 (OH) D 30-60 ng/ml (75-150 nmol/l).
• Toxicity: Level 25 (OH) D is more than 100 ng/ml (250 nmol/l). (It is extremely rare and usually associated with excessive techniques of vitamin D)

The doctor may prescribe a blood test for vitamin D in the presence of risk factors or symptoms indicating its deficiency.

1.5 Treatment and prevention of vitamin D deficiency during pregnancy:

Treatment and prevention of vitamin D deficiency during pregnancy includes the following measures:

• Reception of vitamin D additives: Most pregnant women are recommended to take vitamin D3 additives (cholecalciferol) at a dose of 1000-2000 IU (international units) per day. In some cases, especially with a pronounced deficiency, the doctor may prescribe higher doses under the control of level 25 (OH) D in the blood.
• Balanced nutrition: The inclusion in the diet of products rich in vitamin D, such as fatty fish (salmon, herring, mackerel), egg yolk, enriched dairy products and cereals.
• Regular stay in the sun: A moderate stay in the sun (15-20 minutes a day) without sunscreen in the hours of the smallest solar activity (morning or evening) can contribute to the synthesis of vitamin D in the skin. However, it should be remembered about the risks associated with the excessive effect of solar radiation, such as sunburn and skin cancer.
• Vitamin D level control: Regular control of level 25 (OH) D in the blood allows you to evaluate the effectiveness of treatment and prevention and adjust the dose of vitamin D if necessary.

It is important to consult a doctor before taking vitamin D additives to determine the optimal dose and avoid an overdose. An overdose of vitamin D can lead to undesirable side effects, such as nausea, vomiting, constipation, weakness and increased blood calcium (hypercalcemia).

Section 2: iron deficiency during pregnancy: causes, symptoms and consequences

Iron deficiency is one of the most common scarce conditions during pregnancy. Iron plays an important role in the formation of hemoglobin, protein in red blood cells, which transfers oxygen to all tissues of the body. During pregnancy, the need for gland increases significantly, since it is necessary to provide oxygen of the fetus, placenta and increase the volume of the blood of the mother.

2.1 The role of iron in pregnancy:

Iron performs a number of vital functions during pregnancy:

• Oxygen transport: Iron is a key component of hemoglobin, which transfers oxygen from the lungs to all organs and tissues of the body, including the fetus.
• Fetal development: Iron is necessary for the growth and development of the fetus, especially for the formation of the brain and nervous system.
• Placenta formation: Iron is involved in the formation of the placenta, an organ that provides nutrition and oxygen to the fetus.
• Maintaining immunity: Iron plays a role in maintaining the immune system, helping to fight infections.
• Energy regulation: Iron is involved in the processes of energy production in the body.

2.2 Risk factors for the development of iron deficiency during pregnancy:

Some factors increase the likelihood of developing iron deficiency during pregnancy:

• Insufficient consumption of iron with food: A low iron diet, especially hem iron (contained in meat, poultry and fish), can lead to iron deficiency.
• Increased blood volume: During pregnancy, the blood volume increases by about 50%, which requires more iron for the production of hemoglobin.
• Multiple pregnancy: With multiple pregnancy, the need for iron increases, increasing the risk of deficiency.
• Previous pregnancies: Frequent pregnancy can deplete iron supplies in the body.
• Menstrual bleeding: Abundant menstrual bleeding before pregnancy can lead to depletion of iron reserves.
• Diseases affecting iron absorption: Some diseases, such as Crohn’s disease or celiac disease, can violate the absorption of iron in the intestines.
• Bleeding: Bleeding during pregnancy, even insignificant, can lead to iron loss.
• Vegetarian or vegan diet: Plant sources of iron (non -meter iron) are worse absorbed by the body than hemic iron.

