Micronutrient deficiencies in pregnancy worldwide: health effects and prevention

Abstract

Micronutrients, vitamins and minerals accessible from the diet, are essential for biologic activity. Micronutrient status varies widely throughout pregnancy and across populations. Women in low-income countries often enter pregnancy malnourished, and the demands of gestation can exacerbate micronutrient deficiencies with health consequences to the fetus. Examples of efficacious single micronutrient interventions include folic acid to prevent neural tube defects, iodine to prevent cretinism, zinc to reduce of preterm birth, and iron to reduce the risk of low birth weight. Folic acid and vitamin D might also increase birth weight. While extensive mechanism and association research links antenatal multiple micronutrients to plausible materno-fetal health advantages, hypothesized benefits have often been absent, minimal or unexpected in trials. These findings suggest a role for population context in determining health responses and extensive gaps in knowledge. Multiple micronutrient supplements reduce risks of being born low birth weight, small for gestational age or stillborn in undernourished settings, and justify micronutrient interventions with antenatal care. Measurable health effects of gestational micronutrient exposure may persist into childhood but few data exists on potential long-term benefits. In this Review, we discuss micronutrient intake recommendations, risks and consequences of deficiencies, and the effects of interventions with a particular emphasis on offspring.

Suplementos en gestación: últimas recomendaciones

“…1). Una alimentación deficiente en micronutrientes está relacionada con preeclampsia, partos prematuros, crecimiento intrauterino retardado (CIR), bajo peso al nacer (BPN) y malformaciones congénitas (1,2).…”

Maternal Supplementation with <em>RRR</em>-&alpha;-Tocopherol (400 IU) and Its Relationship with Serum and Breast Milk Retinol

“…During lactation, nutritional deficiencies may contribute to infants' low nutrient reserves, thus increasing the prevalence of nutritional deficiencies in the first years of life [24].…”

Prevención de la obesidad desde la etapa perinatal

“…Las deficiencias nutricionales de la madre gestante están relacionadas con el CIR y con neonatos con bajo peso al nacer (17), existiendo una asociación entre el bajo peso del recién nacido y un mayor riesgo de obesidad central en la etapa adulta (11,(18)(19) Incremento en las ingestas recomendadas durante el embarazo Tabla I. Incremento en las ingestas recomendadas durante el embarazo La hipótesis de Barker del origen fetal de las enfermedades del adulto establece que la desnutrición en el útero afecta a las células que intervienen en este periodo crítico del crecimiento, ocasionando modificaciones epigenéticas y una programación anormal del desarrollo de órganos y aparatos, adaptándose el organismo a esta situación de carencia y pudiendo tener dificultad de adaptación ante un consumo abundante de alimentos después del nacimiento, aumentando su propensión a la obesidad en la etapa adulta (18,20).…”