Hostname: page-component-77c89778f8-m8s7h Total loading time: 0 Render date: 2024-07-20T21:55:58.479Z Has data issue: false hasContentIssue false
  • English
  • Français

Dietary guidelines for pregnancy: a review of current evidence

Published online by Cambridge University Press:  27 September 2007

AA Jackson  and
SM Robinson
AA Jackson*
Affiliation:
Institute of Human Nutrition, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
SM Robinson
Affiliation:
MRC Environmental Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
*
*Corresponding author: Email aaj@soton.ac.uk
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

In a successful pregnancy maternal health is maintained, a healthy baby is delivered and the mother is able to nurture her newborn adequately. Despite continued interest in the role and importance of maternal diet in this process, we do not have a clear understanding of how the nutritional status of the mother influences fetal growth and development. Recent epidemiological evidence of an association between poor fetal growth and adult disease highlights the need to reconsider the influences which act on the fetus, and the role maternal nutrition may play.

Nutrient needs are increased in pregnancy. For the mother to be solely dependent upon her dietary intake to meet these demands, would represent a very high risk strategy. Hence adequate reserves are important for a successful outcome. Whilst there are numerous observational studies of diet during pregnancy, there are only limited data from well-controlled, randomised supplementation studies. A recent systematic review showed only dietary supplements balanced in energy and protein content to result consistently in improved fetal growth. There is no strong evidence that nutrient supplements confer benefit in women without overt deficiency.

To interpret future dietary studies in pregnancy we need to consider metabolic differences between women which may influence their ability to meet fetal nutrient demand, to allow for nutrient–nutrient interactions, and to take account of differences in timing in gestation. Consideration of these factors in studies of pregnancy, will lead to a clearer understanding of the links between maternal diet and fetal growth and development. Until we have this understanding, it is reasonable to expect that women entering pregnancy are provided with a diet which is adequate, based upon our normal understanding of requirements, and it is not acceptable for women to be expected to carry a pregnancy with an obvious or overt nutritional deficiency.

Keywords

PregnancyDietary guidelines
Type
Research Article
Information
Public Health Nutrition , Volume 4 , Issue 2b , April 2001 , pp. 625 - 630
Copyright
Copyright © CABI Publishing 2001