2.3 Symptoms of iron deficiency during pregnancy:

Symptoms of iron deficiency (iron deficiency anemia) can be different and depend on the degree of deficiency. The most common symptoms include:

• Fatigue and weakness: A constant feeling of fatigue and weakness is one of the most common symptoms of iron deficiency anemia.
• Pallor of the skin and mucous membranes: The pallor of the skin, especially on the face, inner side of the eyelids and nail bed, can indicate a deficiency of iron.
• Dyspnea: Shortness of breath with physical exertion or even at rest can be a sign of iron deficiency anemia.
• Dizziness and headaches: Dizziness and headaches can occur due to insufficient oxygen intake to the brain.
• Far heartbeat: Far heartbeat (tachycardia) can be a compensatory reaction of the body to a lack of oxygen.
• Fitty nails and hair: Nails can become brittle, thin and have a concave shape (coilonichi). Hair can fall out and be dull.
• Carrying to unusual substances (peak): An unusual craving for non -food substances, such as clay, chalk, ice or paint (peak), may indicate a deficiency of iron.
• Restless legs syndrome: Unpleasant sensations in the legs that make them constantly move them, especially at night.
• Reduced immunity: Iron deficiency can reduce immunity and increase susceptibility to infections.

In severe cases, iron deficiency anemia can lead to more serious complications, such as:

• Premature birth: Increased risk of premature birth.
• Low birth weight: An increased risk of a child with low weight.
• Fetal development delay: Iron deficiency can slow down the growth and development of the fetus.
• Increased risk of maternal mortality: In severe cases, iron deficiency anemia can increase the risk of maternal mortality.

2.4 Diagnosis of iron deficiency during pregnancy:

Diagnosis of iron deficiency is based on the results of blood tests, which include:

• General blood test: Determines the level of hemoglobin (HB), hematocrit (HT) and the number of red blood cells (red blood cells). A decrease in these indicators may indicate anemia.
• Determining the level of ferritin: Ferritin is a protein that storages iron in the body. The low level of ferritin is the most sensitive indicator of iron deficiency.
• Determining the level of iron in the blood serum: Assesses the amount of iron circulating in the blood.
• Determination of the general iron -binding ability (OHSSS): Assesses the ability of blood proteins to bind iron. With a deficiency of iron, OZHSS usually rises.
• Posterin saturation with iron: Estimates the percentage of transferrin (protein, carrying iron) associated with iron. With iron deficiency, the saturation of transferrin is reduced with iron.

The doctor may prescribe these tests in the presence of risk factors or symptoms indicating iron deficiency.

2.5 Treatment and prevention of iron deficiency during pregnancy:

Treatment and prevention of iron deficiency during pregnancy includes the following measures:

• Iron preparations: The most effective way to treat iron deficiency anemia is the use of iron preparations. Typically, iron preparations in the form of iron sulfate, iron fumarat or iron gluconate are prescribed. The dose of the drug of iron depends on the degree of deficiency and is prescribed by a doctor. It is important to take iron iron drugs (30 minutes before meals or 2 hours after meals) to improve absorption. The simultaneous use of iron preparations with dairy products, coffee, tea and some drugs should be avoided, as they can reduce iron absorption. Vitamin C (ascorbic acid) improves iron absorption, so it is recommended to take iron drugs with vitamin C or drink them with orange juice. Iron preparations can cause side effects, such as constipation, nausea, vomiting and abdominal pain. To reduce side effects, you can start with a low dose and gradually increase it, as well as take iron drugs after eating.
• Balanced nutrition: The inclusion in the diet of products rich in iron, especially hemal iron, such as red meat, poultry and fish. Plant sources of iron (non -meter iron) are found in legumes, spinach, broccoli and dried fruits. To improve the absorption of a non -meter iron, it is recommended to use it in combination with products rich in vitamin C.
• Limiting the consumption of iron absorption inhibitors: It is necessary to limit the consumption of products that can reduce iron absorption, such as tea, coffee, dairy products and foods rich in phytates (contained in grain and legumes).
• Iron level control: Regular control of the level of iron in the blood allows you to evaluate the effectiveness of treatment and prevention and adjust the dose of iron drugs if necessary.

It is important to consult a doctor before taking iron drugs in order to determine the optimal dose and avoid overdose. An overdose of iron can lead to serious side effects, such as damage to the liver and heart.

