Inadequate Maternal Dietary Micronutrient Intake and Differences by Nutritional Status: Findings From Pregnant Women in the COVID-19 Era

Abstract

ObjectivesCOVID-19 pandemic increases the risk of an inadequate micronutrient intake and therefore, the risk of double burden of malnutrition in countries with high obesity prevalence. An adequate nutritional status, including micronutrient status is critical for pregnancy and offspring development; however, there is a lack of evidence regarding maternal dietary micronutrient intake and its relationship with BMI in the COVID-19 era. Henceforth, we sought to assess the adequacy of maternal dietary micronutrient intake and its relationship with BMI in pregnant women exposed to the COVID-19 pandemic.MethodsThis prospective cohort study included 810 Chilean pregnant women (>18 years) enrolled between March and October 2020 in Santiago, Chile. Maternal lifestyle, anthropometric and dietary intake (24-hr recall, n = 389) information was collected in the first trimester by telephonic interviews and from clinical records.Folate, calcium, iron, vitamins B-6, B-12 and D intake was estimated using the USDA nutrient database. Pre-pregnancy BMI was categorized according to the WHO criteria.ResultsOverall, 70% of women were classified as overweight or obese. Median (IQR) daily intake was 1.3 (0.8–1.8) mg for B-6, 2.5 (1.3–4.4) µg for B-12, 284 (187–408) µg for folate, 26 (7.2–86) IU for vitamin D, 639 (391–951) mg for calcium and 9.9 (6.9–13.7) mg for iron. Of all, <10% met the daily intake recommendation (RDA) for folate, vitamin D, iron, and calcium, while <25% and 50% met the recommendation for B-6 and B-12, respectively. B-6 intake was inversely correlated with BMI (ρ = −0.15, P < 0.05; Spearman correlation test). Furthermore, B-6, B-12, folate, iron, and calcium intake significantly differed by pre-pregnancy BMI categories (P < 0.05; KruskalWallis test), with obese and overweight women having a lower intake compared to normal or underweight women.ConclusionsIn this subgroup of Chilean pregnant women exposed to the COVID-19 pandemic, the inadequacy of micronutrient intake was highly prevalent, especially in women with excess weight; these results need to be confirmed with the complete sample and by including more detailed analyses of both diet and potential confounders but suggest a very concerning nutrition scenario emerging from the pandemic.Funding SourcesChilean National Agency for Investigation