References

1Rush, D.Nutrition and maternal mortality in the developing world. Am. J. Clin. Nutr. 2000; 72: 212S–40S.CrossRefGoogle ScholarPubMed
2Susser, M, Stein, Z.Timing in prenatal nutrition: a reprise of the Dutch Famine Study. Nutr. Rev. 1994; 52: 84–94.CrossRefGoogle ScholarPubMed
3Institute of Medicine. Nutrition during pregnancy. Washington: National Academy Press, 1990.Google Scholar
4Barker, DJP. Mothers, babies and health in later life. Churchill Livingstone (1998).CrossRefGoogle Scholar
5de Onis, M, Villar, J, Gülmezoglu, M.Nutritional interventions to prevent intrauterine growth retardation: evidence from randomized controlled trials. Eur. J. Clin. Nutr. 1998; 52: S83–93.Google ScholarPubMed
6Ramakrishnan, U, Manjrekar, R, Rivera, J, Gonzales-Cossio, T, Martorell, R.Micronutrients and pregnancy outcome: a review of the literature. Nutr. Res. 1999; 19: 103–59.CrossRefGoogle Scholar
7Brown, JE. Preconceptional nutrition and reproductive outcomes. Ann. NY Acad. Sci. 1993; 670: 286–92.CrossRefGoogle Scholar
8Caan, B, Horgen, DM, Margen, S, King, JC, Jewell, NP. Benefits associated with WIC supplemental feeding during the interpregnancy interval. Am. J. Clin. Nutr. 1987; 45: 29–41.CrossRefGoogle ScholarPubMed
9Kramer, MS. Determinants of low birthweight: methodological assessment and meta-analysis. Bull. WHO 1987; 65: 663–737.Google ScholarPubMed
10Forsen, T, Eriksson, JG, Tuomilehto, J, Teramo, K, Osmond, C, Barker, DJP. Mother's weight in pregnancy and coronary heart disease in a cohort of Finnish men: follow up study. BMJ 1997; 315: 837–40.CrossRefGoogle Scholar
11Brown, JE, Kahn, ESB. Maternal nutrition and the outcome of pregnancy – A renaissance in research. Clin. Perinatol. 1997; 24: 433–49.CrossRefGoogle ScholarPubMed
12Prentice, AM, Spaaij, CJK, Goldberg, GR, Poppitt, SD, van Raaij, JMA, Totton, M, Swann, D, Black, AE. Energy requirements of pregnant and lactating women. Eur. J. Clin. Nutr. 1996; 50: S82–111.Google ScholarPubMed
13Kramer, MS. Effects of energy and protein intakes on pregnancy outcome: an overview of the research evidence from controlled clinical trials. Am. J. Clin. Nutr. 1993; 58: 627–35.CrossRefGoogle ScholarPubMed
14Olsen, SF, Olsen, J, Frische, G.Does fish consumption during pregnancy increase fetal growth? A study of the size of the newborn, placental weight and gestational age in relation to fish consumption during pregnancy. Int. J. Epidemiol. 1990; 19: 971–977.CrossRefGoogle ScholarPubMed
15Al, MDM, van Houwelingen, AC, Hornstra, G.Long-chain polyunsaturated fatty acids, pregnancy and pregnancy outcome. Am. J. Clin. Nutr. 2000; 71(suppl): 285S–291S.CrossRefGoogle ScholarPubMed
16Allen, LH. Anemia and iron deficiency: effects on pregnancy outcome. Am. J. Clin. Nutr. 2000; 71(suppl): 1280S–1284S.CrossRefGoogle ScholarPubMed
17Scholl, TO, Hediger, ML. Anemia and iron-deficiency anemia: compilation of data on pregnancy outcome. Am. J. Clin. Nutr. 1994; 59(suppl): 492S–500S.CrossRefGoogle ScholarPubMed
18Scholl, TO, Hediger, ML, Schall, JI, Fischer, RL, Khoo, C-S. Low zinc intake during pregnancy: its association with preterm and very preterm delivery. Am. J. Epidemiol. 1993; 137: 1115–24.Google Scholar
19Ghebremeskel, K, Burns, L, Burden, TJ, Harbige, L, Costeloe, K, Powell, JJ, Crawford, M.Vitamin A and related essential nutrients in cord blood: relationships with anthropometric measurements at birth. Early Human Dev. 1994; 39: 177–88.CrossRefGoogle ScholarPubMed
20Goldenberg, RL, Tamura, T, Neggers, Y, Copper, RL, Johnston, KE, DuBard, MB, Hauth, JC. The effect of zinc supplementation on pregnancy outcome. JAMA 1995; 274: 463–8.CrossRefGoogle ScholarPubMed
21Osendarp, SJM, van Raaij, JMA, Arifeen, SE, Wahed, MA, Baqui, AH, Fuchs, GJ. A randomized placebo-controlled trial of the effect of zinc supplementation during pregnancy on pregnancy outcome in Bangladeshi urban poor. Am. J. Clin. Nutr. 2000; 71: 114–9.CrossRefGoogle ScholarPubMed
22Tamura, T, Goldenberg, RL, Johnston, KE, DuBard, M.Maternal plasma zinc concentrations and pregnancy outcomes. Am. J. Clin. Nutr. 2000; 71: 109–13.CrossRefGoogle Scholar