Section 3: Folic acid deficiency during pregnancy: critical role and consequences

Folic acid (vitamin B9) is a water -soluble vitamin that plays a key role in the development of the fetal nervous tube in the first weeks of pregnancy. Folic acid deficiency during pregnancy can lead to serious congenital defects such as defects in the nervous tube (DNT).

3.1 The role of folic acid in pregnancy:

Folic acid is necessary for the following processes:

• The development of the nervous tube: Folic acid plays a critical role in the formation of the nerve tube of the fetus, which develops in the brain and spinal cord. The deficiency of folic acid in the first weeks of pregnancy can lead to DNT, such as a cleft spine (Spina Bifida) and anencephalus (lack of a brain).
• Synthesis DNA and RNA: Folic acid is involved in the synthesis of DNA and RNA, the genetic material of the cells.
• Cell growth and division: Folic acid is necessary for the normal growth and division of cells, especially in periods of rapid growth, such as pregnancy.
• Formation of red blood cells: Folic acid is involved in the formation of red blood cells. Folic acid deficiency can lead to megaloblastic anemia.

3.2 Risk factors for the development of folic acid deficiency during pregnancy:

Some factors increase the likelihood of developing folic acid deficiency during pregnancy:

• Insufficient consumption of folic acid with food: A low folic acid diet, especially before and in the first weeks of pregnancy, is the main risk factor for folic acid deficiency.
• Diseases affecting the absorption of folic acid: Some diseases, such as Crohn’s disease or celiac disease, may disrupt the absorption of folic acid in the intestines.
• Reception of some drugs: Some drugs, such as anticonvulsant drugs (phenytoid, valproic acid) and methotrexate, can reduce the level of folic acid in the body.
• Alcoholism: Chronic alcohol consumption can disrupt the absorption and metabolism of folic acid.
• Pregnancy in adolescence: Teenagers, being pregnant, have an increased need for folic acid.
• Multiple pregnancy: With multiple pregnancy, the need for folic acid increases, increasing the risk of deficiency.
• Previous pregnancy with DNT: Women who had a previous pregnancy with DNT have an increased risk of re -birth of a child with DNT.

3.3 Symptoms of folic acid deficiency during pregnancy:

Symptoms of folic acid deficiency can be non -specific and often go unnoticed. However, with a progressive deficiency, the following signs may appear:

• Fatigue and weakness: General weakness and increased fatigue are common symptoms of folic acid deficiency.
• Pallor of the skin and mucous membranes: The pallor of the skin, especially on the face, inner side of the eyelids and nail bed, may indicate a deficiency of folic acid.
• Irritability: Increased irritability and mood swings.
• Difficulties with concentration: Difficulties with concentration of attention and memory deterioration.
• Taries in the mouth: Painful ulcers in the mouth (AFTA).
• Glossit: Inflammation of the tongue, which can lead to pain and difficulty swallowing.
• Diarrhea: Chronic diarrhea.

However, the most serious consequence of folic acid deficiency during pregnancy is an increased risk of DNT in a child.

3.4 Diagnosis of folic acid deficiency during pregnancy:

Diagnosis of folic acid deficiency is based on determining the level of folic acid in the blood.

• Determining the level of folic acid in blood serum: This analysis measures the amount of folic acid circulating in the blood.
• Determining the level of folic acid in red blood cells: This analysis measures the amount of folic acid contained in red blood cells. It is considered a more accurate indicator of the long -term status of folic acid than the level of folic acid in the blood serum.

The doctor may prescribe these tests in the presence of risk factors or symptoms indicating a deficiency of folic acid.

3.5 Treatment and prevention of folic acid deficiency during pregnancy:

Treatment and prevention of folic acid deficiency during pregnancy includes the following measures:

• Reception of folic acid additives: All women planning pregnancy or in the early stages of pregnancy are recommended to take folic acid supplements at a dose of 400-800 mcg per day. Women with a high risk of DNT development (for example, having a previous pregnancy with DNT taking anticonvulsants or having diabetes) may require a higher dose of folic acid (up to 4 mg per day). It is important to start taking folic acid additives at least 1-3 months before conception and continue during the first trimester of pregnancy.
• Balanced nutrition: The inclusion in the diet of products rich in folic acid, such as dark green leafy vegetables (spinach, broccoli, salad label), legumes, citrus fruits, avocados and enriched cereals.
• Alcohol consumption restriction: Alcohol is avoided during pregnancy, as it can disrupt the absorption and metabolism of folic acid.

