Supplementation during pregnancy: beliefs and science.

Nils Milman, Tomasz Paszkowski, Irene Cetin, Camil Castelo-Branco

Journal: Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology 2017;32(7):509-16

PMID: 26956254

Abstract

Pregnancy represents a challenge from a nutritional perspective, because micronutrient intake during the periconceptional period and in pregnancy affects fetal organ development and the mother's health. Inappropriate diet/nutrition in pregnancy can lead to numerous deficiencies including iron deficiency and may impair placental function and play a role in miscarriage, intrauterine growth restriction, preterm delivery, and preeclampsia. This article reviews the risks associated with nutrient deficiencies in pregnant women and presents an overview of recommendations for dietary supplementation in pregnancy, focusing on oral iron supplementation. Risk factor detection, including dietary patterns and comorbidities, is paramount in optimal pregnancy management. Dietary habits, which can lead to deficiencies (e.g., iron, folate, vitamin D, and calcium) and result in negative health consequences for the mother and fetus/newborn, need to be investigated. Prenatal care should be personalized, accounting for ethnicity, culture, education, information level about pregnancy, and dietary and physical habits. Clinicians should make a plan for appropriate supplementation and prophylaxis/treatment of nutritional and other needs, and consider adequate intake of calcium, iodine, vitamin D, folate, and iron. Among the available oral iron supplements, prolonged-released ferrous sulfate (ferrous sulfate-polymeric complex) presents the lowest incidence of overall and gastrointestinal adverse events, with positive implications for compliance.

Address: a Departments of Clinical Biochemistry and Obstetrics , Naestved Hospital, Naestved, University of Copenhagen , Naestved , Denmark .; b 3rd Chair and Department of Gynecology, Medical University of Lublin , Lublin , Poland .; c Department of Obstetrics and Gynecology , University of Milan, Hospital Luigi Sacco , Milan , Italy , and.; d Clínic Institute of Gynecology, Obstetrics and Neonatology, Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine-University of Barcelona , Barcelona , Spain.
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