Keen Carl L, Clegg Michael S, Hanna Lynn A, Lanoue Louise, Rogers John M, Daston George P, Oteiza Patricia, Uriu-Adams Janet Y
Department of Nutrition and Internal Medicine, University of California, Davis, CA 95616, USA.
J Nutr. 2003 May;133(5 Suppl 2):1597S-1605S. doi: 10.1093/jn/133.5.1597S.
Numerous studies support the concept that a major cause of pregnancy complications can be suboptimal embryonic and fetal nutrition. Although the negative effects of diets low in energy on pregnancy outcome are well documented, less clear are the effects of diets that are low in one or more essential micronutrients. However, several observational and intervention studies suggest that diets low in essential vitamins and minerals can pose a significant reproductive risk in diverse human populations. Although maternal nutritional deficiencies typically occur as a result of low dietary intakes of essential nutrients, nutritional deficiencies at the level of the conceptus can arise through multiple mechanisms. Evidence from experimental animals supports the concept that in addition to primary deficiencies, secondary embryonic and fetal nutritional deficiencies can be caused by diverse factors including genetics, maternal disease, toxicant insults and physiological stressors that can trigger a maternal acute phase response. These secondary responses may be significant contributors to the occurrence of birth defects. An implication of the above is that the frequency and severity of pregnancy complications may be reduced through an improvement in the micronutrient status of the mother.
众多研究支持这样一种观点，即妊娠并发症的一个主要原因可能是胚胎和胎儿营养欠佳。尽管能量摄入低的饮食对妊娠结局的负面影响已有充分记录，但一种或多种必需微量营养素含量低的饮食所产生的影响尚不清楚。然而，多项观察性研究和干预性研究表明，必需维生素和矿物质含量低的饮食会在不同人群中带来重大的生殖风险。虽然母体营养缺乏通常是由于必需营养素的膳食摄入量低所致，但在孕体层面的营养缺乏可通过多种机制产生。实验动物的证据支持这样一种观点，即除了原发性缺乏外，继发性胚胎和胎儿营养缺乏可由多种因素引起，包括遗传、母体疾病、毒物损伤和可引发母体急性期反应的生理应激源。这些继发性反应可能是出生缺陷发生的重要因素。上述情况的一个启示是，通过改善母亲的微量营养素状况，妊娠并发症的发生率和严重程度可能会降低。
