Skip to main content Accessibility help
×
Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-27T03:24:47.437Z Has data issue: false hasContentIssue false

16 - Intervention strategies to improve outcome in obese pregnancies: micronutrients and dietary supplements

from Section 4 - Interventions

Published online by Cambridge University Press:  05 August 2012

Matthew W. Gillman
Affiliation:
Harvard Medical School
Lucilla Poston
Affiliation:
King's College London
Get access

Summary

This chapter reviews data highlighting the vulnerability of obese women to multiple micronutrient deficiencies. It summarizes the evidence supporting the effectiveness of nutrition interventions at preventing key birth outcomes among obese pregnant women. Increased body mass index (BMI) in non-pregnant women is associated with decreased serum folate, ascorbic acid, vitamin E, total carotenoids, and selenium in a variety of populations. With the poor micronutrient status of obese women of childbearing age, and potentially the same relationship in obese pregnant women, it is critical to understand whether micronutrient interventions could positively impact birth outcomes in obese pregnancy. Several high-quality observational studies of birth defects, pre-eclampsia may provide additional insight into whether micronutrient supplementation may reduce the likelihood of poor outcomes among obese pregnant women. Future rigorous observational studies exploring a wide range of micronutrients and risk of poor outcomes of women with high pre-pregnancy BMIs will add to the evidence base.
Type
Chapter
Information
Maternal Obesity , pp. 199 - 208
Publisher: Cambridge University Press
Print publication year: 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bodnar, L M Baker, P Balen, A H Poston, L Sattars, N Obesity and Reproductive Health London RCOG Press 2007 145
Garcia, O P Long, K Z Rosado, J L Impact of micronutrient deficiencies on obesity Nutr Rev 2009 67 559 Google Scholar
Mojtabai, R. Body mass index and serum folate in childbearing age women Eur J Epidemiol 2004 19 1029 Google Scholar
Kimmons, J E Blanck, H M Tohill, B C Zhang, J Khan, L K Associations between body mass index and the prevalence of low micronutrient levels among us adults Med Gen Med 2006 8 59 Google Scholar
Ortega, R M Lopez-Sobaler, A M Andres, P Folate status in young overweight and obese women: changes associated with weight reduction and increased folate intake J Nutr Sci Vitaminol (Tokyo) 2009 55 149 Google Scholar
Han, Y S Ha, E H Park, H S Kim, Y J Lee, S S Relationships between pregnancy outcomes, biochemical markers and pre-pregnancy body mass index Int J Obes (Lond) 2010 35 570 Google Scholar
Poston, L Briley, A L Seed, P T Kelly, F J Shennan, A H Vitamin C and vitamin E in pregnant women at risk for pre-eclampsia (VIP trial): randomised placebo-controlled trial Lancet 2006 367 1145 Google Scholar
Rajasingam, D Seed, P T Briley, A L Shennan, A H Poston, L. A prospective study of pregnancy outcome and biomarkers of oxidative stress in nulliparous obese women Am J Obstet Gynecol 2009 200 395e1 Google Scholar
Bates, C J Mishra, G D Prentice, A. Gamma-tocopherol as a possible marker for nutrition-related risk: results from four national diet and nutrition surveys in Britain Br J Nutr 2004 92 137 Google Scholar
Hahn, S Haselhorst, U Tan, S Low serum 25-hydroxyvitamin d concentrations are associated with insulin resistance and obesity in women with polycystic ovary syndrome Exp Clin Endocrinol Diabetes 2006 114 577 Google Scholar
Bodnar, L M Catov, J M Roberts, J M Simhan, H N Prepregnancy obesity predicts poor vitamin D status in mothers and their neonates J Nutr 2007 137 2437 Google Scholar
Chambers, E C Heshka, S Gallagher, D Serum iron and body fat distribution in a multiethnic cohort of adults living in New York City J Am Diet Assoc 2006 106 680 Google Scholar
Zimmermann, M B Zeder, C Muthayya, S Adiposity in women and children from transition countries predicts decreased iron absorption, iron deficiency and a reduced response to iron fortification Int J Obes (Lond) 2008 32 1098 Google Scholar
Bodnar, L M Siega-Riz, A M Arab, L Chantala, K McDonald, T. Predictors of pregnancy and postpartum iron status in low-income women Public Health Nutr 2004 7 701 Google Scholar
Garn, S M Petzold, A S Fatness and hematological levels during pregnancy Am J Clin Nutr 1982 36 729 Google Scholar
Bodnar, L M Siega-Riz, A M Cogswell, M E High prepregnancy BMI increases the risk of postpartum anemia Obes Res 2004 12 941 Google Scholar
Tamura, T Goldenberg, R L Johnston, K E Chapman, V R Relationship between pre-pregnancy bmi and plasma zinc concentrations in early pregnancy Br J Nutr 2004 91 773 Google Scholar
Major, G C Chaput, J P Ledoux, M Recent developments in calcium-related obesity research Obes Rev 2008 9 428 Google Scholar
