Maternal Diet and Nutrient Requirements in Pregnancy and Breastfeeding. An Italian Consensus Document

Franca Marangoni, Irene Cetin, Elvira Verduci, Giuseppe Canzone, Marcello Giovannini, Paolo Scollo, Giovanni Corsello, Andrea Poli, Franca Marangoni, Irene Cetin, Elvira Verduci, Giuseppe Canzone, Marcello Giovannini, Paolo Scollo, Giovanni Corsello, Andrea Poli

Abstract

The importance of lifestyle and dietary habits during pregnancy and breastfeeding, for health of mothers and their offspring, is widely supported by the most recent scientific literature. The consumption of a varied and balanced diet from the preconceptional period is essential to ensure both maternal well-being and pregnancy outcomes. However, the risk of inadequate intakes of specific micronutrients in pregnancy and lactation is high even in the most industrialized countries. This particularly applies to docosahexaenoic acid (DHA), iron, iodine, calcium, folic acid, and vitamin D, also in the Italian population. Moreover, the risk of not reaching the adequate nutrient supply is increased for selected groups of women of childbearing age: those following exclusion diets, underweight or overweight/obese, smokers, adolescents, mothers who have had multiple or close pregnancies, and those with previous unfavorable pregnancy outcomes.

Keywords: DHA; adequate intake; breastfeeding; micronutrients; nutrient requirement; pregnancy.

Conflict of interest statement

The authors declare no conflict of interest. The founding sponsors had no role in the preparation of contents, in writing of the manuscript, and in the decision to publish the document.

References

    1. Adair L.S. Long-term consequences of nutrition and growth in early childhood and possible preventive interventions. Nestlé Nutr. Inst. Workshop Ser. 2014;78:111–120.
    1. Berti C., Cetin I., Agostoni C., Desoye G., Devlieger R., Emmett P.M., Ensenauer R., Hauner H., Herrera E., Hoesli I., et al. Pregnancy and infants’ outcome: Nutritional and metabolic implications. Crit. Rev. Food Sci. Nutr. 2016;56:82–91. doi: 10.1080/10408398.2012.745477.
    1. Marmot M., Atinmo T., Byers T., Chen J., Hirohata T., Jackson A., James W. Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective. [(accessed on 15 September 2016)]. Available online:
    1. Davanzo R., Maffeis C., Silano M., Bertino E., Agostoni C., Cazzato T., Tonetto P., Staiano A., Vitiello R., Natale F. Allattamento al seno e uso del Latte Materno/Umano. [(accessed on 2 May 2016)]; Available online: .
    1. Bruce K.D. Maternal and in utero determinants of type 2 diabetes risk in the young. Curr. Diabetes Rep. 2014;14:446. doi: 10.1007/s11892-013-0446-0.
    1. Catalano P., deMouzon S.H. Maternal obesity and metabolic risk to the offspring: Why lifestyle interventions may have not achieved the desired outcomes. Int. J. Obes. 2015;39:642–649. doi: 10.1038/ijo.2015.15.
    1. Società di Nutrizione Umana (SINU) LARN—Livelli di Assunzione di Riferimento di Nutrienti ed Energia per la Popolazione Italiana. SICS; Milano, Italy: 2014. pp. 1–655. IV Revisione.
    1. Panel on Dietetic Products, Nutrition and Allergies (NDA) Scientific opinion on dietary reference values for energy. EFSA J. 2013;11:3005–3016.
    1. Kramer M.S., Kakuma R. Energy and protein intake in pregnancy. Cochrane Database Syst. Rev. 2003 doi: 10.1002/14651858.CD000032.
    1. Schaafsma G. The protein digestibility-corrected amino acid score. J. Nutr. 2000;130:1865S–1867S.
    1. Food and Agriculture Organization of the United Nations Dietary Protein Quality Evaluation in Human Nutrition: Report of an FAO Expert Consultation. [(accessed on 10 October 2016)]. Available online:
    1. Trumbo P., Schlicker S., Yates A. A., Poos M. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids. J. Am. Diet. Assoc. 2002;102:1621–1630. doi: 10.1016/S0002-8223(02)90346-9.
