Lowensohn et al explain the chemical competition between mother and baby as follows: During the development of a foetus, starting from conception, the foetus seems to assess the available nutritional environment and adapt its growth rate accordingly.²

Simultaneously, while the foetus aims to optimise its chances of successful development and reproduction, the mother's body prioritises maximising her long-term reproductive potential, even if it requires sacrificing the current foetus to achieve that goal.²

Therefore, a nutrient-rich maternal diet before and during pregnancy is essential. It is associated with improved foetal health, more appropriate birth weight, and increased rates of maternal and infant survival.^1,2

Consequences of inadequate nutrition

Inadequate nutrition during pregnancy can lead to various maternal and neonatal complications. Gestational diabetes is one such complication, characterised by altered macronutrient metabolism, insulin resistance, maternal weight gain, and an increased risk of delivering larger-than-average babies through cesarean section. It also increases the risk of pre-eclampsia and maternal death.^1,2

Poor gestational diets lacking essential nutrients can result in both maternal and fetal malnourishment, leading to premature births, low birth weight, and babies that are small for gestational age. These conditions can have long-lasting effects on the child's growth, neurologic and cognitive development, as well as cardiometabolic, pulmonary, and immune functions during infancy.^1,2

The deficiency of foetal micronutrients is believed to persist for generations, potentially leading to intergenerational consequences. Poor nutrient distribution during foetal life, gestation, and early infancy can contribute to the development of diseases later in adult life.¹

Children who experienced inadequate nutrition during early life may exhibit stunted development of muscles, nephrons, and bones. Additionally, if these children adopt feeding habits that contribute to weight gain, they may develop insulin resistance and be at risk of chronic diseases such as type 2 diabetes and metabolic syndrome. Overall, proper maternal nutrition is vital to ensure healthy development and well-being for both mothers and their infants.^1,2

Essential micronutrients before and during pregnancy

Micronutrient deficiency in developed and developing countries affects more than two billion people in all age groups and is responsible for 10% of child mortality.¹

Adequate consumption of omega-3 fatty acids is vitally important during pregnancy as they are critical building blocks of fetal brain and retina. Omega-3 fatty acids may also play a role in determining the length of gestation and in preventing perinatal depression.³

Micronutrients such as iron, iodine, folate, zinc, and vitamin A play crucial roles in growth and development. These essential vitamins and minerals act as cofactors and coenzymes, supporting various metabolic activities in the body, including cell signaling, motility, proliferation, differentiation, and apoptosis. While macronutrients are required in larger quantities, micronutrients are needed in smaller amounts, typically below 100mg/day.¹

Folate is essential in pregnancy, with supplementation playing a beneficial role and being associated with improved foetal outcomes. Zinc, another vital micronutrient, is necessary for embryonic cell proliferation and immune system regulation. Deficiency of zinc during pregnancy can result in premature birth, stunted growth, and increased susceptibility to infections.^1,4

Iron maintains oxygen transport in the body and supports the immune system. Iron deficiency during pregnancy can lead to anaemia, affecting maternal and foetal health, and may result in delayed speech and developmental issues in children.¹

Vitamin A is crucial for vision, bone development, and immune function. Adequate vitamin A levels during pregnancy are vital for both the mother and the foetus, but excessive intake can lead to teratogenic effects.⁵

Vitamin D3 deficiency has been linked to various adverse health effects, including increased susceptibility to asthma and diabetes later in life. Vitamin D3 is also plays an important role in bone health. Calcium is vital for bone tissue maintenance and several biological processes during pregnancy.^1,6

Severe calcium deficiency can lead to pre-eclampsia, spontaneous prematurity, and increased risk of preterm birth. Selenium acts as an antioxidant and is essential for the immune system and prevention of heart diseases and cancer.¹

Selenium deficiency during pregnancy can lead to complications such as pre-eclampsia, glucose intolerance, and mental and psychomotor delays in children.¹

Conclusion

Overall, adequate intake of these micronutrients during pregnancy is crucial for the health and well-being of both the mother and the fetus. Supplementation and a balanced diet rich in essential vitamins and minerals can help prevent complications and support optimal development during the prenatal and postnatal periods.

REFERENCES

1. Farias PM, Marcelino G, Santana LF, et al. Minerals in Pregnancy and Their Impact on Child Growth and Development. Molecules, 2020.
2. Lowensohn RI, Stadler DD, Naze C. Current Concepts of Maternal Nutrition. Obstet Gynecol Surv, 2016.
3. Coletta JM, Bell SJ, Roman AS. Omega-3 Fatty acids and pregnancy. Rev Obstet Gynecol. 2010
4. Moussa HN, Nasab SH, Haidar ZA, et al. Folic acid supplementation: what is new? Fetal, obstetric, long-term benefits and risks. Future Science, 2016.
5. Bastos Maia S, Rolland Souza AS, et al. Vitamin A and Pregnancy: A Narrative Review. Nutrients, 2019.
6. Mansur JL, Oliveri B, Giacoia E, et al. Vitamin D: Before, during and after Pregnancy: Effect on Neonates and Children. Nutrients, 2022.