Zemel, M B Shi, H Greer, B Dirienzo, D Zemel, P C Regulation of adiposity by dietary calcium FASEB J 2000 14 1132 Google Scholar
Major, G C Alarie, F P Dore, J Tremblay, A Calcium plus vitamin d supplementation and fat mass loss in female very low-calcium consumers: potential link with a calcium-specific appetite control Br J Nutr 2009 101 659 Google Scholar
Rifas-Shiman, S L Rich-Edwards, J W Kleinman, K P Oken, E Gillman, M W Dietary quality during pregnancy varies by maternal characteristics in Project Viva: a US cohort J Am Diet Assoc 2009 109 1004 Google Scholar
Laraia, B A Bodnar, L M Siega-Riz, A M Pregravid body mass index is negatively associated with diet quality during pregnancy Public Health Nutr 2007 10 920 Google Scholar
Pearson, T C Guthrie, D L Simpson, J Interpretation of measured red cell mass and plasma volume in adults: Expert Panel on Radionuclides of the International Council for Standardization in Haematology Br J Haematol 1995 89 748 Google Scholar
Andersen, L F Jacobs, D R Gross, M D Longitudinal associations between body mass index and serum carotenoids: the Cardia study Br J Nutr 2006 95 358 Google Scholar
Wortsman, J Matsuoka, L Y Chen, T C Lu, Z Holick, M F Decreased bioavailability of vitamin D in obesity Am J Clin Nutr 2000 72 690 Google Scholar
McClung, J P Karl, J P Iron deficiency and obesity: the contribution of inflammation and diminished iron absorption Nutr Rev 2009 67 100 Google Scholar
Vincent, H K Innes, K E Vincent, K R Oxidative stress and potential interventions to reduce oxidative stress in overweight and obesity Diabetes Obes Metab 2007 9 813 Google Scholar
Al-Saleh, E Nandakumaran, M Al-Harmi, J Sadan, T Al-Enezi, H. Maternal–fetal status of copper, iron, molybdenum, selenium, and zinc in obese pregnant women in late gestation Biol Trace Elem Res 2006 113 113 Google Scholar
Lee, D H Steffen, L M Jacobs, D R Association between serum gamma-glutamyltransferase and dietary factors: the coronary artery risk development in young adults (CARDIA) study Am J Clin Nutr 2004 79 600 Google Scholar
Lee, D H Gross, M D Jacobs, D R Association of serum carotenoids and tocopherols with gamma-glutamyltransferase: the cardiovascular risk development in young adults (CARDIA) study Clin Chem 2004 50 582 Google Scholar
Henson, M C Castracane, V D Leptin in pregnancy Biol Reprod 2000 63 1219 Google Scholar
Shankar, P Boylan, M Sriram, K. Micronutrient deficiencies after bariatric surgery Nutrition 2010 26 1031 Google Scholar
Block, G Mangels, A R Patterson, B H Body weight and prior depletion affect plasma ascorbate levels attained on identical vitamin c intake: a controlled-diet study J Am Coll Nutr 1999 18 628 Google Scholar
Modder, J Fitzsimons, K J 2010
American College of Obstetricians and Gynecologists ACOG Committee Opinion number 315, September 2005. Obesity in pregnancy Obstet Gynecol 2005 106 671 Google Scholar
Fall, C H Fisher, D J Osmond, C Margetts, B M Multiple micronutrient supplementation during pregnancy in low-income countries: a meta-analysis of effects on birth size and length of gestation Food Nutr Bull 2009 30 S533 Google Scholar
Villar, J Purwar, M Merialdi, M World Health Organisation multicentre randomised trial of supplementation with vitamins C and E among pregnant women at high risk for pre-eclampsia in populations of low nutritional status from developing countries BJOG 2009 116 780 Google Scholar
Goldenberg, R L Tamura, T Neggers, Y The effect of zinc supplementation on pregnancy outcome. [see comment] JAMA 1995 274 463 Google Scholar
Werler, M M Louik, C Shapiro, S Mitchell, A A Prepregnant weight in relation to risk of neural tube defects JAMA 1996 275 1089 Google Scholar
Ray, J G Wyatt, P R Vermeulen, M J Meier, C Cole, D E Greater maternal weight and the ongoing risk of neural tube defects after folic acid flour fortification Obstet Gynecol 2005 105 261 Google Scholar
Watkins, M L Botto, L D Maternal prepregnancy weight and congenital heart defects in offspring Epidemiology 2001 12 439 Google Scholar
Velie, E M Block, G Shaw, G M Maternal supplemental and dietary zinc intake and the occurrence of neural tube defects in California Am J Epidemiol 1999 150 605 Google Scholar
Carmichael, S L Shaw, G M Selvin, S Schaffer, D M Diet quality and risk of neural tube defects Med Hypotheses 2003 60 351 Google Scholar
Bodnar, L M Tang, G Ness, R B Harger, G Roberts, J M Periconceptional multivitamin use reduces the risk of preeclampsia Am J Epidemiol 2006 164 470 Google Scholar
Catov, J M Nohr, E A Bodnar, L M Association of periconceptional multivitamin use with reduced risk of preeclampsia among normal-weight women in the Danish national birth cohort Am J Epidemiol 2009 169 1304 Google Scholar
Catov, J M Bodnar, L M Ness, R B Markovic, N Roberts, J M Association of periconceptional multivitamin use and risk of preterm or small-for-gestational-age births Am J Epidemiol 2007 166 296 Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×