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Micronutrients Intake and Status during Pregnancy and Lactation

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A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (30 November 2018) | Viewed by 61036

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Dr. Louise Brough

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School of Food Technology and Natural Sciences, College of Sciences, Massey University, Palmerston North 4410, New Zealand
Interests: iodine; thyroid; micronutrients; pregnancy; breastfeeding; infancy
Special Issues, Collections and Topics in MDPI journals

Dr. Gail Rees

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Senior Lecturer in Human Nutrition, School of Biomedical Sciences, University of Plymouth, Drake Circus, Plymouth, Devon PL4 8AA, UK
Interests: dietary interventions to improve nutrition in women during pregnancy and in young children; management of obesity during pregnancy and childhood; micronutrient status in women and children
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Special Issue Information

Dear Colleagues,

Optimal nutrition is important during pregnancy and lactation for the health of both the mother and infant. Chronic deficiencies of both macronutrients and micronutrients are well established in developing countries. Although in developed countries overconsumption of macronutrients is a major issue, micronutrient deficiencies which occur concomitantly are no less of a concern. Furthermore in developed countries there is also the risk of excessive micronutrient intake from dietary supplements.

Micronutrients have a role in fetal and neonatal health and also health in later life. Micronutrient deficiency or toxicity during pregnancy or early life can permanently affect developing tissues, resulting in adverse growth and development of the infant which is associated with chronic diseases in adulthood. An aberrant micronutrient intake during pregnancy or lactation can also have detrimental effect on the mother both in the neonatal period and in later life.

This Special Issue of Nutrients entitled “Micronutrient Intake and Status during Pregnancy and Lactation” welcomes the submission of manuscripts describing either original research, systematic reviews or meta-analyses.

Manuscripts will be considered concerning the effects of both micronutreint deficiency and toxicity in developing or developed countries.

Dr. Louise Brough
Dr. Gail Rees
Guest Editors

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Keywords

Micronutrient deficiency
Micronutrient toxicity
pregnancy
lactation
breastfeeding

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Published Papers (10 papers)

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Research

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13 pages, 1869 KiB

Open AccessArticle

Factors Associated with Serum 25-Hydroxyvitamin D Concentration in Two Cohorts of Pregnant Women in Southern Ontario, Canada

by Maude Perreault, Caroline J. Moore, Gerhard Fusch, Koon K. Teo and Stephanie A. Atkinson

Nutrients 2019, 11(1), 123; https://doi.org/10.3390/nu11010123 - 9 Jan 2019

Cited by 13 | Viewed by 3890

Abstract

Vitamin D deficiency in pregnancy is widely reported, but whether this applies in North America is unclear since no population-based surveys of vitamin D status in pregnancy exist in Canada or the United States. The objectives were to assess (i) the intake and sources of vitamin D, (ii) vitamin D status, and (iii) factors associated with serum 25-hydroxyvitamin D (25-OHD) concentration in two cohorts of pregnant women from Southern Ontario, Canada, studied over a span of 14 years. Maternal characteristics, physical measurements, fasting blood samples and nutrient intake were obtained at enrolment in 332 pregnant women from the Family Atherosclerosis Monitoring In early Life (FAMILY) study and 191 from the Be Healthy in Pregnancy (BHIP) study. Serum 25-OHD was measured by LC/MS-MS. The median (Q1, Q3) total vitamin D intake was 383 IU/day (327, 551) in the FAMILY study and 554 IU/day (437, 796) in the BHIP study. Supplemental vitamin D represented 64% of total intake in participants in FAMILY and 78% in BHIP. The mean (SD) serum 25-OHD was 76.5 (32.9) nmol/L in FAMILY and 79.7 (22.3) nmol/L in BHIP. Being of European descent and blood sampling in the summer season were significantly associated with a higher maternal serum 25-OHD concentration. In summary, health care practitioners should be aware that vitamin D status is sufficient in the majority of pregnant Canadian women of European ancestry, likely due to sun exposure. Full article

(This article belongs to the Special Issue Micronutrients Intake and Status during Pregnancy and Lactation)

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23 pages, 458 KiB

Open AccessArticle

Assessment of Dietary Intake and Nutrient Gaps, and Development of Food-Based Recommendations, among Pregnant and Lactating Women in Zinder, Niger: An Optifood Linear Programming Analysis

by K. Ryan Wessells, Rebecca R. Young, Elaine L. Ferguson, Césaire T. Ouédraogo, M. Thierno Faye and Sonja Y. Hess