    1. Sauerwald T.U., Demmelmair H., Koletzko B. Polyunsaturated fatty acid supply with human milk. Lipids. 2001;36:991–996. doi: 10.1007/s11745-001-0810-9.
    1. Koletzko B., Cetin I., Brenna J.T. Dietary fat intakes for pregnant and lactating women. Br. J. Nutr. 2007;98:873–877. doi: 10.1017/S0007114507764747.
    1. Innis S.M., Friesen R.W. Essential n-3 fatty acids in pregnant women and early visual acuity maturation in term infants. Am. J. Clin. Nutr. 2008;87:548–557.
    1. Koletzko B., Agostoni C., Bergmann R., Ritzenthaler K., Shamir R. Physiological aspects of human milk lipids and implications for infant feeding: A workshop report. Acta Paediatr. 2011;100:1405–1415. doi: 10.1111/j.1651-2227.2011.02343.x.
    1. Lauritzen L., Carlson S.E. Maternal fatty acid status during pregnancy and lactation and relation to newborn and infant status. Matern. Child Nutr. 2011;7:S41–S58. doi: 10.1111/j.1740-8709.2011.00303.x.
    1. Sallis H., Steer C., Paternoster L., Davey Smith G., Evans J. Perinatal depression and omega-3 fatty acids: A Mendelian randomisation study. J. Affect. Disord. 2014;166:124–131. doi: 10.1016/j.jad.2014.04.077.
    1. Mennitti L.V., Oliveira J.L., Morais C.A., Estadella D., Oyama L.M., Oller do Nascimento C.M., Pisani L.P. Type of fatty acids in maternal diets during pregnancy and/or lactation and metabolic consequences of the offspring. J. Nutr. Biochem. 2015;26:99–111. doi: 10.1016/j.jnutbio.2014.10.001.
    1. Arterburn L.M., Hall E.B., Oken H. Distribution, interconversion, and dose response of n-3 fatty acids in humans. Am. J. Clin. Nutr. 2006;83:1467S–1476S.
    1. Brenna J.T., Salem N., Jr., Sinclair A.J., Cunnane S.C. International society for the study of fatty acids and lipids, ISSFAL. Alpha-Linolenic acid supplementation and conversion to n-3 long-chain polyunsaturated fatty acids in humans. Prostaglandins Leukot. Essent. Fat. Acids. 2009;80:85–91. doi: 10.1016/j.plefa.2009.01.004.
    1. Mozaffarian D., Rimm E.B. Fish intake, contaminants, and human health: Evaluating the risks and the benefits. JAMA. 2006;296:1885–1899. doi: 10.1001/jama.296.15.1885.
    1. USDA National Nutrient Database for Standard Reference. [(accessed on 14 July 2016)]; Available online: .
    1. Danaei G., Ding E.L., Mozaffarian D., Taylor B., Rehm J., Murray C.J., Ezzati M. The preventable causes of death in the United States: Comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS Med. 2009;6:629. doi: 10.1371/journal.pmed.1000058.
    1. Tavani A., Pelucchi C., Parpinel M., Negri E., Franceschi S., Levi F., La Vecchia C. n-3 polyunsaturated fatty acid intake and cancer risk in Italy and Switzerland. Int. J. Cancer. 2003;105:113–116. doi: 10.1002/ijc.11018.
    1. Pounis G., de Lorgeril M., Salen P., Laporte F., Krogh V., Siani A., Arnout J., Cappuccio F.P., van Dongen M., Donati M.B., et al. Dietary patterns and fatty acids levels of three European populations. Results from the IMMIDIET study. Nutr. Metab. Cardiovasc. Dis. 2014;24:883–890. doi: 10.1016/j.numecd.2014.01.012.
    1. EFSA Scientific Committee Statement on the benefits of fish/seafood consumption compared to the risks of methylmercury in fish/seafood. EFSA J. 2015;13:3982–4017.
    1. Panel on Dietetic Products, Nutrition and Allergies Scientific Opinion on the extension of use for DHA and EPA-rich algal oil from Schizochytrium sp. As a Novel Food ingredient. EFSA J. 2014;12:3843–3859.
