Abstract
Studies assessing maternal dietary intakes and the relationship with birthweight are inconsistent, thus attempting to draw inferences on the role of maternal nutrition in determining the fetal growth trajectory is difficult. The aim of this review is to provide updated evidence from epidemiological and randomized controlled trials on the impact of dietary and supplemental intakes of omega-3 long-chain polyunsaturated fatty acids, zinc, folate, iron, calcium, and vitamin D, as well as dietary patterns, on infant birthweight. A comprehensive review of the literature was undertaken via the electronic databases Pubmed, Cochrane Library, and Medline. Included articles were those published in English, in scholarly journals, and which provided information about diet and nutrition during pregnancy and infant birthweight. There is insufficient evidence for omega-3 fatty acid supplements’ ability to reduce risk of low birthweight (LBW), and more robust evidence from studies supplementing with zinc, calcium, and/or vitamin D needs to be established. Iron supplementation appears to increase birthweight, particularly when there are increases in maternal hemoglobin concentrations in the third trimester. There is limited evidence supporting the use of folic acid supplements to reduce the risk for LBW; however, supplementation may increase birthweight by ~130 g. Consumption of whole foods such as fruit, vegetables, low-fat dairy, and lean meats throughout pregnancy appears beneficial for appropriate birthweight. Intervention studies with an understanding of optimal dietary patterns may provide promising results for both maternal and perinatal health. Outcomes from these studies will help determine what sort of dietary advice could be promoted to women during pregnancy in order to promote the best health for themselves and their baby.
Highlights
Optimal nutrition supply to the developing fetus is paramount in achieving appropriate fetal growth and development
3 fatty acids birthweight small for gestational age pregnancy”; “zinc birthweight small for gestational age pregnancy”; “iron birthweight small for gestational age pregnancy”; “folate birthweight small for gestational age pregnancy”; “calcium birthweight small for gestational age pregnancy”; “vitamin D
The most recent meta-analysis of 15 RCTs reported that birthweight was slightly higher among infants born to women in the LC n-3 PUFA supplemented group compared to placebo (RR 42.2; 95% CI: 14.8, 69.7); risk of low birthweight (LBW) was not significantly different (RR 0.92; 95% CI: 0.83, 1.02) [49] (Table 1)
Summary
Optimal nutrition supply to the developing fetus is paramount in achieving appropriate fetal growth and development. Dietary energy and nutrient requirements are generally increased to support increased maternal metabolism, blood volume and red cell mass expansion, and the delivery of nutrients to the fetus [1,2]. Iron, zinc, calcium, vitamin D, and essential fatty acids function to promote red blood cell production, enzyme activity, bone development, and brain development. That micronutrient intake during pregnancy is less than optimal [4]. This is of concern given the current consensus that maternal nutrition is relevant to both the short- and long-term health of the infant
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