Annales 78.1 - How to Feed the Fetus

Editor(s): Ferdinand Haschke .

Metabolic imbalances during pregnancy, such as GDM, might result in epigenetic changes which affect the offspring and might predispose to noncommunicable diseases later in life. Preventive measures for GDM must be initiated during pre-pregnancy and early pregnancy, in particular in women with high BMI. In pregnant women who develop GDM, medical nutrition therapy has to be provided by healthcare professionals. Omega-3 LCPUFA supplementation during the second half of pregnancy is effective to prevent premature birth and low birth weight. In developing societies, multiple micronutrient supplementation before and during pregnancy can contribute to better growth and cognitive development of the offspring. Annales Nestlé “How to Feed the Fetus” addresses short- and long-term consequences of nutrition and health issues before and during pregnancy.

Articles

Gestational Diabetes Mellitus and Developmental Programming

Author(s): Anne H.Y. Chu, Keith M. Godfrey

Gestational diabetes mellitus (GDM) affects an estimated 14% of pregnancies worldwide. It is now clear that children born to mothers with GDM have an increased lifetime risk of metabolic diseases compared to unexposed children. Other long-term adverse consequences in the offspring include cardiovascular abnormalities, dysregulation of glucose metabolism, increased risk of allergic/respiratory disease, and neurodevelopmental abnormalities. Together, these findings highlight the importance of the intra-uterine environment as a driver of epigenetic changes in the offspring.

Nutrition Management of Gestational Diabetes Mellitus

Author(s): Kavita Kapur, Anil Kapur, Moshe Hod

Gestational diabetes mellitus (GDM) is one of the most common metabolic disturbances that occurs during pregnancy. A successful approach for addressing GDM is the use of medical nutrition therapy. The goal of medical nutrition therapy is to meet maternal and fetal nutritional needs while maintaining optimal glycemic control. This strategy is based on providing individualized advice alongside practical tools and training to optimize nutrition self-management and healthy eating. Considering the impact of GDM on future health of the mother and the offspring, preventive strategies could have several benefits.

Prenatal Nutritional Strategies to Reduce the Risk of Preterm Birth

Author(s): Karen Patricia Best, Judith Gomersall, Maria Makrides

Preterm birth (PTB) is one of the most challenging problems in obstetric and neonatal care. Because of its complex etiology, the causes of PTB are unclear and there are currently no reliable strategies for prevention or treatment. Maternal nutrition before and during pregnancy plays a critical role in providing the necessary nutrients for fetal growth and may be an important modifiable risk factor for the prevention of PTB. Nutrients contribute to a variety of mechanisms that are potentially important to preterm delivery, such as infection, inflammation, oxidative stress, and muscle contractility. Current evidence indicates that the use of omega-3 polyunsaturated fatty acids (PUFA) may be a promising approach for PTB prevention.

Maternal Undernutrition before and during Pregnancy and Offspring Health and Development

Author(s): Melissa F. Young, Usha Ramakrishnan

Maternal undernutrition remains a critical public health problem with large regional and intra-country disparities in the prevalence of underweight, anemia, and micronutrient deficiencies. The greatest burden is seen among the poorest women in poor countries. Another major problem that disproportionately affects women of reproductive age is anemia, which is also associated with an increased risk of poor maternal and infant outcomes. A keydriver of poor nutrition is food insecurity. Despite the existence of evidence-based strategies for improving maternal nutrition during pregnancy, there are still large gaps in program implementation and outreach.