Supplementation during pregnancy: beliefs and science

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.

Chinese abstract

怀孕从营养的角度来看是一个挑战，因为在妊娠期微量元素的摄入影响胎儿的器官发育和母体健康。妊娠期不恰当的饮食/营养可导致包含缺铁在内的众多缺乏，并与流产、宫内发育迟缓、早产和子痫前期相关。本文回顾了与妊娠期营养缺乏有关的风险，以口服铁补充剂为重点概述妊娠期膳食补充。最佳妊娠期管理最重要的是包括饮食模式和伴随疾病在内的风险因素检测。饮食习惯可导致缺乏症（如铁、叶酸、维生素D和钙）并造成母亲和胎儿/新生儿的负面健康结局，需要进行研究。考虑到种族，文化，教育，对怀孕的认知水平以及饮食习惯和运动习惯，产前保健应个体化。临床医生应制定营养和其他需要的恰当的补充和预防/治疗，并考虑到钙、碘、维生素D、叶酸和铁的充分摄入。在所有可用的口服铁补充剂中，长效释放硫酸亚铁（聚合硫酸亚铁）表现出总体和胃肠道副作用的最低发生率，并意味着良好的依从性。

• Anemia
• calcium
• dietary supplementation
• ferrous sulfate
• folic acid
• pregnancy
• vitamin A
• vitamin D

Acknowledgements

The authors wish to thank David P. Figgitt PhD, Content Ed Net, for providing editorial support in the preparation of the article.

Declaration of interest

This review is based on a saTel: +lite symposium entitled ‘Pregnancy Management: Beliefs and Science’ which was part of the European Society for Human Reproduction and Embryology annual meeting (ESHRE, 14 − 17 June 2015, Lisbon, Portugal) and was funded by Pierre Fabre Medicament. All authors report receiving personal fees from Pierre Fabre Medicament for preparing and presenting the information included in this review, which they presented at the symposium, and no other relevant conflicts of interest. Funding for editorial support was provided by Pierre Fabre Medicament, France.