“The largest knowledge deficit was observed for vitamin B12 among pregnant women, with over half unable to identify any fetal effect; however, provider knowledge was also incomplete,” wrote researchers at Goethe University Frankfurt, in Nutrients.
“These findings suggest that more structured communication regarding micronutrient supplementation during pregnancy is needed.”
They warned that the results regarding B12 warrant particular clinical attention; “This discrepancy likely reflects the prevailing assumption that vitamin B12 deficiency is relevant only in vegetarian or vegan women, an assumption reflected in current German guidelines,” they wrote.
“However, given that 18.2% of women in our cohort followed a vegetarian or vegan diet, and with plant-based diets becoming increasingly prevalent among women of childbearing age, the clinical relevance of vitamin B12 in routine prenatal care may be underestimated by healthcare professionals.”
The study noted that the formal recommendation for omega-3 fatty acids in German guidelines is inconsistent, even though professional bodies endorse supplementation given its role in fetal brain development. The findings revealed similar rates of ambiguity regarding benefits among pregnant women and health professionals.
“In contrast, the high concordance observed for folic acid confirms that clear, long-standing, and widely disseminated public health recommendations are more reliably translated into both clinical recommendations and patient behavior.”
Study details
The cross-sectional study design enabled researchers to make direct comparisons between healthcare professionals and pregnant women about their micronutrient knowledge, perceived dietary adequacy, and supplementation practices and recommendations.
Two parallel questionnaires using identical core items were administered to pregnant women and healthcare professionals.
The healthcare professionals included midwives, obstetricians, obstetric residents, or medical students working in obstetric practice at the Department of Obstetrics and Prenatal Medicine, University Hospital Frankfurt, Germany.
The pregnant women were mainly aged 26-35 and highly educated. Over 95% of the women reported having actively sought nutrition information during pregnancy, and nearly 94% took micronutrient supplements.
132 pregnant women responded, and 80 healthcare professionals completed the questionnaire fully. The researchers assessed responses using statistical methods and restricted comparative analyses to fully completed questionnaires.
Micronutrient knowledge
The results showed that healthcare providers consistently demonstrated greater knowledge of fetal effects across all assessed micronutrients.
“Knowledge gaps were most pronounced for vitamin B12: over half of pregnant women (53.0%) reported not knowing any fetal effect of this micronutrient, compared to 20.0% of providers,” the study noted. Similarly, knowledge about vitamin D for fetal bone development and folic acid’s role in the nervous system was substantially lower among patients than providers.
There was similar knowledge about omega-3 fatty acids’ role in brain development, and 25% and 18.8% uncertainty for patients and providers, respectively.
The sources of nutrition information during pregnancy were mainly the internet and gynecologists for pregnant women, and the internet, scientific literature, and professional training for healthcare providers.
Dietary sufficiency
Both groups largely recognized that dietary intake alone is not sufficient to meet vitamin D and folic acid requirements during pregnancy.
However, beliefs about vitamin B12 differed substantially: half of pregnant women believed diet was sufficient, whereas the majority of professionals (79.2%) considered dietary B12 adequate.
Supplementation
As far as supplementation was concerned, pregnant women “reported substantially higher rates of supplementation than those recommended by healthcare providers,” with the discrepancy most marked for vitamin B12, where 70% of pregnant women supplemented compared to only 3.8% of providers recommending it.
The researchers noted that the study was exploratory and “findings should be interpreted as hypothesis-generating”.
Source: Nutrients 2026, 18(12), 1934; https://doi.org/10.3390/nu18121934 (registering DOI), “Differences in Micronutrient Knowledge, Beliefs, and Supplementation Practices Between Pregnant Women and Healthcare Providers: A Cross-Sectional Study.” Authors: A. E. Hentrich et al.
