Written by Dr. Shyam Sundar Gupta, PhD, Medically Reviewed by Dr. Ajay Kumar Tiwari, MD (Ay.)
Micronutrient deficiency is mostly common during pregnancy due to high nutrient demand of both fetus and mother and, it can negatively affect both (1). Protein, iron,folate or folic acid, omega-3 fatty acid, calcium, iodine, zinc, vitamin B6, Vitamin B12 and vitamin D are essential for growth and development of fetal body, brain, eyes and prevention of pre-eclampsia, preterm birth, neural tube defects and mortality of the fetus. Iron enhances the red cell mass, zinc, balancing of hormones and improves the immune system of the mother. These essential nutrients can be taken from food sources or medication.
- Folate or Folic acid
Folic acid or folate is more essential before and during pregnancy. It may help in the prevention of major birth defects of fetal brain or spine (2). The daily suggested dose of folic acid is 400 μg one month before pregnancy and during the first three months of pregnancy (3).
During pregnancy, more iron is required mainly to supply the developing fetus and placenta, and to enhance the maternal red cell mass. Hemoglobin concentrations are high in iron-supplemented pregnant women and improve the oxygen-carrying power of the blood and also setups a buffer against the loss of blood during childbirth (4). The daily suggested dose of iron during pregnancy is 30 mg (5).
During pregnancy calcium supplementation is essential for prevention of maternal deaths, preterm birth, preeclampsia, neonatal and infant mortality, bone development of neonates, improvement of mother bone mineral content and breast milk concentration (6). WHO and the Food, and Agriculture Organization of the United Nations recommend 1200 mg/day of calcium from 20 weeks gestation to ending a pregnancy (7).
Zinc deficiency during have a poor pregnancy outcomes and infant development. Lower plasma zinc concentrations decrease placental zinc transport and may have an effect on the zinc supply to the fetus. Zinc to help in balancing the hormones related to the beginning of labour, improving immune system, preventing intrauterine infections and pre-term birth (8). The current recommended dietary allowances for zinc for pregnant women age 18 years and younger are 12 mg per day and for pregnant women age 19 years and older are 11 mg per day during the last two trimesters of pregnancy (9).
- Omega-3 Fatty Acid
Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are two important omega-3 fatty acids, for pregnant women that cannot be synthesized within the human body and must be taken from marine sources such as seafood, fish oil, flax seed oil, and vegetable oils. Omega-3 fatty acids are critically important for the development of fetal brain and eye during the third trimester and up to 1.5 years of life (10). During pregnancy, the daily requirements for omega-3 fatty acids are 650 mg, of which 300 is DHA (11).
Iodine is necessary for synthesis of thyroid hormone. Iodine supplies are higher in pregnant women than non-pregnant women for fetal iodine requirements. High iodine deficiency in pregnant women can cause congenital anomalies, decreased intelligence, mother, and fetal goitre. The sufficient thyroid hormone is necessary for normal fetal development. Salt iodization is a cheap and helpful resource to make sure iodine supplementation (12).
- Vitamin B6
Vitamin B6 prevents pre-eclampsia and preterm birth and also treats nausea and vomiting in pregnant women (13). A daily dose of 1.9 mg of vitamin B6 for pregnant women is recommended for supplementation to prevent pre-eclampsia and preterm birth in pregnancy. A dose of 10–25 mg of vitamin B6 three times per day for treatment of nausea and vomiting in pregnancy is recommended by The American Congress of Obstetrics and Gynecology (ACOG) (14).
- Vitamin B12
Vitamin B12 deficiency may lead to infertility, recurrent spontaneous abortion, and neural tube defects or preterm delivery. A daily intake of 2.6 mcg of vitamin B12 is sufficient for supplementation during pregnancy (15).
- Vitamin D
During pregnancy, Vitamin D supplementation improves maternal vitamin D status, safety of pregnancy and infant outcomes, and also may reduce the threat of pre-eclampsia, high blood pressure, delivering a premature baby, low birth weight baby, and preterm birth. Some investigations have demonstrated that doses of 1000 IU/d may be required during pregnancy to maintain a normal blood concentration of vitamin D (16).
Protein supplementation is essential for flourishing pregnancy. Maternal protein deficiency continuously reduced the body weight and growth, numbers of cells, and a variety of biochemical changes in the fetus (17). A daily dose of 75 to 100 grams of protein required for supplementation during pregnancy (18).
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