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Micronutrients and Pregnancy

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Micronutrients and Human Health".

Deadline for manuscript submissions: closed (10 June 2021) | Viewed by 54314

Special Issue Editor


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Guest Editor
School of Medicine, Griffith University, Queensland, Australia
Interests: micronutrients; anaemia, iron deficiency; multiple micronutrient supplement; diet quality; vitamin D and chronic diseases

Special Issue Information

Dear Colleagues,

Micronutrient deficiencies are known to affect more than two billion people globally. The magnitude of the problem is much greater in low-income countries where multiple micronutrient deficiencies often occur concurrently as a result of a poor-quality diet. Suboptimal dietary intake of micronutrients during pregnancy has been associated with poor foetal growth, pre-term delivery, poor infant survival, and increased risk of chronic diseases in later life. Hence, adequate micronutrient status and good dietary practice during pregnancy are necessary to achieve healthy birth outcomes.

Establishing the relationship of maternal dietary micronutrient intakes with maternal and foetal outcomes requires accurate estimation of micronutrient intakes throughout pregnancy. Further, there is limited information about the determinants of poor dietary behaviours, specifically concerning micronutrients, of pregnant women in different settings. These knowledge gaps should be filled by high-quality data to develop an appropriate intervention for the prevention of micronutrient deficiency during pregnancy and help the public health practitioners in targeting effort to those who are at highest risk.

Thus, the aim of this Special Issue on “Micronutrients and Pregnancy” is to bring together the latest research on a broad range of topics, including micronutrient deficiency, the dietary intake of micronutrients, interactions between micronutrients, supplemental intakes, dietary recommendations, validation studies, and factors associated with poor dietary intakes of micronutrients and micronutrient deficiencies including intervention trials. Submissions of original papers, reviews, meta-analyses, and commentaries on the aforementioned issues are welcome.

Dr. Faruk Ahmed
Guest Editor

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Keywords

  • micronutrient intake
  • dietary intake
  • dietary pattern
  • dietary assessment
  • validation studies
  • micronutrient supplement
  • pregnant women
  • intervention

Published Papers (9 papers)

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Editorial

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4 pages, 187 KiB  
Editorial
Micronutrients and Pregnancy
by Faruk Ahmed
Nutrients 2022, 14(3), 585; https://doi.org/10.3390/nu14030585 - 28 Jan 2022
Cited by 2 | Viewed by 2697
Abstract
Micronutrient deficiencies are known to affect more than two billion people globally [...] Full article
(This article belongs to the Special Issue Micronutrients and Pregnancy)