Nutrients 2019, 11(1), 72; https://doi.org/10.3390/nu11010072 - 2 Jan 2019

Cited by 31 | Viewed by 7712

Abstract

Pregnant and lactating women in rural Niger are at high risk for inadequate intakes of multiple micronutrients. Thus, 24 h dietary recalls were conducted and analyzed for dietary intakes in this population (n = 202). Using linear programming analyses, micronutrient gaps in women’s diets were identified, food-based recommendations (FBR) to improve dietary micronutrient adequacy were developed, and various supplementation strategies were modelled. Energy intakes were below estimated requirements, and, for most micronutrients, >50% of women were at risk of inadequate intakes. Linear programming analyses indicated it would be difficult to select a diet that achieved recommended dietary allowances for all but three (vitamin B₆, iron and zinc) of 11 modeled micronutrients. Consumption of one additional meal per day, and adherence to the selected FBR (daily consumption of dark green leafy vegetables, fermented milk, millet, pulses, and vitamin A fortified oil), would result in a low percentage of women at risk of inadequate intakes for eight modeled micronutrients (vitamin A, riboflavin, thiamin, B_6, folate, iron, zinc, and calcium). Because the promotion of realistic FBRs likely will not ensure that a low percentage of women are at risk of inadequate intakes for all modeled micronutrients, multiple micronutrient supplementation or provision of nutrient-dense foods should be prioritized. Full article

(This article belongs to the Special Issue Micronutrients Intake and Status during Pregnancy and Lactation)

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11 pages, 236 KiB

Open AccessArticle

Selenium Intake in Iodine-Deficient Pregnant and Breastfeeding Women in New Zealand

by Ying Jin, Jane Coad, Janet L Weber, Jasmine S Thomson and Louise Brough

Nutrients 2019, 11(1), 69; https://doi.org/10.3390/nu11010069 - 1 Jan 2019

Cited by 22 | Viewed by 5576

Abstract

Selenium plays a role in antioxidant status and, together with iodine, in thyroid function. Iodine deficiency exists in New Zealand during pregnancy and lactation, and selenium deficiency may further affect thyroid function. This study investigated selenium intakes of pregnant and lactating women, in Palmerston North, in the North Island of New Zealand. Dietary intake was estimated using three repeated 24-h dietary recalls. Dietary intake in pregnancy was also estimated from 24-h urinary excretion of selenium. Selenium concentrations were determined in urine and breastmilk using inductively-coupled plasma mass spectrometry. Median selenium intakes based on dietary data were 51 (39, 65) μg/day in pregnancy and 51 (36, 80) μg/day in lactation, with 61% and 68% below estimated average requirement (EAR). Median daily selenium intake in pregnancy based on urinary excretion was 49 (40, 60) µg/day, with 59% below EAR. Median selenium concentration in breastmilk was 11 (10, 13) µg/L and estimated median selenium intake for infants was 9 (8, 10) µg/day, with 91% below the Adequate Intake of 12 μg/day. These pregnant and breastfeeding women were at risk of dietary selenium inadequacy. Further research is required to assess selenium status in relation to thyroid function and health in this group. Full article

(This article belongs to the Special Issue Micronutrients Intake and Status during Pregnancy and Lactation)

11 pages, 466 KiB

Open AccessArticle

The Impact of Maternal Pre-Pregnancy Body Weight and Gestational Diabetes on Markers of Folate Metabolism in the Placenta

by Jole Martino, Maria Teresa Segura, Luz García-Valdés, M C. Padilla, Ricardo Rueda, Harry J. McArdle, Helen Budge, Michael E. Symonds and Cristina Campoy