    1. Michaelsen K.F., Dewey K.G., Perez-Exposito A.B., Nurhasan M., Lauritzen L., Roos N. Food sources and intake of n-6 and n-3 fatty acids in low-income countries with emphasis on infants, young children (6–24 months), and pregnant and lactating women. Matern. Child Nutr. 2011;7:124–140. doi: 10.1111/j.1740-8709.2011.00302.x.
    1. Agostoni C., Galli C., Riva E., Colombo C., Giovannini M., Marangoni F. Reduced docosahexaenoic acid synthesis may contribute to growth restriction in infants born to mothers who smoke. J. Pediatr. 2005;147:854–856. doi: 10.1016/j.jpeds.2005.05.040.
    1. Agostoni C., Marangoni F., Grandi F., Lammardo A.M., Giovannini M., Riva E., Galli C. Earlier smoking habits are associated with higher serum lipids and lower milk fat and polyunsaturated fatty acid content in the first 6 months of lactation. Eur. J. Clin. Nutr. 2003;57:1466–1472. doi: 10.1038/sj.ejcn.1601711.
    1. Koletzko B., Bauer C.P., Bung P., Cremer M., Flothkötter M., Hellmers C., Kersting M., Krawinkel M., Przyrembel H., Rasenack R.A., et al. German national consensus recommendations on nutrition and lifestyle in pregnancy by the ‘Healthy Start—Young Family Network’. Ann. Nutr. Metab. 2013;63:311–322. doi: 10.1159/000358398.
    1. Stevens G., Finucane M., De-Regil L.M., Paciorek C., Flaxman S., Branca F., Peña-Rosas J.P., Bhutta Z.A., Ezzati M. Global, regional, and national trends in total and severe anaemia prevalence in children and pregnant and non-pregnant women. Lancet Glob. Health. 2013;1:e16–e25. doi: 10.1016/S2214-109X(13)70001-9.
    1. Eussen S., Alles M., Uijterschout L., Brus F., van der Horst-Graat J. Iron intake and status of children aged 6–36 months in Europe: A systematic review. Ann. Nutr. Met. 2015;66:80–92. doi: 10.1159/000371357.
    1. Cetin I., Berti C., Mandò C., Parisi F. Placental iron transport and maternal absorption. Ann. Nutr. Metab. 2011;59:55–58. doi: 10.1159/000332133.
    1. Allen L.H. Anemia and iron deficiency: Effects on pregnancy outcome. Am. J. Clin. Nutr. 2005;71:1280S–1284S.
    1. Khambalia A.Z., Collins C.E., Roberts C.L., Morris J.M., Powell K.L., Tasevski V., Nassar N. Iron deficiency in early pregnancy using serum ferritin and soluble transferrin receptor concentrations are associated with pregnancy and birth outcomes. Eur. J. Clin. Nutr. 2015;70:358–363. doi: 10.1038/ejcn.2015.157.
    1. Alwan N.A., Cade J.E., McArdle H.J., Greenwood D.C., Hayes H.E., Simpson N.A. Maternal iron status in early pregnancy and birth outcomes: Insights from the Baby’s Vascular health and Iron in Pregnancy study. Br. J. Nutr. 2015;113:1985–1992. doi: 10.1017/S0007114515001166.
    1. Siu A.L. Screening for iron deficiency anemia and iron supplementation in pregnant women to improve maternal health and birth outcomes: U.S. preventive services task force recommendation statement. Ann. Intern. Med. 2015;163:529–536. doi: 10.7326/M15-1707.
    1. Krebs N.F., Domellöf M., Ziegler E. Balancing benefits and risks of iron fortification in resource-rich countries. J. Pediatr. 2015;167:S20–S25. doi: 10.1016/j.jpeds.2015.07.016.
    1. EFSA NDA Panel (EFSA Panel on Dietetic Products, Nutrition and Allergies) Scientific opinion on dietary reference values for iron. EFSA J. 2015 doi: 10.2903/j.efsa.2015.4101.
    1. EFSA NDA Panel (EFSA Panel on Panel on Dietetic Products Nutrition and Allergies) Scientific opinion on dietary reference values for iodine. EFSA J. 2014;12:3660–3716.
