Zinc and pregnancy: role, needs, and zinc-rich foods for pregnant women

By: Solène Limongi (Nutritionniste et diététicienne) — 22/02/2026

The role of zinc during pregnancy

Zinc is an essential trace element involved in the function of more than 300 enzymes and in the structure of approximately 3,000 proteins. During pregnancy, a period of intense cell division, its roles are particularly critical:

DNA synthesis and cell division

Zinc is essential for the activity of thymidine kinase and DNA polymerase, two key enzymes in DNA replication. Without sufficient zinc, cell division — extremely rapid in the embryo and then the fetus — is slowed, which can affect fetal growth.

Neural tube development

Zinc deficiency impairs the proliferation of fetal neural progenitor cells. A 2022 meta-analysis (Cheng & Gao, 8 studies, 187 cases and 894 controls) showed that mothers of children with neural tube defects had significantly lower serum zinc levels (SMD = -0.77, 95% CI: -1.16 to -0.37, p = 0.0001).

Immune function

Zinc is required for the development and function of immune cells: neutrophils, NK cells, and T lymphocytes. Maternal zinc deficiency affects the immune function of offspring, with effects that can persist across several generations (animal studies). Zinc is also an essential component of the antioxidant barrier (via Cu/Zn superoxide dismutase).

Placental development

Zinc is a critical regulator of placental morphogenesis and maternal hemodynamics. A deficiency can lead to abnormal placental morphogenesis, one of the suspected mechanisms of pre-eclampsia. A 2022 meta-analysis (Zhang et al., 51 studies, 6,947 participants) confirmed that pre-eclamptic women had significantly lower zinc levels (SMD = -1.00, 95% CI: -1.29 to -0.70).

Taste and smell

Zinc is a cofactor of alkaline phosphatase, the most abundant enzyme in taste bud membranes. It influences the production of gustin, linked to taste bud renewal. Zinc deficiency can worsen dysgeusia (taste alteration) often reported by pregnant women — 93% of them report taste changes during pregnancy.

Zinc needs and recommended doses during pregnancy

Zinc needs depend on the level of phytates in the diet (phytates reduce zinc absorption). ANSES and EFSA distinguish three levels:

*Depending on dietary phytate level (300, 600, or 900 mg/day). Lower value = diet rich in animal proteins. Higher value = vegetarian diet rich in whole grains and legumes.

During pregnancy, needs increase by approximately +1.6 mg/day compared to non-pregnant women (EFSA 2014), due to the fetus's zinc needs for DNA synthesis and tissue growth. If you follow a vegetarian or vegan diet, your needs are higher due to the lower bioavailability of plant-based zinc.

Zinc deficiency during pregnancy: frequency and risks

Zinc deficiency is a global problem: it is estimated that zinc intake is inadequate in 82% of pregnant women worldwide (Caulfield et al.). In Europe and North America, biochemical deficiency is rarer (4-7% according to the WHO), but sub-optimal intakes are possible, particularly in vegetarians and women whose diet is rich in whole grains (high phytates).

Complications associated with zinc deficiency during pregnancy are documented in numerous studies:

Important nuance: the most recent Cochrane review (Carducci et al. 2021, 25 trials, more than 18,000 women) concludes that there is not enough evidence to assert that zinc supplementation improves pregnancy outcomes. The WHO recommends zinc supplementation only in the context of research, not routinely. The priority should remain a varied and balanced diet.

Zinc-rich foods for pregnant women

Zinc is found in both animal and plant foods, but its bioavailability varies considerably. Animal sources are better absorbed (20-40% absorption) than plant sources (5-15% due to phytates).

Animal sources (high bioavailability)

Plant sources (lower bioavailability)

In practice: a 150 g serving of braised beef (approx. 13 mg) already covers your entire daily needs. For a vegetarian diet, combine pumpkin seeds, cashews, lentils, and wheat germ daily, prioritizing soaking and sprouting to reduce phytates.

Bioavailability: phytates and zinc absorption

Phytates (phytic acid) are compounds found in whole grains, legumes, and seeds. They bind to zinc in the intestine and significantly reduce its absorption. This is why EFSA and ANSES adjust zinc recommendations based on the phytate level in the diet.

To improve zinc absorption in a plant-rich diet:

• Soaking legumes and grains before cooking (12-24 h) — reduces phytates by 30 to 50%
• Sprouting seeds (lentils, chickpeas) — activates phytase which breaks down phytates
• Fermentation: sourdough bread contains fewer phytates than yeast bread, thanks to bacterial phytase activity
• Pairing with animal protein (meat, fish) at meals — animal proteins improve zinc absorption

Zinc-iron interactions and other nutrients

The interaction between zinc and iron is particularly important during pregnancy, as iron supplementation is very common:

• Iron doses ≥ 25 mg of elemental iron, taken at the same time as zinc, reduce zinc absorption and plasma zinc concentrations.
• Iron doses > 60 mg/day (and possibly lower doses) depress zinc in pregnant women.
• Practical recommendation: when iron supplementation exceeds 30 mg/day, ensure adequate zinc intake. Take iron and zinc at different times of the day (at least 2 hours apart).

The interaction with calcium is less concerning at usual doses. The zinc-folate interaction is debated in the literature: the evidence is insufficient to conclude a significant negative effect. In practice, both are well tolerated together.

Zinc supplementation: when and how much?

Zinc supplementation is not routinely recommended during pregnancy, by neither the WHO nor ANSES. It may however be considered in certain cases:

• High-dose iron supplementation (> 30 mg/day) without increased dietary zinc intake
• Strict vegan diet with insufficient intake despite dietary precautions
• Multiple pregnancy with increased needs
• Chronic digestive disorders (celiac disease, Crohn's) impairing absorption

The usual supplementation dose is 10-15 mg/day of elemental zinc, in gluconate, citrate, or bisglycinate form. Do not exceed the safety limit set by EFSA.

Safety and limits of zinc supplementation

A zinc intake ≥ 50 mg/day for several weeks triggers the synthesis of metallothionein in the intestine. This protein traps copper and prevents its absorption, leading to a risk of copper deficiency (anemia, neutropenia, bone abnormalities). This is the main danger of excess zinc.

Side effects of zinc overdose include:

• > 40 mg/day: nausea, vomiting, abdominal cramps, diarrhea
• > 50 mg/day: inhibition of copper and iron absorption, decrease in HDL cholesterol

ANSES recommends the utmost caution with dietary supplements during pregnancy and advises against multiple micronutrient sources. Zinc supplementation should be done under medical supervision.