23Carroli, G, Duley, L, Belizan, JM, Villar, J.Calcium supplementation during pregnancy: a systematic review of randomised controlled trials. Br. J. Obstet. Gynaecol. 1994; 101: 753–8.CrossRefGoogle ScholarPubMed
24Levine, RJ, Hauth, JC, Curet, LB, Sibai, BM, Catalano, PM, Morris, CD, DerSimonian, R, Esterlitz, JR, Raymond, EG, Bild, DE, Clemens, JD, Cutler, JA. Trial of calcium to prevent preeclampsia. New Engl. J. Med. 1997; 337: 69–76.CrossRefGoogle ScholarPubMed
25Belizán, JM, Villar, J, Bergel, E, Del Pino, A, Di Fulvio, S, Galliano, SV, Kattan, C.Long term effect of calcium supplementation during pregnancy on the blood pressure of offspring: follow up of a randomised controlled trial. BMJ 1997; 315: 281–5.CrossRefGoogle ScholarPubMed
26Doyle, W, Crawford, MA, Wynn, AH, Wynn, SW. Maternal magnesium intake and pregnancy outcome. Magnesium Research 1989; 2: 205–10.Google ScholarPubMed
27Kovacs, L, Molnar, BG, Huhn, E, Bodis, L.Magnesium substitution in pregnancy. A prospective randomized double-blind study. Geburtshilfe Frauenheilkunde 1988; 48: 595–600.Google ScholarPubMed
28Spatling, L, Spatling, G.Magnesium supplementation in pregnancy. A double blind study. Br. J. Obstet. 1988; 95: 120–5.CrossRefGoogle ScholarPubMed
29Sibai, BM, Villar, MA, Bray, EB. Magnesium supplementation during pregnancy: A double-blind randomized controlled clinical trial. Am. J. Obstet. Gynecol. 1989; 161: 115–9.CrossRefGoogle ScholarPubMed
30Arnaud, J, Preziosi, P, Mashako, L, Galan, P, Nsibu, C, Favier, A, Kapongo, C, Hercberg, S.Serum trace elements in Zairian mothers and their newborns. Eur. J. Clin. Nutr. 1994; 48: 341–348.Google ScholarPubMed
31Hetzel, BS. Iodine deficiency disorders and their eradication. Lancet. 1983; 2: 1126–1129.CrossRefGoogle ScholarPubMed
32Delange, F.Administration of iodized oil during pregnancy: a summary of published evidence. Bull. WHO 1996; 74: 101–108.Google ScholarPubMed
33Shah, RS, Rajalakshmi, R.Vitamin A status of the newborn in relation to gestational age, body weight and maternal nutritional status. Am. J. Clin. Nutr. 1984; 40: 794–800.CrossRefGoogle ScholarPubMed
34Tamura, T, Goldenberg, RL, Johnston, KE, Cliver, SP, Hoffman, HJ. Serum concentrations of zinc, folate, vitamins A and E, and proteins and their relationships to pregnancy outcome. Acta. Obstet. Gynecol. Scand. 1997; 76: 63–70.Google Scholar
35West, KP, Katz, J, Khatry, SK, LeClerq, SC, Pradhan, EK, Shrestha, SR, Connor, PB, Dali, SM, Christian, P, Pokhrel, RP, Sommer, A, on behalf of the NNIPS-2 Study Group. Double blind, cluster randomised trial of low dose supplementation with vitamin A or beta carotene on mortality related to pregnancy in Nepal. BMJ 1999; 318: 570–575.CrossRefGoogle ScholarPubMed
36Katz, J, West, KP, Khatry, SK, Pradhan, EK, LeClerq, SC, Christian, P, Wu, LS, Adhikari, RK, Shrestha, SR, Sommer, A, NNIPS-2 Study Group. Maternal low dose vitamin A or β-carotene supplementation has no effect on fetal loss and early infant mortality: a randomized cluster trial in Nepal. Am. J. Clin. Nutr. 2000; 71: 1570–1576.CrossRefGoogle ScholarPubMed
37Rothman, KJ, Moore, LL, Singer, MR, Nguyen, UDT, Mannino, S, Milunsky, A.Teratogenicity of high vitamin A intake. N. Engl. J. Med. 1995; 333: 1369–1373.CrossRefGoogle ScholarPubMed
38MRC Vitamin Study Research Group. Prevention of neural tube defects: Results of the Medical Research Council Vitamin Study. Lancet 1991; 338: 131–137.CrossRefGoogle Scholar
39Brooke, OG, Brown, IRF, Bone, CDM, Carter, ND, Cleeve, HJW, Maxwell, JD, Robinson, VP, Winder, SM. Vitamin D supplements in pregnant Asian women: effects on calcium status and fetal growth. BMJ 1980; 1: 751–754.CrossRefGoogle Scholar
40Mallet, E, Gügi, B, Brunelle, P, Hénocq, A, Basuyau, JP, Lemeur, H.Vitamin D supplementation in pregnancy: a controlled trial of two methods. Obstet. Gynecol. 1986; 68: 300–304.CrossRefGoogle ScholarPubMed
41Ravelli, ACJ, van der Meulen, JHP, Michels, RPJ, Osmond, C, Barker, DJP, Hales, CN, Bleker, OP. Glucose tolerance in adults after prenatal exposure to famine. Lancet. 1998; 351: 173–177.CrossRefGoogle ScholarPubMed