    1. Novaković R., Cavelaars A.E., Bekkering G.E., Roman-Viñas B., Ngo J., Gurinović M., Glibetić M., Nikolić M., Golesorkhi M., Medina M.W., et al. Micronutrient intake and status in Central and Eastern Europe compared with other European countries, results from the EURRECA network. Public Health Nutr. 2013;16:824–840. doi: 10.1017/S1368980012004077.
    1. Pastorelli A.A., Stacchini P., Olivieri A. Daily iodine intake and the impact of salt reduction on iodine prophylaxis in the Italian population. Eur. J. Clin. Nutr. 2015;69:211–215. doi: 10.1038/ejcn.2014.206.
    1. Trumpff C., Vandevijvere S., Moreno-Reyes R., Vanderpas J., Tafforeau J., Van Oyen H., De Schepper J. Neonatal thyroid-stimulating hormone level is influenced by neonatal, maternal, and pregnancy factors. Nutr. Res. 2015;35:975–981. doi: 10.1016/j.nutres.2015.09.002.
    1. Zimmermann M.B. The effects of iodine deficiency in pregnancy and infancy. Paediatr. Perinat. Epidemiol. 2012;26:108–117. doi: 10.1111/j.1365-3016.2012.01275.x.
    1. Bhutta Z.A., Das J.K., Rizvi A., Gaffey M.F., Walker N., Horton S., Webb P., Lattey A., Black R.E., Lancet Nutrition Interventions Review Group. Maternal and Child Nutrition Study Group Evidence-based interventions for improvement of maternal and child nutrition: What can be done and at what cost? Lancet. 2013;382:452–477. doi: 10.1016/S0140-6736(13)60996-4.
    1. Istituto Superiore di Sanità Monitoring of the Nationwide Program of Iodine Prophylaxis in Italy. [(accessed on 2 May 2016)]. Available online: .
    1. WHO/UNICEF Reaching Optimal Iodine Nutrition in Pregnant and Lactating Women and Young Children. [(accessed on 4 June 2016)]. Available online: .
    1. Allen L.H., Kerstetter J.E. Calcium. In: Allen L., Prentice A., editors. Encyclopedia of Human Nutrition. 2nd ed. Elsevier Ltd.; Amsterdam, The Netherlands: 2005. pp. 253–259.
    1. Lombardi-Boccia G., Aguzzi A., Cappelloni M., Di Lullo G., Lucarini M. Total-diet study: Dietary intakes of macro elements and trace elements in Italy. Br. J. Nutr. 2003;90:1117–1121. doi: 10.1079/BJN2003997.
    1. Freisling H., Fahey M.T., Moskal A., Ocké M.C., Ferrari P., Jenab M., Norat T., Welch A.A., Navarro C., Schulz M., et al. Region-specific nutrient intake patterns exhibit a geographical gradient within and between European countries. J. Nutr. 2010;140:1280–1286. doi: 10.3945/jn.110.121152.
    1. Sette S., Le Donne C., Piccinelli R., Arcella D., Turrini A., Leclercq C. The third italian national food consumption survey, INRAN-SCAI 2005-06—Part 1: Nutrient intakes in Italy. Nutr. Metab. Cardiovasc. Dis. 2011;21:922–932. doi: 10.1016/j.numecd.2010.03.001.
    1. Theobald H.E. Calcium and health. Nutr. Bull. 2005;30:237–277. doi: 10.1111/j.1467-3010.2005.00514.x.
    1. Hofmeyr G.J., Lawrie T.A., Atallah A.N., Duley L., Torloni M.R. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst. Rev. 2014 doi: 10.1002/14651858.CD001059.pub3.
    1. Olausson H., Goldberg G.R., Laskey M.A., Schoenmakers I., Jarjou L.M., Prentice A. Calcium economy in human pregnancy and lactation. Nutr. Res. Rev. 2012;25:40–67. doi: 10.1017/S0954422411000187.
    1. Spiro A., Buttriss J.L. Vitamin D: An overview of vitamin D status and intake in Europe. Nutr. Bull. 2014;39:322–350. doi: 10.1111/nbu.12108.
    1. Cashman K.D., Kiely M. Recommended dietary intakes for vitamin D: Where do they come from, what do they achieve and how can we meet them? J. Hum. Nutr. Diet. 2014;27:434–442. doi: 10.1111/jhn.12226.
