Abstract
Zinc plays critical roles during embryogenesis, fetal growth, and milk secretion, which increase the zinc need for pregnancy and lactation. Increased needs can be met by increasing the dietary zinc intake, along with making homeostatic adjustments in zinc utilization. Potential homeostatic adjustments include changes in circulating zinc, increased zinc absorption, decreased zinc losses, and changes in whole body zinc kinetics. Although severe zinc deficiency during pregnancy has devastating effects, systematic reviews and meta-analysis of the effect of maternal zinc supplementation on pregnancy outcomes have consistently shown a limited benefit. We hypothesize, therefore, that zinc homeostatic adjustments during pregnancy and lactation improve zinc utilization sufficiently to provide the increased zinc needs in these stages and, therefore, mitigate immediate detrimental effects due to a low zinc intake. The specific questions addressed are the following: How is zinc utilization altered during pregnancy and lactation? Are those homeostatic adjustments influenced by maternal zinc status, dietary zinc, or zinc supplementation? These questions are addressed by critically reviewing results from published human studies on zinc homeostasis during pregnancy and lactation carried out in different populations worldwide.
Highlights
Zinc is widely recognized for its critical roles in cell division, differentiation and function that are essential for tissue growth
The data are limited, the following conclusions can be drawn regarding the relationship between maternal dietary zinc and homeostatic adjustments:
Endogenous fecal zinc losses have not been measured in human pregnancy, it is not known if these losses vary with dietary zinc
Summary
Zinc is widely recognized for its critical roles in cell division, differentiation and function that are essential for tissue growth. It is surprising to note that human observational studies have failed to find associations between poor maternal zinc status or intake and pregnancy complications, duration of gestation, and measurements of fetal growth and development. In a study of African-American pregnant women living in the USA without health-care coverage, zinc supplementation (25 mg/day) during the second half of pregnancy significantly increased infant birth weight and head circumference [21]. When underweight Bangladeshi urban poor pregnant women with low BMIs (mean = 18.9 kg/m2) were given supplemental zinc (30 mg/day) for the last two trimesters, no effect was seen on infant birth weight, gestational age, infant length or other infant measurements [22]. We review the relationship between maternal zinc intake and the various homeostatic changes normally occurring during pregnancy and lactation to the extent possible from the data available
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