It is important to consult a doctor before taking folic acid additives in order to determine the optimal dose and exclude other possible causes of symptoms.

Section 4: Vitamin B12 deficiency during pregnancy: importance for the nervous system and blood

Vitamin B12 (cobalamin) is a water -soluble vitamin that plays an important role in the functioning of the nervous system, the formation of red blood cells and DNA synthesis. Vitamin B12 deficiency during pregnancy can lead to neurological disorders in both the mother and the child, as well as to megaloblastic anemia.

4.1 The role of vitamin B12 in pregnancy:

Vitamin B12 is necessary for the following processes:

• The functioning of the nervous system: Vitamin B12 plays an important role in maintaining the health of nerve cells and the myelin shell, which protects the nerve fibers. Vitamin B12 deficiency can lead to neurological disorders, such as numbness and tingling in the limbs, weakness, depression and cognitive disorders.
• The formation of red blood cells: Vitamin B12 is involved in the formation of red blood cells. Vitamin B12 deficiency can lead to megaloblastic anemia, characterized by the formation of large and immature red blood cells.
• DNA synthesis: Vitamin B12 is involved in the synthesis of DNA, the genetic material of the cells.
• Fetal development: Vitamin B12 is necessary for the normal growth and development of the fetus, especially for the development of the brain and nervous system.

4.2 Risk factors for the development of vitamin B12 deficiency during pregnancy:

Some factors increase the likelihood of developing vitamin B12 during pregnancy:

• Vegetarian or vegan diet: Vitamin B12 is contained mainly in animal products, such as meat, poultry, fish, eggs and dairy products. Vegetarians and vegans that do not use these products are at risk of vitamin B12 deficiency.
• Diseases affecting the absorption of vitamin B12: Some diseases, such as atrophic gastritis, pernicious anemia, Crohn’s disease and celiac disease, may violate the absorption of vitamin B12 in the intestines.
• Reception of some drugs: Some drugs, such as metformin (used to treat diabetes) and proton pump inhibitors (are used to treat heartburn), can reduce the absorption of vitamin B12.
• Surgical removal of part of the stomach or intestines: Operations to remove part of the stomach or intestines can violate the absorption of vitamin B12.
• Age: With age, the absorption of vitamin B12 worsens.
• Helicobacter pylori infection: Helicobacter pylori infection can lead to atrophic gastritis and impaired absorption of vitamin B12.

4.3 Symptoms of vitamin B12 deficiency during pregnancy:

Symptoms of vitamin B12 deficiency can be different and depend on the degree of deficiency. The most common symptoms include:

• Fatigue and weakness: A constant feeling of fatigue and weakness is one of the most common symptoms of vitamin B12 deficiency.
• Pallor of the skin and mucous membranes: The pallor of the skin, especially on the face, inner side of the eyelids and nail bed, may indicate a deficiency of vitamin B12.
• Dyspnea: Shortness of breath with physical activity or even at rest can be a sign of vitamin B12 deficiency.
• Numbness and tingling in the limbs: Numbness and tingling in the hands and legs are common neurological symptoms of vitamin B12 deficiency.
• Weakness: Muscle weakness and difficulties when walking.
• Depression and irritability: Depression, irritability and mood swings.
• Difficulties with concentration: Difficulties with concentration of attention and memory deterioration.
• Glossit: Inflammation of the tongue, which can lead to pain and difficulty swallowing.
• Diarrhea or constipation: Stool disorders such as diarrhea or constipation.

In children born from mothers with vitamin B12 deficiency, developmental delay, neurological disorders and anemia may be observed.

