Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-19T09:21:41.443Z Has data issue: false hasContentIssue false
  • English
  • Français

Micronutrients in pregnancy

Published online by Cambridge University Press:  09 March 2007

Robert E. Black
Robert E. Black*
Affiliation:
Department of International Health, Johns Hopkins School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA
*
Corresponding author: Dr Robert E. Black, fax +410 955 7159, email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Vitamins and minerals, referred to collectively as micronutrients, have important influences on the health of pregnant women and the growing fetus. Iron deficiency results in anemia which may increase the risk of death from hemorrhage during delivery, but its effects on fetal development and birth outcomes is still unclear. Folic acid deficiency can lead to hematological consequences, pregnancy complications and congenital malformations, but again the association with other birth outcomes is equivocal. Zinc deficiency has been associated in some, but not all studies with complications of pregnancy and delivery, as well as with growth retardation, congenital abnormalities and retarded neurobehavioral and immunological development in the fetus. Iodine deficiency during pregnancy results in cretinism and possible fetal wastage and preterm delivery. Deficiency of other minerals such as magnesium, selenium, copper, and calcium have also been associated with complications of pregnancy, childbirth or fetal development. Deficiencies of vitamins other than folate may likewise be related to such complications; and vitamin A or β-carotene supplements in pregnancy reduced maternal mortality by 50 % in a controlled trial in Nepal. Additional research is need on the prevalence of such deficiencies and their consequences and on cost-effective public health interventions for their control.

Keywords

PregnancyFetal growthVitaminsMineralsTrace elementsLow birth weightMicronutrients
Type
Research Article
Information
British Journal of Nutrition , Volume 85 , Issue S2 , May 2001 , pp. S193 - S197
Copyright
Copyright © The Nutrition Society 2001