Nutrients 2018, 10(11), 1750; https://doi.org/10.3390/nu10111750 - 13 Nov 2018

Cited by 7 | Viewed by 4557

Abstract

Dietary methyl donors, including folate, may modify the placenta and size at birth but the influence of maternal body weight has not been widely investigated. We therefore examined whether maternal or fetal folate status, together with indices of placental folate transport, were modulated by either maternal pre-pregnancy body mass index (BMI i.e., overweight: 25 ≤ BMI < 30 or obesity: BMI ≥ 30 kg/m²) and/or gestational diabetes mellitus (GD). We utilised a sub-sample of 135 pregnant women participating in the Spanish PREOBE survey for our analysis (i.e., 59 healthy normal weight, 29 overweight, 22 obese and 25 GD). They were blood sampled at 34 weeks gestation, and, at delivery, when a placental sample was taken together with maternal and cord blood. Placental gene expression of folate transporters and DNA methyltransferases (DNMT) were all measured. Folate plasma concentrations were determined with an electro-chemiluminescence immunoassay. Food diaries indicated that folate intake was unaffected by BMI or GD and, although all women maintained normal folate concentrations (i.e., 5–16 ng/mL), higher BMIs were associated with reduced maternal folate concentrations at delivery. Umbilical cord folate was not different, reflecting an increased concentration gradient between the mother and her fetus. Placental mRNA abundance for the folate receptor alpha (FOLR1) was reduced with obesity, whilst DNMT1 was increased with raised BMI, responses that were unaffected by GD. Multi-regression analysis to determine the best predictors for placental FOLR1 indicated that pre-gestational BMI had the greatest influence. In conclusion, the placenta’s capacity to maintain fetal folate supply was not compromised by either obesity or GD. Full article

(This article belongs to the Special Issue Micronutrients Intake and Status during Pregnancy and Lactation)

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12 pages, 250 KiB

Open AccessArticle

Longitudinal Maternal Vitamin D Status during Pregnancy Is Associated with Neonatal Anthropometric Measures

by Ellen C. Francis, Stefanie N. Hinkle, Yiqing Song, Shristi Rawal, Sarah R. Donnelly, Yeyi Zhu, Liwei Chen and Cuilin Zhang

Nutrients 2018, 10(11), 1631; https://doi.org/10.3390/nu10111631 - 2 Nov 2018

Cited by 29 | Viewed by 4363

Abstract

Findings on maternal 25-hydroxyvitamin D (25[OH]D) and neonatal anthropometry are inconsistent, and may at least be partly due to variations in gestational week (GW) of 25(OH)D measurement and the lack of longitudinal 25(OH)D measurements across gestation. The aim of the current study was to examine the associations of longitudinal measures of maternal 25(OH)D and neonatal anthropometry at birth. This study included 321 mother–offspring pairs enrolled in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies–Singletons. This study was a prospective cohort design without supplementation and without data on dietary supplementation. Nevertheless, measurement of plasma 25(OH)D reflects vitamin D from different sources, including supplementation. Maternal concentrations of total 25(OH)D were measured at 10–14, 15–26, 23–31, and 33–39 GW and categorized as <50 nmol/L, 50–75 nmol/L, and >75 nmol/L. Generalized linear models were used to examine associations of 25(OH)D at each time-point with neonate birthweight z-score, length, and sum of skinfolds at birth. At 10–14 GW, 16.8% and 49.2% of women had 25(OH)D <50 nmol/L and between 50–75 nmol/L, respectively. The association of maternal 25(OH)D with neonatal anthropometry differed by GW and women’s prepregnancy BMI (normal (<25.0 kg/m²), overweight/obese (25.0–44.9 kg/m²)). All analyses were stratified by prepregnancy BMI status. Among women with an overweight/obese BMI, 25(OH)D <50 nmol/L at 10–14 GW was associated with lower birthweight z-score (0.56; 95% CI: −0.99, −0.13) and length (−1.56 cm; 95% CI: −3.07, −0.06), and at 23–31 GW was associated with shorter length (−2.77 cm; 95% CI: −13.38, −4.98) and lower sum of skinfolds (−9.18 mm; 95% CI: −13.38, −4.98). Among women with a normal BMI, 25(OH)D <50 nmol/L at 10–14 GW was associated with lower sum of skinfolds (−2.64 mm; 95% CI: −5.03, −0.24), at 23–31 GW was associated with larger birthweight z-scores (0.64; 95% CI: 0.03, 1.25), and at 33-39 GW with both higher birthweight z-score (1.22; 95% CI: 0.71, 1.73) and longer length (1.94 cm; 95% CI: 0.37, 3.52). Maternal 25(OH)D status during pregnancy was associated with neonatal anthropometric measures, and the associations were specific to GW of 25(OH)D measurement and prepregnancy BMI. Full article

(This article belongs to the Special Issue Micronutrients Intake and Status during Pregnancy and Lactation)

12 pages, 557 KiB

Open AccessArticle

Compliance to Prenatal Iron and Folic Acid Supplement Use in Relation to Low Birth Weight in Lilongwe, Malawi

by Aaron Thokozani Chikakuda, Dayeon Shin, Sarah S. Comstock, SuJin Song and Won O. Song

