Micronutrient deficiencies in pregnancy worldwide: health effects and prevention.
Micronutrient deficiencies in pregnancy worldwide: health effects and prevention.
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DOI：
10.1038/nrendo.2016.37
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发表时间：
2016-05
期刊：
影响因子：
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通讯作者：
Christian P
中科院分区：
文献类型：
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作者：
Gernand AD;Schulze KJ;Stewart CP;West KP Jr;Christian P
从饮食中获得的营养素、维生素和矿物质是生物活性所必需的。在整个怀孕期间和不同人群中，营养素状况差异很大。低收入国家的妇女在怀孕时往往营养不良，妊娠期的需求会加剧微量营养素缺乏，对胎儿造成健康后果。有效的单一微量营养素干预措施的例子包括：叶酸，以防止神经管缺陷，碘，以防止克汀病，锌，以减少早产，铁，以减少低出生体重的风险。叶酸和维生素D也可能增加出生体重。虽然广泛的机制和关联研究将产前多种微量营养素与合理的母胎健康优势联系起来，但在试验中，假设的益处往往不存在，最小或出乎意料。这些研究结果表明，人口背景在确定健康对策和广泛的知识差距方面发挥了作用。多种微量营养素补充剂可降低出生体重低、小于胎龄儿或在营养不良环境中死胎的风险，并证明通过产前护理进行微量营养素干预是合理的。妊娠期微量营养素暴露对健康的可测量影响可能持续到儿童期，但关于潜在长期益处的数据很少。在这篇综述中，我们讨论了微量营养素的摄入建议，缺乏的风险和后果，以及特别强调对后代的干预措施的影响。
Micronutrients, vitamins and minerals accessible from the diet, are essential for biologic activity. Micronutrient status varies widely throughout pregnancy and across populations. Women in low-income countries often enter pregnancy malnourished, and the demands of gestation can exacerbate micronutrient deficiencies with health consequences to the fetus. Examples of efficacious single micronutrient interventions include folic acid to prevent neural tube defects, iodine to prevent cretinism, zinc to reduce of preterm birth, and iron to reduce the risk of low birth weight. Folic acid and vitamin D might also increase birth weight. While extensive mechanism and association research links antenatal multiple micronutrients to plausible materno-fetal health advantages, hypothesized benefits have often been absent, minimal or unexpected in trials. These findings suggest a role for population context in determining health responses and extensive gaps in knowledge. Multiple micronutrient supplements reduce risks of being born low birth weight, small for gestational age or stillborn in undernourished settings, and justify micronutrient interventions with antenatal care. Measurable health effects of gestational micronutrient exposure may persist into childhood but few data exists on potential long-term benefits. In this Review, we discuss micronutrient intake recommendations, risks and consequences of deficiencies, and the effects of interventions with a particular emphasis on offspring.