References

ACC/SCN (1992) Second Report on the World Nutrition Situation.Global and Regional Results, volume 1, ACC/SCN, Geneva.Google Scholar
Allen, LH (1997) Pregnancy and iron deficiency: unresolved issues. Nutrition Reviews 55, 91–101.CrossRefGoogle ScholarPubMed
Arnaud, J, Preziosi, L, Mashako, L, Galan, P, Favier, A, Kapongo, C & Hercberg, S (1994) Serum trace elements in Zairian mothers and their newborns. European Journal of Clinical Nutrition 48, 341–348.Google ScholarPubMed
Azais-Braesco, V & Pasca, G (2000) Vitamin A in pregnancy: requirements and safety limits. American Journal of Clinical Nutrition 71 (suppl.), 1325–1333.CrossRefGoogle ScholarPubMed
Baumslag, N, Edelstein, T & Metz, J (1970) Reduction of incidence of prematurity by folic acid supplementation in pregnancy. British Medical Journal 1, 16–17.CrossRefGoogle ScholarPubMed
Beard, JL (2000) Effectiveness and strategies of iron supplementation during pregnancy. American Journal of Clinical Nutrition 71 (suppl.), 1288–1294.CrossRefGoogle ScholarPubMed
Caulfield, LE, Zavaleta, N, Shankar, AH & Merialdi, M (1998) Potential contribution of maternal zinc supplementation during pregnancy to maternal and child survival. American Journal of Clinical Nutrition 68 (suppl.), 499–508.CrossRefGoogle ScholarPubMed
Caulfield, LE, Zavaleta, N, Figueroa, A & Leon, Z (1999) Maternal zinc supplementation does not affect size at birth or pregnancy duration in Peru. Journal of Nutrition 129, 1563–1568.CrossRefGoogle ScholarPubMed
Chappell, LC, Seed, PT, Briley, AL, Kelly, FJ, Lee, R, Hunt, BJ, Pamar, K, Bewley, SJ, Shennan, AH, Steer, PH & Poston, L (1999) Effect of antioxidants on the occurrence of pre-eclampsia in women at increased risk: a randomized trial. Lancet 354, 810–816.CrossRefGoogle Scholar
Chien, PFW, Khan, KS & Arnott, N (1996) Magnesium sulphate in the treatment of eclampsia and pre-eclampsia: an overview of the evidence from randomized trials. British Journal of Obstetrics and Gynecology 103, 1085–1091.Google Scholar
Conradt, A, Weidinger, H & Algayer, H (1985) Magnesium therapy decreased the rate of intrauterine fetal retardation, premature rupture of membranes and premature delivery in risk pregnancies treated with betamimetics. Magnesium 4, 20–28.Google ScholarPubMed
Czeizel, AE (1993) Controlled studies of multivitamin supplementation on pregnancy outcomes. Annals of New York Academy of Sciences 687, 266–275.CrossRefGoogle Scholar
Dunn, JT (1993) Iodine supplementation and the prevention of cretinism. Annals of New York Academy of Sciences 678, 158–168.CrossRefGoogle ScholarPubMed
Fawzi, WW, Msamanga, GI, Spiegelman, D, Urassa, EJN, McGrath, N, Mwakagile, D, Antelman, G, Mbise, R, Herrera, G, Kapiga, S, Willett, W, Hunter, DJ and (1998) Randomised trial of effects of vitamin supplements on pregnancy outcomes and T cell counts in HIV-1-infected women in Tanzania. Lancet 351, 1477–1482.CrossRefGoogle Scholar
Festa, MD, Anderson, HL, Dowdy, RP & Ellersieck, MR (1985) Effect of zinc intake on copper excretion and retention in men. American Journal of Clinical Nutrition 41, 258–292.CrossRefGoogle ScholarPubMed
Fleming, AF, Ghatoura, GBS, Harrison, KA, Briggs, ND & Dunn, DT (1986) The prevention of anaemia in pregnancy in primigravidar in the Guinea savanna of Nigeria. Annals of Tropical Medicine and Parasitology 80, 211–233.Google Scholar
Garg, HK, Singhal, KC & Arshad, Z (1993) A study of the effects of oral zinc supplementation during pregnancy outcomes. Indian Journal of Physiology and Pharmacology 37, 276–284.Google Scholar
Garn, SM, Ridella, SA, Petzold, S & Falkner, F (1981) Maternal Hb levels and pregnancy outcomes. Seminars in Perinatology 5, 155–162.Google Scholar
Ghebremeskal, K, Burns, L, Burden, TJ, Harbige, L, Costeloe, K, Powell, JJ & Crawford, M (1994) Vitamin A and related essential nutrient in cord blood: relationships with anthropometric measurements at birth. Early Human Development 39, 177–188.CrossRefGoogle Scholar
Goldenberg, RL, Tamura, T, Neggers, Y, Copper, RL, Johnston, K, Dubard, MG & Hauth, JC (1995) The effect of zinc supplementation on pregnancy outcome. Journal of American Medical Association 274, 463–468.Google Scholar
Hambidge, KM, Krebs, NF, Sibley, L & English, J (1987) Acute effects of iron therapy on zinc status during pregnancy. Obstetrics and Gynecology 70, 593–596.Google Scholar
Hemminki, E & Starfield, B (1978) Routine administration of iron and vitamins during pregnancy: review of controlled clinical trials. British Journal of Obstetrics and Gynecology 85, 404–410.CrossRefGoogle ScholarPubMed
Hetzel, BS (1987) An overview of the prevention and control of iodine deficiency disorders In The Prevention and Control of Iodine Deficiency Disorders, 7, pp. 31–34. [Hetzel, BS, Dunn, JT and Stanbury, JB. editors] Amsterdam: Elsevier.Google Scholar
Iyengar, L & Rajalakshmi, K (1975) Effect of folic acid supplementation on birth weights of infants. American Journal of Obstetrics and Gynecology 122, 332–336.CrossRefGoogle Scholar
Jameson, S (1982) Zinc status and pregnancy outcome in humans Clinical Applications of Recent Advances in Zinc Metabolism 39–52 [Prasad, AS, reosti, IED and Hetzel, BS,editors]. New York: Alan R. Liss..Google Scholar
