Micronutrients in Adverse Pregnancy Outcomes

Area of Science:

• Obstetrics and Gynecology
• Nutritional Science
• Maternal-Fetal Medicine

Background:

• Pregnancy complications such as spontaneous abortion (SA), preeclampsia (PE), preterm birth (PTB), and fetal growth restriction (FGR) affect 10-20% of pregnancies.
• Maternal nutritional alterations are implicated in 60% of these complications.
• Current antenatal multiple micronutrient (MMN) supplementation lacks validated guidelines for dosage, timing, initiation, and duration, leading to potential overuse and adverse outcomes.

Purpose of the Study:

• To review the impact of micronutrient deficiency and supplementation on adverse pregnancy outcomes.
• To identify the specific populations that require micronutrient supplementation to prevent abuse.
• To explore the role of micronutrients in spontaneous abortion (SA), fetal growth restriction (FGR), gestational diabetes mellitus (GDM), preterm delivery, and preeclampsia (PE).

Main Methods:

• A comprehensive literature search was conducted using PubMed, Google Scholar, Mendeley, and Scopus databases.
• Keywords included "pregnancy," specific complications (SA, GDM, FGR, PTB, PE), and "micronutrients" or "supplementation."
• In-house literature databases and Kasturba Medical College (KMC) Health sciences library resources were also consulted.

Main Results:

• Micronutrients are crucial for fetoplacental growth, hormone secretion, immune regulation, and insulin sensitivity.
• Over-supplementation of micronutrients has been linked to adverse pregnancy outcomes, including spontaneous abortion and gestational diabetes mellitus.
• Specific roles of micronutrients in conditions like hypertension and immune-inflammatory pathways were noted.

Conclusions:

• There is a significant lack of standardization in micronutrient supplementation during pregnancy.
• Systematic studies are needed to define the role of micronutrients in each trimester to optimize supplementation.
• Standardized guidelines are essential to prevent the hazards associated with micronutrient over-supplementation and abuse.