Salam Rehana A, Das Jai K, Bhutta Zulfiqar A
Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan.
Ann Nutr Metab. 2014;65(1):4-12. doi: 10.1159/000365792. Epub 2014 Sep 6.
Malnutrition, including micronutrient deficiencies, remains one of the major public health challenges, particularly in low-to-middle-income countries. Micronutrient deficiencies affect people of all ages, but its effects appear more devastating in pregnant women and children. Poor maternal nutrition contributes to at least 20% of maternal deaths and increases the probability of poor pregnancy outcomes including intrauterine growth restriction, resulting in low birth weight, stunting, wasting and mortality. Key Messages: Several strategies have been employed to provide pregnant women with micronutrients. These strategies include education, dietary modification, food provision, agricultural interventions, supplementation and fortification either alone or in combination. Micronutrient supplementation is the most widely practiced intervention to prevent and manage single or multiple micronutrient deficiencies. Micronutrient supplementation either alone or in combination has shown to be effective in improving maternal, birth and child outcomes.
There is a need to focus on maternal micronutrient status as a continuum from the periconceptional period throughout pregnancy to lactation. Given the wide prevalence of multiple micronutrient deficiencies in low-to-middle-income countries, the challenge is to implement intervention strategies that combine appropriate maternal and child health interventions with micronutrient interventions.
营养不良，包括微量营养素缺乏，仍然是主要的公共卫生挑战之一，尤其是在中低收入国家。微量营养素缺乏影响所有年龄段的人群，但其影响在孕妇和儿童中似乎更为严重。孕产妇营养状况不佳导致至少20%的孕产妇死亡，并增加了包括宫内生长受限在内的不良妊娠结局的可能性，从而导致低出生体重、发育迟缓、消瘦和死亡。关键信息：已采用多种策略为孕妇提供微量营养素。这些策略包括教育、饮食调整、食物供应、农业干预、单独或联合补充和强化。微量营养素补充是预防和管理单一或多种微量营养素缺乏最广泛采用的干预措施。单独或联合补充微量营养素已被证明在改善孕产妇、出生和儿童结局方面有效。
有必要将孕产妇微量营养素状况作为一个连续体来关注，从受孕前期贯穿整个孕期直至哺乳期。鉴于中低收入国家多种微量营养素缺乏普遍存在，挑战在于实施将适当的孕产妇和儿童健康干预措施与微量营养素干预措施相结合的干预策略。