    1. Lamberg-Allardt C., Ala-Houhala M., Ahola M., Parviainen M.T., Räsänen L., Visakorpi J. Vitamin D status of children and adolescents in Finland. Ann. Nutr. Metab. 1986;30:267–272. doi: 10.1159/000177203.
    1. De-Regil L.M., Palacios C., Lombardo L.K., Peña-Rosas J.P. Vitamin D supplementation for women during pregnancy. Cochrane Database Syst. Rev. 2016 doi: 10.1002/14651858.CD008873.pub2.
    1. Italian Society of Preventive and Social Pediatrics SIPPS Consensus 2015—Vitamina D in età Pediatrica. Pediatria Preventiva & Sociale 3. [(accessed on 2 May 2016)]. pp. 142–258. Available online: .
    1. Schoenmakers I., Pettifor J.M., Peña-Rosas J.P., Lamberg-Allardt C., Shaw N., Jones K.S., Lips P., Glorieux F.H., Bouillon R. Prevention and consequences of vitamin D deficiency in pregnant and lactating women and children: A symposium to prioritise vitamin D on the global agenda. J. Steroid. Biochem. Mol. Biol. 2015 doi: 10.1016/j.jsbmb.2015.11.004.
    1. Wagner C.L., Greer F.R. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics. 2008;122:1142–1152. doi: 10.1542/peds.2008-1862.
    1. Hoey L., McNulty H., Duffy M.E., Hughes C.F., Strain J.J. EURRECA-Estimating folate requirements for deriving dietary reference values. Crit. Rev. Food Sci. Nutr. 2013;53:1041–1050. doi: 10.1080/10408398.2012.742858.
    1. Berti C., Fekete K., Dullemeijer C., Trovato M., Souverein O.W., Cavelaars A., Dhonukshe-Rutten R., Massari M., Decsi I., van’t Veer P., et al. Folate intake and markers of folate status in women of reproductive age, pregnant and lactating women: A meta-analysis. J. Nutr. Metab. 2012;2012:470656. doi: 10.1155/2012/470656.
    1. De-Regil L.M., Fernández-Gaxiola A.C., Dowswell T., Peña-Rosas J.P. Effects and safety of periconceptional folate supplementation for preventing birth defects. Cochrane Database Syst. Rev. 2010 doi: 10.1002/14651858.CD007950.
    1. Cawley S., Mullaney L., McKeating A., Farren M., McCartney D., Turner M.J. A review of European guidelines on periconceptional folic acid supplementation. Eur. J. Clin. Nutr. 2016;70:143–154. doi: 10.1038/ejcn.2015.131.
    1. Fekete K., Berti C., Trovato M., Lohner S., Dullemeijer C., Souverein O.W., Cetin I., Decsi T. Effect of folate intake on health outcomes in pregnancy: A systematic review and meta-analysis on birth weight, placental weight and length of gestation. Nutr. J. 2012;11:75. doi: 10.1186/1475-2891-11-75.
    1. US Preventive Services Task Force Folic acid for the prevention of neural tube defects: US Preventive Services Task Force recommendation statement. Ann. Intern. Med. 2009;150:626–631.
    1. O’Connor D.L., Green T., Picciano M.F. Maternal folate status and lactation. J. Mammary Gland. Biol. 1997;2:279–289. doi: 10.1023/A:1026388522182.
    1. EFSA NDA Panel (EFSA Panel on Dietetic Products, Nutrition and Allergies) Scientific opinion on dietary reference values for folate. EFSA J. 2014;12:3893–3951.
    1. WHO Recommendations for the Prevention and Management of Tobacco Use and Second-Hand Smoke Exposure in Pregnancy. [(accessed on 4 June 2016)]. Available online: .
    1. Oken E., Levitan E.B., Gillman M.W. Maternal smoking during pregnancy and child overweight: Systematic review and meta-analysis. Int. J. Obes. 2008;32:201–210. doi: 10.1038/sj.ijo.0803760.