Jameson, S (1993) Zinc status in pregnancy: the effect of zinc therapy on perinatal mortality, prematurity, and placental ablation. Annals of New York Academy of Sciences 678, 178–192.CrossRefGoogle Scholar
King, JC (2000) Physiology of pregnancy and nutrient metabolism. American Journal of Clinical Nutrition 71 (suppl.), 1218–1225.Google Scholar
Kolsteren, P, Rahman, SR, Kilderbrand, K & Diniz, A (1999) Treatment for iron deficiency anaemia with a combined supplementation of iron, vitamin A and zinc in women of Dinajpur, Bangladesh. European Journal of Clinical Nutrition 53, 102–106.CrossRefGoogle ScholarPubMed
Ladipo, OA (2000) Nutrition in pregnancy: mineral and vitamin supplements. American Journal of Clinical Nutrition 72((S)), 280–290.CrossRefGoogle ScholarPubMed
Menendez, C, Todd, J, Alonso, PL, Francis, N, Lulat, S, Ceesay, S & Boge, BM (1994) The effects of iron supplementation during pregnancy, given by traditional birth attendants, on the prevalence of anaemia and malaria. Transactions of the Royal Society of Tropical Medicine and Hygiene 88, 590–593.Google Scholar
Merialdi, M, Caulfield, LE, Zavaleta, N, Figueroa, A & DiPietro, JA (1998) Adding zinc to prenatal iron and folate tablets improves fetal neurobehavioral development. American Journal of Obstetrics and Gynecology 180, 483–490.Google Scholar
Milman, N, Agger, AO & Nielsen, OJ (1994) Iron status markers and serum erythropoietin in 120 mothers and newborn infants: effect of iron supplementation in normal pregnancy. Acta Obstetrics and Gynecology Scan 73, 200–204.CrossRefGoogle ScholarPubMed
MRC Vitamin Study Research Group(1991) Prevention of neural tube defects: results of Medical Research Council Vitamin Study. Lancet 338, 131–137.Google Scholar
Osendarp, SJM, van Raaij, JMA, Arifeen, SE, Wahed, MA, Baqui, AH & Fuchs, GJ (2000) A randomized, placebo-controlled trial of the effect of zinc supplementation during pregnancy on pregnancy outcomes in Bangladeshi urban poor. American Journal of Clinical Nutrition 71, 114–119.CrossRefGoogle ScholarPubMed
Porter, KG, Mcmaster, D, Elmes, ME & Love, AHG (1977) Anaemia and low serum-copper during zinc therapy. Lancet ii, 774.Google Scholar
Preziosi, P, Prual, A, Galan, P, Daouda, H, Boureima, H & Hercberg, S (1997) Effect of iron supplementation on the iron status of pregnant women: consequences for newborns. American Journal of Clinical Nutrition 66, 1178–1182.Google Scholar
Ramakrishnan, U, Manjrekar, R, Rivera, J, Gonzales-Cossio, T & Martorell, R (1999) Micronutrients and pregnancy outcome: a review of the literature. Nutrition Research 19, 103–159.Google Scholar
Ritchie, LD & King, JC (2000) Dietary calcium and pregnancy-induced hypertension: is there a relation. American Journal of Clinical Nutrition 71 (suppl.), 1371–1374.CrossRefGoogle ScholarPubMed
Scholl, TO & Johnson, WG (2000) Folic acid: influence on the outcome of pregnancy. American Journal of Clinical Nutrition 71, 1295–1303.CrossRefGoogle ScholarPubMed
Shankar, AH & Prasad, A (1998) Zinc and immune function: the biological basis of altered resistance to infection. American Journal of Clinical Nutrition 68 (Suppl.), 447–463.CrossRefGoogle ScholarPubMed
Sibai, BM, Villar, L & Bray, E (1989) Magnesium supplementation during pregnancy. A double-blind randomized controlled clinical trial. American Journal of Obstetrics and Gynecology 161, 115–119.Google Scholar
Skikne, B, Baynes, RD (1994) Iron absorption In Iron Metabolism in Health and Disease, pp. 151–187 [Brock, JH, Halliday, JW, Pippard, MJ and Powell, LS editors]. London: WB Saunders.Google Scholar
Solomons, NW & Ruz, M (1997) Zinc and iron interaction: concepts and perspectives in the developing world. Nutrition Research 17, 177–185.CrossRefGoogle Scholar
Spatling, L & Spatling, G (1988) Magnesium supplementation in pregnancy: a double blind study. British Journal of Obstetrics and Gynecology 95, 120–125.Google Scholar
Suharno, D, West, CE, Muhilal, , Karyadi, D & Hautvast, JGAJ (1993) Supplementation with vitamin A and iron for nutritional anaemia in pregnant women in west Java, Indonesia. Lancet 342, 1325–1328.CrossRefGoogle ScholarPubMed
UNICEF (1999) Composition of a multi-micronutrient supplement to be used in pilot programmes among pregnant women in developing countries.Google Scholar
US Preventive Services Task Force(1993) Routine iron supplementation during pregnancy. Policy statement. Journal of the American Medical Association 270 2846–2848.CrossRefGoogle Scholar
Villar, J & Belizen, JM (2000) Same nutrient, different hypotheses: disparities in trials of calcium supplementation during pregnancy. American Journal of Clinical Nutrition 71 (suppl.), 1375–1379.Google Scholar
West, KP, Katz, J, Khatry, SK, LeClerq, SC, Pradhan, EK, Shrestha, SR, Connor, PB, Dali, SM, Christian, P, Pokhrel, RP, Sommer, A & Sommer A the NNIPS-2 Study Group (1999) Double blind, cluster randomized trial of low dose supplementation with vitamin A or β-carotene on mortality related to pregnancy in Nepal. British Medical Journal 318, 570–575.CrossRefGoogle ScholarPubMed