Knowledge, awareness and recommendation on micronutrition during pregnancy-a survey of healthcare providers.

Background: The market for dietary supplements targeting women of reproductive age and pregnant individuals is rapidly expanding. Despite accumulating evidence regarding the benefits of specific micronutrients during pregnancy, there is considerable variability in international and national guidelines, compounded by knowledge gaps among healthcare professionals.

Objective: This study aimed to assess the knowledge, attitudes, and counseling practices of midwives and physicians in Germany concerning micronutrient supplementation during pregnancy.

Methods: A cross-sectional online survey was conducted among healthcare professionals in Frankfurt and surrounding regions in April to May 2024. A newly developed 24-item questionnaire was utilized to gather demographic data, assess counseling practices related to micronutrients and knowledge concerning of the roles of folic acid, vitamin D, vitamin B12, and omega-3 fatty acids in fetal development. Data were analyzed using descriptive statistics and Fisher's exact test (p < 0.05).

Results: Of the 360 individuals who accessed the survey, 107 completed it (33 midwives, 72 physicians). While 96.8% recommended supplementation during pregnancy, only 48.1% rated their knowledge as moderate. Folic acid was most frequently recommended supplement (78.7%), followed by omega-3 fatty acids (68%) and vitamin B12 (notably for vegan diets, 96.1%). Gaps in knowledge were identified, particularly regarding the biochemical forms of folate (34.5% unaware), sources and function of omega-3 fatty acids (20% lacked knowledge), and the role of vitamin B12 in fetal development (19% unaware). Only 41.8% explicitly recommended vitamin D, despite strong evidence of its importance. The majority of respondents expressed a strong interest in further education (91.0%).

Conclusion: Although healthcare professionals are generally engaged in counseling on prenatal supplementation, substantial knowledge gaps and inconsistent practices persist, particularly regarding newer recommendations beyond folic acid. To improve maternal and fetal health outcomes, there is a pressing need for improved educational initiatives and the broader implementation of tools such as the FIGO nutrition checklist.