Nutrients 2018, 10(9), 1275; https://doi.org/10.3390/nu10091275 - 10 Sep 2018

Cited by 16 | Viewed by 6223

Abstract

Prenatal iron and folic acid (IFA) supplements are offered free to all pregnant women in Malawi to reduce maternal anemia and improve birth outcomes. We investigated the association between self-reported compliance to IFA intake and risk of low birth weight (LBW). Pregnant women who attended Bwaila Maternity Wing of Lilongwe District Hospital for delivery were recruited (n = 220). We used a questionnaire to collect self-reported information on IFA use and maternal sociodemographic data. Before delivery, blood samples for maternal hemoglobin (Hb) and folate status, and upon delivery, birth weight, and other newborn anthropometrics were measured. We used multivariable logistic regression to determine risk of LBW by prenatal IFA intake. The self-reported number of IFA pills taken during pregnancy was positively associated with Hb, but not serum and RBC folate concentration: <45, 45–89 and ≥90 pills taken corresponded with mean (SD) Hb 10.7 (1.6), 11.3 (1.8), and 11.7 (1.6) g/dL, respectively (p = 0.006). The prevalence of LBW was 20.1%, 13.5% and 5.6% for those who reported taking IFA pills <45, 45–89, and ≥90 pills, respectively (p = 0.027). Taking >60 IFA pills reduced risk of LBW delivery (OR (95% CI) = 0.15 (0.03–0.70), p = 0.033) than taking ≤30 pills. Self-reported compliance to IFA use is valid for assessing prenatal supplement program in Malawi, especially Hb status, and can reduce the rate of LBW. Full article

(This article belongs to the Special Issue Micronutrients Intake and Status during Pregnancy and Lactation)

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18 pages, 1907 KiB

Open AccessArticle

Single Nucleotide Polymorphisms in Vitamin D Receptor Gene Affect Birth Weight and the Risk of Preterm Birth: Results From the “Mamma & Bambino” Cohort and A Meta-Analysis

by Martina Barchitta, Andrea Maugeri, Maria Clara La Rosa, Roberta Magnano San Lio, Giuliana Favara, Marco Panella, Antonio Cianci and Antonella Agodi

Nutrients 2018, 10(9), 1172; https://doi.org/10.3390/nu10091172 - 27 Aug 2018

Cited by 61 | Viewed by 5126

Abstract

The effect of vitamin D receptor gene (VDR) polymorphisms on adverse pregnancy outcomes—including preterm birth (PTB), low birth weight and small for gestational age—is currently under debate. We investigated 187 mother-child pairs from the Italian “Mamma & Bambino” cohort to evaluate the association of maternal VDR polymorphisms—BsmI, ApaI, FokI and TaqI—with neonatal anthropometric measures and the risk of PTB. To corroborate our results, we conducted a meta-analysis of observational studies. For the FokI polymorphism, we showed that gestational duration and birth weight decreased with increasing number of A allele (p = 0.040 and p = 0.010, respectively). Compared to the GG and GA genotypes, mothers who carried the AA genotype exhibited higher PTB risk (OR = 12.049; 95% CI = 2.606–55.709; p = 0.001) after adjusting for covariates. The meta-analysis confirmed this association under the recessive model (OR = 3.67, 95%CI 1.18–11.43), and also pointed out the protective effect of BsmI polymorphism against the risk of PTB under the allelic (A vs. G: OR = 0.74; 95%CI 0.59–0.93) and recessive (AA vs. GG + AG: OR = 0.62; 95%CI 0.43–0.89) models. Our results suggest the association between some maternal VDR polymorphisms with neonatal anthropometric measures and the risk of PTB. Full article

(This article belongs to the Special Issue Micronutrients Intake and Status during Pregnancy and Lactation)

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14 pages, 321 KiB

Open AccessArticle

Trimester-Specific Dietary Intakes in a Sample of French-Canadian Pregnant Women in Comparison with National Nutritional Guidelines

by Claudia Savard, Simone Lemieux, S. John Weisnagel, Bénédicte Fontaine-Bisson, Claudia Gagnon, Julie Robitaille and Anne-Sophie Morisset