Research

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9 pages, 665 KiB  
Article
Factors Influencing the Compliance of Pregnant Women with Iron and Folic Acid Supplementation in the Philippines: 2017 Philippine Demographic and Health Survey Analysis
by Eva Belingon Felipe-Dimog, Chia-Hung Yu, Chung-Han Ho and Fu-Wen Liang
Nutrients 2021, 13(9), 3060; https://doi.org/10.3390/nu13093060 - 31 Aug 2021
Cited by 8 | Viewed by 5057
Abstract
Anemia in pregnancy, which is a public health concern for most developing countries, is predominantly caused by iron deficiency. At least, 180 days of iron and folic acid (IFA) supplementation is recommended for pregnant women to mitigate anemia and its adverse effects. This [...] Read more.
Anemia in pregnancy, which is a public health concern for most developing countries, is predominantly caused by iron deficiency. At least, 180 days of iron and folic acid (IFA) supplementation is recommended for pregnant women to mitigate anemia and its adverse effects. This study aimed to examine compliance with the recommendation of IFA supplementation and its underlying factors using the 2017 Philippine National Demographic and Health Survey data. The variables assessed included age, highest level of education, occupation, wealth index, ethnicity, religion, residence, number of pregnancies, time of first antenatal care (ANC) visit and number of ANC visits. Compliance with the recommendation of at least 180 days of IFA supplementation was the outcome variable. The study assessed 7983 women aged 15–49 years with a history of pregnancy. Of these participants, 25.8% complied with the IFA supplementation recommendation. Multiple logistic regression analysis showed that pregnant women of Islamic faith and non-Indigenous Muslim ethnicity were less likely to comply with the IFA supplementation recommendation. Being aged between 25 and 34 years, having better education and higher wealth status, rural residency, initiating ANC visits during the first trimester of pregnancy and having at least four ANC visits positively influenced compliance with IFA supplementation. The effect of residence on IFA adherence differed across the wealth classes. Strategies targeted at specific groups, such as religious minorities, poor urban residents, the less educated and young women, should be strengthened to encourage early and regular antenatal care visits for improving compliance. Full article
(This article belongs to the Special Issue Micronutrients and Pregnancy)
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15 pages, 1654 KiB  
Article
Effect of Selenium and Iodine on Oxidative Stress in the First Trimester Human Placenta Explants
by Nahal Habibi, Agatha Labrinidis, Shalem Yiner-Lee Leemaqz, Tanja Jankovic-Karasoulos, Dylan McCullough, Jessica A. Grieger, Sarah Gilbert, Carmela Ricciardelli, Shao Jia Zhou, Anthony V. Perkins, Claire T. Roberts and Tina Bianco-Miotto
Nutrients 2021, 13(3), 800; https://doi.org/10.3390/nu13030800 - 28 Feb 2021
Cited by 9 | Viewed by 2950
Abstract
Imbalanced maternal micronutrient status, poor placentation, and oxidative stress are associated with greater risk of pregnancy complications, which impact mother and offspring health. As selenium, iodine, and copper are essential micronutrients with key roles in antioxidant systems, this study investigated their potential protective [...] Read more.
Imbalanced maternal micronutrient status, poor placentation, and oxidative stress are associated with greater risk of pregnancy complications, which impact mother and offspring health. As selenium, iodine, and copper are essential micronutrients with key roles in antioxidant systems, this study investigated their potential protective effects on placenta against oxidative stress. First trimester human placenta explants were treated with different concentrations of selenium (sodium selenite), iodine (potassium iodide), their combination or copper (copper (II) sulfate). The concentrations represented deficient, physiological, or super physiological levels. Oxidative stress was induced by menadione or antimycin. Placenta explants were collected, fixed, processed, and embedded for laser ablation inductively coupled plasma-mass spectrometry (LA ICP-MS) element imaging or immunohistochemical labelling. LA ICP-MS showed that placenta could uptake selenium and copper from the media. Sodium selenite and potassium iodide reduced DNA damage and apoptosis (p < 0.05). Following oxidative stress induction, a higher concentration of sodium selenite (1.6 µM) was needed to reduce DNA damage and apoptosis while both concentrations of potassium iodide (0.5 and 1 µM) were protective (p < 0.05). A high concentration of copper (40 µM) increased apoptosis and DNA damage but this effect was no longer significant after induction of oxidative stress. Micronutrients supplementation can increase their content within the placenta and an optimal maternal micronutrient level is essential for placenta health. Full article
