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Pregnancy

Evidence Considered in Estimating the Average Requirement

Factorial Approach. The average daily rates of zinc accumulation by maternal and embryonic/fetal tissues during the four quarters of pregnancy are 0.08, 0.24, 0.53, and 0.73 mg (Swanson and King, 1987). On the assumption of no compensatory change in intestinal excretion of endogenous zinc, it is concluded that increasing daily zinc absorption by these amounts is desirable.

The average fractional absorption of zinc was 27 percent for nonpregnant women from eight studies in which dietary zinc averaged 10 mg/day (Fung et al., 1997; Hunt JR et al., 1992, 1998; Miller et al., 1998; Sian et al., 1996; Turnlund et al., 1991). Increases in fractional absorption during pregnancy have been reported to be nonsignificant (Fung et al., 1997), but this outcome may reflect inadequate power of the study design. Therefore, increases in dietary zinc requirements during pregnancy are calculated to be the following:

First quarter

0.08 ÷ 0.27 = 0.3 mg/day of zinc

Second quarter

0.24 ÷ 0.27 = 0.9 mg/day of zinc

Third quarter

0.53 ÷ 0.27 = 2.0 mg/day of zinc

Fourth quarter

0.73 ÷ 0.27 = 2.7 mg/day of zinc

To set a single EAR for pregnant women, the EAR is based on the additional requirement during the fourth quarter (2.7 mg/day) of pregnancy plus the EAR for nonpregnant adolescent girls and women. It should be noted, however, that the zinc requirement during the first quarter of pregnancy is only minimally greater than the preconceptional requirement.

Other Criteria. Dietary supplementation reduced the decline in plasma/serum zinc concentration across pregnancy in a large cohort of Peruvian women whose dietary zinc intake was estimated to be 7 mg/day (Caulfield et al., 1999a), but not in North American women whose dietary zinc intake averaged 11 mg/day (Hambidge et al., 1983). Correlations observed between maternal biochemical indexes of zinc status and complications of pregnancy, delivery, and fetal development have been inconsistent.

Gravid women with a zinc intake of 6 mg/day or less were found to have a high incidence of premature deliveries (Scholl et al., 1993). Increased gestational age at delivery and increased birth size



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