Nutrients 2018, 10(6), 768; https://doi.org/10.3390/nu10060768 - 14 Jun 2018

Cited by 52 | Viewed by 8788 | Correction

Abstract

Diet during pregnancy greatly impacts health outcomes. This study aims to measure changes in dietary intakes throughout trimesters and to assess pregnant women’s dietary intakes in comparison with current Canadian nutritional recommendations. Seventy-nine pregnant women were recruited and completed, within each trimester, three Web-based 24-h dietary recalls and one Web questionnaire on supplement use. Dietary intakes from food, with and without supplements, were compared to nutritional recommendations throughout pregnancy. Energy and macronutrient intakes remained stable throughout pregnancy. A majority of women exceeded their energy and protein requirements in the first trimester, and fat intakes as a percentage of energy intakes were above recommendations for more than half of the women in all trimesters. Supplement use increased dietary intakes of most vitamins and minerals, but 20% of women still had inadequate total vitamin D intakes and most women had excessive folic acid intakes. This study showed that pregnant women did not increase their energy intakes throughout pregnancy as recommended. Furthermore, although prenatal supplementation reduces the risk of inadequate intake for most micronutrients, there is still a risk of excessive folic acid and insufficient vitamin D intake, which needs further investigation. Full article

(This article belongs to the Special Issue Micronutrients Intake and Status during Pregnancy and Lactation)

8 pages, 222 KiB

Open AccessArticle

Use of Iodine-Containing Dietary Supplements Remains Low among Women of Reproductive Age in the United States: NHANES 2011–2014

by Priya M. Gupta, Jaime J. Gahche, Kirsten A. Herrick, Abby G. Ershow, Nancy Potischman and Cria G. Perrine

Nutrients 2018, 10(4), 422; https://doi.org/10.3390/nu10040422 - 29 Mar 2018

Cited by 22 | Viewed by 5767

Abstract

In the United States, the American Thyroid Association recommends that women take a dietary supplement containing 150 µg of iodine 3 months prior to conception and while pregnant and lactating to support fetal growth and neurological development. We used data from the National Health and Nutrition Examination Survey 2011–2014 to describe the use of dietary supplements with and without iodine in the past 30 days among 2155 non-pregnant, non-lactating (NPNL) women; 122 pregnant women; and 61 lactating women. Among NPNL women, 45.3% (95% Confidence Interval [CI]: 42.0, 48.6) used any dietary supplement and 14.8% (95% CI: 12.7, 16.8) used a dietary supplement with iodine in the past 30 days. Non-Hispanic black and Hispanic women were less likely to use any dietary supplement as well as one with iodine, than non-Hispanic white or non-Hispanic Asian women (p < 0.05). Among pregnant women, 72.2% (95% CI: 65.8, 78.6) used any dietary supplement; however, only 17.8% (95% CI: 11.4, 24.3) used a dietary supplement with iodine. Among lactating women, 75.0% (95% CI: 63.0, 87.0) used a dietary supplement; however, only 19.0% (95% CI: 8.8, 29.2) used a dietary supplement with iodine. Among NPNL women using a supplement with iodine, median daily iodine intake was 75.0 µg. Self-reported data suggests that the use of iodine containing dietary supplements among pregnant and lactating women remains low in contrast with current recommendations. Full article

(This article belongs to the Special Issue Micronutrients Intake and Status during Pregnancy and Lactation)

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18 pages, 589 KiB

Open AccessReview

Elemental Metabolomics and Pregnancy Outcomes

by Daniel R. McKeating, Joshua J. Fisher and Anthony V. Perkins

Nutrients 2019, 11(1), 73; https://doi.org/10.3390/nu11010073 - 2 Jan 2019

Cited by 48 | Viewed by 7333

Abstract

Trace elements are important for human health and development. The body requires specific micronutrients to function, with aberrant changes associated with a variety of negative health outcomes. Despite this evidence, the status and function of micronutrients during pregnancy are relatively unknown and more information is required to ensure that women receive optimal intakes for foetal development. Changes in trace element status have been associated with pregnancy complications such as gestational diabetes mellitus (GDM), pre-eclampsia (PE), intrauterine growth restriction (IUGR), and preterm birth. Measuring micronutrients with methodologies such as elemental metabolomics, which involves the simultaneous quantification and characterisation of multiple elements, could provide insight into gestational disorders. Identifying unique and subtle micronutrient changes may highlight associated proteins that are affected underpinning the pathophysiology of these complications, leading to new means of disease diagnosis. This review will provide a comprehensive summary of micronutrient status during pregnancy, and their associations with gestational disorders. Furthermore, it will also comment on the potential use of elemental metabolomics as a technique for disease characterisation and prediction. Full article

(This article belongs to the Special Issue Micronutrients Intake and Status during Pregnancy and Lactation)

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