    1. Burke H., Leonardi-Bee J., Hashim A., Pine-Abata H., Chen Y., Cook D.G., Britton J.R., Mc Keever T.M. Prenatal and passive smoke exposure and incidence of asthma and wheeze: Systematic review and meta-analysis. Pediatrics. 2012;129:735–744. doi: 10.1542/peds.2011-2196.
    1. Marangoni F., Colombo C., De Angelis L., Gambaro V., Agostoni C., Giovannini M., Galli C. Cigarette smoke negatively and dose-dependently affects the biosynthetic pathway of the n-3 polyunsaturated fatty acid series in human mammary epithelial cells. Lipids. 2004;39:633–637. doi: 10.1007/s11745-004-1276-5.
    1. Shepherd S.J., Gibson P.R. Nutritional inadequacies of the gluten-free diet in both recently-diagnosed and long-term patients with coeliac disease. J. Hum. Nutr. Diet. 2013;26:349–358. doi: 10.1111/jhn.12018.
    1. Silano M., Agostoni C., Sanz Y., Guandalini S. Infant feeding and risk of developing celiac disease: A systematic review. BMJ Open. 2016;6:e009163. doi: 10.1136/bmjopen-2015-009163.
    1. Clarys P., Deliens T., Huybrechts I., Deriemaeker P., Vanaelst B., De Keyzer W., Hebbelinck M., Mullie P. Comparison of nutritional quality of the vegan, vegetarian, semi-vegetarian, pesco-vegetarian and omnivorous diet. Nutrients. 2014;6:1318–1332. doi: 10.3390/nu6031318.
    1. Piccoli G.B., Clari R., Vigotti F.N., Leone F., Attini R., Cabiddu G., Mauro G., Castelluccia N., Colombi N., Capizzi I., et al. Vegan-vegetarian diets in pregnancy: Danger or panacea? A systematic narrative review. BJOG Int. J. Obstet. Gynaecol. 2015;122:623–633. doi: 10.1111/1471-0528.13280.
    1. Victora C.G., Adair L., Fall C., Hallal P.C., Martorell R., Richter L., Sachdev H.S., Maternal and Child Undernutrition Study Group Maternal and child undernutrition: Consequences for adult health and human capital. Lancet. 2008;371:340–357. doi: 10.1016/S0140-6736(07)61692-4.
    1. Lu W.P., Lu M.S., Li Z.H., Zhang C.X. Effects of multimicronutrient supplementation during pregnancy on postnatal growth of children under 5 years of age: A meta-analysis of randomized controlled trials. PLoS ONE. 2014;9:629. doi: 10.1371/journal.pone.0088496.
    1. Koletzko B., Thiel I., Abiodun P.O. The fatty acid composition of human milk in Europe and Africa. J. Pediatr. 1992;120:S62–S70. doi: 10.1016/S0022-3476(05)81238-7.
    1. Kolasa K.M., Firnhaber G., Haven K. Diet for a Healthy Lactating Woman. Clin. Obstet. Gynecol. 2015;58:893–901. doi: 10.1097/GRF.0000000000000144.
    1. Bodnar L.M., Siminerio L.L., Himes K.P., Hutcheon J.A., Lash T.L., Parisi S.M., Abrams B. Maternal obesity and gestational weight gain are risk factors for infant death. Obesity. 2016;24:490–498. doi: 10.1002/oby.21335.
    1. Mandò C., Calabrese S., Mazzocco M.I., Novielli C., Anelli G.M., Antonazzo P., Cetin I. Sex specific adaptations in placental biometry of overweight and obese women. Placenta. 2016;38:1–7. doi: 10.1016/j.placenta.2015.12.008.
    1. Sbraccia P., Vettor R., Società Italiana dell’Obesità (SIO) Associazione Dietetica Italiana (ADI) Standard Italiani per la cura Dell’obesità 2012–2013. [(accessed on 2 May 2016)]. Available online: .
    1. Karefylakis C., Näslund I., Edholm D., Sundbom M., Karlsson F.A., Rask E. Prevalence of anemia and related deficiencies 10 years after gastric bypass—A retrospective study. Obes. Surg. 2015;25:1019–1023. doi: 10.1007/s11695-014-1500-y.