(This article belongs to the Special Issue Micronutrients and Pregnancy)
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16 pages, 472 KiB  
Article
Prevalence and Predictors of Vitamin D Deficiency and Insufficiency among Pregnant Rural Women in Bangladesh
by Faruk Ahmed, Hossein Khosravi-Boroujeni, Moududur Rahman Khan, Anjan Kumar Roy and Rubhana Raqib
Nutrients 2021, 13(2), 449; https://doi.org/10.3390/nu13020449 - 29 Jan 2021
Cited by 15 | Viewed by 2879
Abstract
Although adequate vitamin D status during pregnancy is essential for maternal health and to prevent adverse pregnancy outcomes, limited data exist on vitamin D status and associated risk factors in pregnant rural Bangladeshi women. This study determined the prevalence of vitamin D deficiency [...] Read more.
Although adequate vitamin D status during pregnancy is essential for maternal health and to prevent adverse pregnancy outcomes, limited data exist on vitamin D status and associated risk factors in pregnant rural Bangladeshi women. This study determined the prevalence of vitamin D deficiency and insufficiency, and identified associated risk factors, among these women. A total of 515 pregnant women from rural Bangladesh, gestational age ≤ 20 weeks, participated in this cross-sectional study. A separate logistic regression analysis was applied to determine the risk factors of vitamin D deficiency and insufficiency. Overall, 17.3% of the pregnant women had vitamin D deficiency [serum 25(OH)D concentration <30.0 nmol/L], and 47.2% had vitamin D insufficiency [serum 25(OH)D concentration between 30–<50 nmol/L]. The risk of vitamin D insufficiency was significantly higher among nulliparous pregnant women (OR: 2.72; 95% CI: 1.75–4.23), those in their first trimester (OR: 2.68; 95% CI: 1.39–5.19), anaemic women (OR: 1.53; 95% CI: 0.99–2.35; p = 0.056) and women whose husbands are farmers (OR: 2.06; 95% CI: 1.22–3.50). The risk of vitamin deficiency was significantly higher among younger pregnant women (<25 years; OR: 2.12; 95% CI: 1.06–4.21), nulliparous women (OR: 2.65; 95% CI: 1.34–5.25), women in their first trimester (OR: 2.55; 95% CI: 1.12–5.79) and those with sub-optimal vitamin A status (OR: 2.30; 95% CI: 1.28–4.11). In conclusion, hypovitaminosis D is highly prevalent among pregnant rural Bangladeshi women. Parity and gestational age are the common risk factors of vitamin D deficiency and insufficiency. A husband’s occupation and anaemia status might be important predictors of vitamin D insufficiency, while younger age and sub-optimal vitamin A status are risk factors for vitamin D deficiency in this population. Full article
(This article belongs to the Special Issue Micronutrients and Pregnancy)
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16 pages, 1725 KiB  
Article
Maternal Dietary Selenium Intake during Pregnancy Is Associated with Higher Birth Weight and Lower Risk of Small for Gestational Age Births in the Norwegian Mother, Father and Child Cohort Study
by Pol Solé-Navais, Anne Lise Brantsæter, Ida Henriette Caspersen, Thomas Lundh, Louis J. Muglia, Helle Margrete Meltzer, Ge Zhang, Bo Jacobsson, Verena Sengpiel and Malin Barman
Nutrients 2021, 13(1), 23; https://doi.org/10.3390/nu13010023 - 23 Dec 2020
Cited by 13 | Viewed by 3390
Abstract
Selenium is an essential trace element involved in the body’s redox reactions. Low selenium intake during pregnancy has been associated with low birth weight and an increased risk of children being born small for gestational age (SGA). Based on data from the Norwegian [...] Read more.
Selenium is an essential trace element involved in the body’s redox reactions. Low selenium intake during pregnancy has been associated with low birth weight and an increased risk of children being born small for gestational age (SGA). Based on data from the Norwegian Mother, Father and Child Cohort Study (MoBa) and the Medical Birth Registry of Norway (MBRN), we studied the association of maternal selenium intake from diet and supplements during the first half of pregnancy (n = 71,728 women) and selenium status in mid-pregnancy (n = 2628 women) with birth weight and SGA status, according to population-based, ultrasound-based and customized growth standards. An increase of one standard deviation of maternal dietary selenium intake was associated with increased birth weight z-scores (ß = 0.027, 95% CI: 0.007, 0.041) and lower SGA risk (OR = 0.91, 95% CI 0.86, 0.97) after adjusting for confounders. Maternal organic and inorganic selenium intake from supplements as well as whole blood selenium concentration were not associated with birth weight or SGA. Our results suggest that a maternal diet rich in selenium during pregnancy may be beneficial for foetal growth. However, the effect estimates were small and further studies are needed to elucidate the potential impact of selenium on foetal growth. Full article
(This article belongs to the Special Issue Micronutrients and Pregnancy)
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Review