4.4 Diagnosis of vitamin B12 deficiency during pregnancy:

Diagnosis of vitamin B12 deficiency is based on the results of blood tests, which include:

• Determining the level of vitamin B12 in blood serum: This analysis measures the amount of vitamin B12 circulating in the blood. However, this indicator may not be accurate enough, since it can be normal even in the presence of vitamin B12 deficiency in tissues.
• Determination of the level of methylmalonic acid (MMA) in the urine or blood: MMA is a substance whose level increases with vitamin B12 deficiency. This analysis is a more sensitive indicator of vitamin B12 deficiency than the level of vitamin B12 in blood serum.
• Determining the level of homocysteine in the blood: Homocysteine is an amino acid whose level increases with a deficiency of vitamin B12 and folic acid.
• General blood test: It can identify signs of megaloblastic anemia.

The doctor may prescribe these tests in the presence of risk factors or symptoms indicating vitamin B12 deficiency.

4.5 Treatment and prevention of vitamin B12 deficiency during pregnancy:

Treatment and prevention of vitamin B12 deficiency during pregnancy includes the following measures:

• Reception of vitamin B12 additives: Pregnant women, especially vegetarian and vegans, are recommended to take vitamin B12 additives at a dose of 2.6 μg per day. In some cases, especially in the presence of diseases that violate the absorption of vitamin B12, a higher dose of vitamin B12 may be required.
• Vitamin B12 injections: In the presence of diseases that violate the absorption of vitamin B12, vitamin B12 injections can be prescribed.
• Balanced nutrition: The inclusion in the diet of products rich in vitamin B12, such as meat, poultry, fish, eggs and dairy products. Vegetarians and vegans are recommended to use products enriched with vitamin B12, such as vegetable milk, cereals and soy products.

It is important to consult a doctor before taking vitamin B12 additives to determine the optimal dose and exclude other possible causes of symptoms.

Section 5: Other important vitamins and minerals during pregnancy and their deficiency

In addition to vitamin D, iron, folic acid and vitamin B12, during pregnancy other vitamins and minerals are important, the deficiency of which can adversely affect the health of the mother and child.

5.1 vitamin A:

• Role in pregnancy: Vitamin A is necessary for the development of vision, immune system and cell growth.
• Risk factors of deficiency: Insufficient consumption of products rich in vitamin A, such as liver, egg yolk, carrots and dark green leafy vegetables.
• Deficiency symptoms: Chicken blindness, dry skin and eyes, reduction of immunity.
• Warning: Excessive use of vitamin A during pregnancy can lead to congenital defects. It is recommended to get vitamin A from food and additives containing beta-carotene (predecessor of vitamin A), which is safe for pregnant women.
• Recommended dose: 770 μg RAE (retinol equivalent) per day.

5.2 Vitamin C:

• Role in pregnancy: Vitamin C is an antioxidant and is necessary for the synthesis of collagen, strengthen the immune system and improve iron absorption.
• Risk factors of deficiency: Insufficient consumption of fruits and vegetables rich in vitamin C, such as citrus fruits, kiwi, strawberries, pepper and broccoli.
• Deficiency symptoms: Fatigue, bleeding gums, slow healing of wounds, frequent colds.
• Recommended dose: 85 mg per day.

5.3 Calcium:

• Role in pregnancy: Calcium is necessary for the formation of the bones and teeth of the fetus, as well as to maintain the health of the bones of the mother.
• Risk factors of deficiency: Insufficient consumption of dairy products, dark green leafy vegetables and enriched products.
• Deficiency symptoms: Bone pain, muscle cramps, osteoporosis.
• Recommended dose: 1000 mg per day.

5.4 iodine:

• Role in pregnancy: Iodine is necessary for the normal functioning of the thyroid gland and the development of the brain of the fetus.
• Risk factors of deficiency: Insufficient consumption of iodized salt, seafood and dairy products.
• Deficiency symptoms: An increase in the thyroid gland (goiter), hypothyroidism, fetal development.
• Recommended dose: 220 mcg per day.

5.5 zinc:

• Role in pregnancy: Zinc is necessary for the growth and development of cells, immune function and wound healing.
• Risk factors of deficiency: Insufficient consumption of meat, poultry, legumes and whole grains.
• ** Symptom