Sources of dietary recommendations and adherence to clinical guidelines in pregnant women in Germany

Nutrition during pregnancy affects the health of both the mother and the child with potential long-term consequences. Consequently, educating pregnant women about recommended nutritional practices is essential. This cross-sectional study examined dietary information sources used by pregnant women in Germany and evaluated their adherence to clinical guidelines. Pregnant women (≥ 6th week of gestation) were recruited nationwide via social media (January–June 2022), and completed an online questionnaire assessing sources and content of their nutritional information. The data were subsequently analyzed for their alignment with guidelines provided by the Germany-wide Healthy Start Network of the Federal Center for Nutrition and the German Nutrition Society. Chi-square and t-tests were used to explore associations, and multivariable logistic regression was conducted to identify significant predictors of supplement use and dietary practices, considering sociodemographic and behavioral factors. Of 3,363 participants, 68.66% reported dietary changes during pregnancy, yet 82.76% received limited or no counseling from healthcare providers. Most women (77.70%) sought information online. While 89.03% took dietary supplements, this percentage was significantly higher among pregnant women with higher income (OR = 1.55, CI 1.18–2.03, p < 0.001) and higher educational levels (OR = 1.47, CI 1.15–1.88, p = 0.001). Although most of the women (87.87%) supplemented with folic acid, only 66.10% supplemented with iodine. However, when considering dosage and supplementation period, at least 37.08% of women for folic acid and 46.06% for iodine did not meet recommendations or did not supplement at all. While recommendations to avoid specific foods and to take a folic acid supplement are widely recognized, the dietary practices of pregnant women frequently deviate from professional guidelines. These results emphasize the importance of targeted education and standardized counseling by qualified professionals to ensure optimal nutrition during pregnancy and reduce potential risks to both mother and child. Future research should identify strategies to effectively address these problems.