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17 pages, 1648 KiB  
Review
Maternal Iron Status in Pregnancy and Child Health Outcomes after Birth: A Systematic Review and Meta-Analysis
by Hugo G. Quezada-Pinedo, Florian Cassel, Liesbeth Duijts, Martina U. Muckenthaler, Max Gassmann, Vincent W. V. Jaddoe, Irwin K. M. Reiss and Marijn J. Vermeulen
Nutrients 2021, 13(7), 2221; https://doi.org/10.3390/nu13072221 - 28 Jun 2021
Cited by 29 | Viewed by 5640
Abstract
In pregnancy, iron deficiency and iron overload increase the risk for adverse pregnancy outcomes, but the effects of maternal iron status on long-term child health are poorly understood. The aim of the study was to systematically review and analyze the literature on maternal [...] Read more.
In pregnancy, iron deficiency and iron overload increase the risk for adverse pregnancy outcomes, but the effects of maternal iron status on long-term child health are poorly understood. The aim of the study was to systematically review and analyze the literature on maternal iron status in pregnancy and long-term outcomes in the offspring after birth. We report a systematic review on maternal iron status during pregnancy in relation to child health outcomes after birth, from database inception until 21 January 2021, with methodological quality rating (Newcastle-Ottawa tool) and random-effect meta-analysis. (PROSPERO, CRD42020162202). The search identified 8139 studies, of which 44 were included, describing 12,7849 mother–child pairs. Heterogeneity amongst the studies was strong. Methodological quality was predominantly moderate to high. Iron status was measured usually late in pregnancy. The majority of studies compared categories based on maternal ferritin, however, definitions of iron deficiency differed across studies. The follow-up period was predominantly limited to infancy. Fifteen studies reported outcomes on child iron status or hemoglobin, 20 on neurodevelopmental outcomes, and the remainder on a variety of other outcomes. In half of the studies, low maternal iron status or iron deficiency was associated with adverse outcomes in children. Meta-analyses showed an association of maternal ferritin with child soluble transferrin receptor concentrations, though child ferritin, transferrin saturation, or hemoglobin values showed no consistent association. Studies on maternal iron status above normal, or iron excess, suggest deleterious effects on infant growth, cognition, and childhood Type 1 diabetes. Maternal iron status in pregnancy was not consistently associated with child iron status after birth. The very heterogeneous set of studies suggests detrimental effects of iron deficiency, and possibly also of overload, on other outcomes including child neurodevelopment. Studies are needed to determine clinically meaningful definitions of iron deficiency and overload in pregnancy. Full article
(This article belongs to the Special Issue Micronutrients and Pregnancy)
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22 pages, 1612 KiB  
Review
Are Pregnant Women Who Are Living with Overweight or Obesity at Greater Risk of Developing Iron Deficiency/Anaemia?
by Anna A. Wawer, Nicolette A. Hodyl, Susan Fairweather-Tait and Bernd Froessler
Nutrients 2021, 13(5), 1572; https://doi.org/10.3390/nu13051572 - 07 May 2021
Cited by 19 | Viewed by 5082
Abstract
Low-grade inflammation is often present in people living with obesity. Inflammation can impact iron uptake and metabolism through elevation of hepcidin levels. Obesity is a major public health issue globally, with pregnant women often affected by the condition. Maternal obesity is associated with [...] Read more.
Low-grade inflammation is often present in people living with obesity. Inflammation can impact iron uptake and metabolism through elevation of hepcidin levels. Obesity is a major public health issue globally, with pregnant women often affected by the condition. Maternal obesity is associated with increased pregnancy risks including iron deficiency (ID) and iron-deficiency anaemia (IDA)—conditions already highly prevalent in pregnant women and their newborns. This comprehensive review assesses whether the inflammatory state induced by obesity could contribute to an increased incidence of ID/IDA in pregnant women and their children. We discuss the challenges in accurate measurement of iron status in the presence of inflammation, and available iron repletion strategies and their effectiveness in pregnant women living with obesity. We suggest that pre-pregnancy obesity and overweight/obese pregnancies carry a greater risk of ID/IDA for the mother during pregnancy and postpartum period, as well as for the baby. We propose iron status and weight gain during pregnancy should be monitored more closely in women who are living with overweight or obesity. Full article