    1. Jans G., Matthys C., Bogaerts A., Lannoo M., Verhaeghe J., van der Schueren B., Devlieger R. Maternal micronutrient deficiencies and related adverse neonatal outcomes after bariatric surgery: A systematic review. Adv. Nutr. 2015;6:420–429. doi: 10.3945/an.114.008086.
    1. Johansson K., Stephansson O., Neovius M. Outcomes of pregnancy after bariatric surgery. N. Engl. J. Med. 2015;372:814–824. doi: 10.1056/NEJMoa1405789.
    1. Wallace J., Bourke D., da Silva P., Aitken R. Nutrient partitioning during adolescent pregnancy. Reproduction. 2001;122:347–357. doi: 10.1530/rep.0.1220347.
    1. Hayward C.E., Greenwood S.L., Sibley C.P., Baker P.N., Challis J.R., Jones R.L. Effect of maternal age and growth on placental nutrient transport: potential mechanisms for teenagers’ predisposition to small-for-gestational-age birth? Am. J. Physiol. Endocrinol. Metab. 2012;302:E233–E242. doi: 10.1152/ajpendo.00192.2011.
    1. Lenders C.M., McElrath T.F., Scholl T.O. Nutrition in adolescent pregnancy. Curr. Opin. Pediatr. 2000;12:291–296. doi: 10.1097/00008480-200006000-00021.
    1. Scholl T.O., Hediger M.L., Schall J.I., Khoo C.S., Fischer R.L. Maternal growth during pregnancy and the competition for nutrients. Am. J. Clin. Nutr. 1994;60:183–188.
    1. Luke B. Nutrition in multiple gestations. Clin. Perinatol. 2005;32:403–429. doi: 10.1016/j.clp.2005.02.005.
    1. Wallace J.M., Bhattacharya S., Campbell D.M., Horgan G.W. Inter-pregnancy weight change impacts placental weight and is associated with the risk of adverse pregnancy outcomes in the second pregnancy. BMC Pregnancy Childbirth. 2014;14:629. doi: 10.1186/1471-2393-14-40.
    1. Cetin I., Assandro P., Massari M., Sagone A., Gennaretti R., Donzelli G., Knowles A., Monasta L. Breastfeeding during pregnancy. Position paper of the italian society of perinatal medicine and the task force on breastfeeding, ministry of health, Italy. J. Hum. Lact. 2014;30:20–27. doi: 10.1177/0890334413514294.
    1. Berks D., Hoedjes M., Franx A., Duvekot H.J., Raat H., Steegers E.A. OS031. Lifestyle intervention after complicated pregnancy successfully improves cardiovascular and metabolic health: Results of the pro-active study. Pregnancy Hypertens. 2012;2:192–193.
    1. Englund-Ögge L., Brantsæter A.L., Sengpiel V., Haugen M., Birgisdottir B.E., Myhre R., Meltzer H.M., Jacobsson B. Maternal dietary patterns and preterm delivery: Results from large prospective cohort study. Br. Med. J. 2014 doi: 10.1136/bmj.g1446.
    1. Timmermans S., Steegers-Theunissen R.P., Vujkovic M., Bakker R., den Breeijen H., Raat H., Russcher H., Lindemans J., Hofman A., Jaddoe V.W., et al. Major dietary patterns and blood pressure patterns during pregnancy: The Generation R Study. Am. J. Obstet. Gynecol. 2011;205:337.e1–337.e12. doi: 10.1016/j.ajog.2011.05.013.
    1. Ronnenberg A.G., Goldman M.B., Chen D., Aitken I.W., Willett W.C., Selhub J., Xu X. Preconception folate and vitamin B(6) status and clinical spontaneous abortion in Chinese women. Obstet. Gynecol. 2002;100:107–113. doi: 10.1097/00006250-200207000-00017.
    1. Oliver E.M., Grimshaw K.E., Schoemaker A.A., Keil T., McBride D., Sprikkelman A.B., Ragnarsdottir H.S., Trendelenburg V., Emmanouil E., Reche M., et al. Dietary habits and supplement use in relation to national pregnancy recommendations: Data from the EuroPrevall birth cohort. Matern. Child Health J. 2014;18:2408–2425. doi: 10.1007/s10995-014-1480-5.

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren