Effect of maternal dietary supplementation on complications of pregnancy and infancy and metabolic syndrome in later adult life

Background. Micronutrient deficiency could be a risk factor for various complications of pregnancy in women and low birth weight of babies. A low birth weight as well as nutrient deficiency may also be a risk factor of cardiovascular diseases (CVDs) and type 2 diabetes in adult life. In this mini-review, we examine the available evidence. Methods. Internet search and discussion with colleagues. Results. Micronutrient deficiency has become a public health problem. Epidemiological studies in the field of nutrition have also established causal associations between micronutrient deficiencies during fetal and early infancy with increased risk of CVDs and type 2 diabetes in later adult life. Some investigators have raised concerns that micronutrient supplementation during pregnancy may increase perinatal mortality and cause adverse effects on the fetus, but none of the previous review articles has adequately addressed this issue. The need for energy increases in the second and particularly the third trimester of pregnancy and poor weight gain during pregnancy often results in low birth weight, which increases an infant’s risk of dying and future risk of chronic diseases. Pregnant women also require more protein, iron, iodine, vitamin A, folate, and other nutrients. Deficiencies of certain nutrients are associated with maternal complications and death, fetal and newborn death, birth defects, and decreased physical and mental potential of the child. Experimental evidence suggests that omega-3 fatty acid and flavonoid deficiency during pregnancy can decrease the performance of arcuate nucleus and POMC neurons resulting in greater appetite, excess of eating and obesity. In several studies, multiple micronutrient supplementation has been found protective. Epidemiological studies indicate that nutrient deficiencies can also occur due to inadequate intake of meat, pulses, fruits, leafy vegetables, nuts and seeds, and to underlying infections during pregnancy. Multiple micronutrient supplementations in pregnant women can cause marked improvement in nutrition and immune status. This appears to be a promising strategy for reducing adverse pregnancy outcomes. Further studies demonstrating the role of nutrient deficiencies on stillbirth and other complications of pregnancies are not very common in India. Among pregnant women, the World Health Organization (WHO) and UNICEF currently recommend iron and folic acid supplementation to reduce the risk of iron deficiency anemia. The effects of maternal multiple micronutrient supplementation have been examined in clinical trials conducted in several countries. Nutrient supplementations may counteract under-nutrition in a way which may be helpful in the prevention of CVDs in adult life. The role of Mediterranean-style diets in the prevention of micronutrient deficiency and complications of pregnancy and infancy need further studies. Conclusion. Micronutrient deficiency is common during pregnancy. Multiple micronutrient supplementation may be protective against still birth, preterm births and low birth weight. The findings indicate that antenatal multiple nutrient supplementation may protect the mothers and babies. This strategy may decrease the susceptibility of babies to develop CVDs and type 2 diabetes in later adult life.