(This article belongs to the Special Issue Micronutrients and Pregnancy)
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17 pages, 814 KiB  
Review
Nutrient Requirements during Pregnancy and Lactation
by Marie Jouanne, Sarah Oddoux, Antoine Noël and Anne Sophie Voisin-Chiret
Nutrients 2021, 13(2), 692; https://doi.org/10.3390/nu13020692 - 21 Feb 2021
Cited by 48 | Viewed by 21734
Abstract
A woman’s nutritional status during pregnancy and breastfeeding is not only critical for her health, but also for that of future generations. Nutritional requirements during pregnancy differ considerably from those of non-pregnant women. Thus, a personalized approach to nutritional advice is recommended. Currently, [...] Read more.
A woman’s nutritional status during pregnancy and breastfeeding is not only critical for her health, but also for that of future generations. Nutritional requirements during pregnancy differ considerably from those of non-pregnant women. Thus, a personalized approach to nutritional advice is recommended. Currently, some countries recommend routine supplementation for all pregnant women, while others recommend supplements only when necessary. Maternal physiological adaptations, as well as nutritional requirements during pregnancy and lactation, will be reviewed in the literature examining the impacts of dietary changes. All of these data have been studied deeply to facilitate a discussion on dietary supplement use and the recommended doses of nutrients during pregnancy and lactation. The aim of this review is to evaluate the knowledge in the scientific literature on the current recommendations for the intake of the most common micronutrients and omega-3 fatty acids during pregnancy and lactation in the United States, Canada, and Europe. Taking into account these considerations, we examine minerals, vitamins, and omega-3 fatty acid requirements. Finally, we conclude by discussing the potential benefits of each form of supplementation. Full article
(This article belongs to the Special Issue Micronutrients and Pregnancy)
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14 pages, 750 KiB  
Review
Micronutrients in Multiple Pregnancies—The Knowns and Unknowns: A Systematic Review
by Magdalena Zgliczynska and Katarzyna Kosinska-Kaczynska
Nutrients 2021, 13(2), 386; https://doi.org/10.3390/nu13020386 - 27 Jan 2021
Cited by 12 | Viewed by 3350
Abstract
Maternal diet and nutritional status are of key importance with regard to the short- and long-term health outcomes of both the mother and the fetus. Multiple pregnancies are a special phenomenon in the context of nutrition. The presence of more than one fetus [...] Read more.
Maternal diet and nutritional status are of key importance with regard to the short- and long-term health outcomes of both the mother and the fetus. Multiple pregnancies are a special phenomenon in the context of nutrition. The presence of more than one fetus may lead to increased metabolic requirements and a faster depletion of maternal macro- and micro- nutrient reserves than in a singleton pregnancy. The aim of this systematic review was to gather available knowledge on the supply and needs of mothers with multiple pregnancies in terms of micronutrients and the epidemiology of deficiencies in that population. It was constructed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). The authors conducted a systematic literature search with the use of three databases: PubMed/MEDLINE, Scopus and Embase. The last search was run on the 18 October 2020 and identified 1379 articles. Finally, 12 articles and 1 series of publications met the inclusion criteria. Based on the retrieved studies, it may be concluded that women with multiple pregnancies might be at risk of vitamin D and iron deficiencies. With regard to other microelements, the evidence is either inconsistent, scarce or absent. Further in-depth prospective and population studies are necessary to determine if nutritional recommendations addressed to pregnant women require adjustments in cases of multiple gestations. Full article
(This article belongs to the Special Issue Micronutrients and Pregnancy)
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