Li Ying, Freedman Robert
Department of Psychiatry Beijing Children's Hospital Capital Medical University National Center for Children's Health Beijing China.
Department of Psychiatry University of Colorado School of Medicine Aurora CO USA.
Pediatr Investig. 2020 Jun 24;4(2):118-126. doi: 10.1002/ped4.12199. eCollection 2020 Jun.
Prenatal micronutrients in pregnant women's diets, including supplements, have an essential role in fetal brain development and may reduce the risk of mental disorders in offspring. Folic acid, vitamin D, omega-3 fatty acids, and choline have been investigated for this purpose. Folic acid supplementation throughout pregnancy has well-established positive effects. Vitamin D, administered to the mother before birth or to the newborn, has also been shown to reduce the risk of neurodevelopmental disorders. Omega-3 fatty acids during pregnancy have a more uncertain role, with recent trials questioning a beneficial effect on cognition and attention deficit disorder, despite positive effects on prematurity and neonatal wheezing prevention. Choline supplementation is associated with positive effects on cognition and behavior, including early behaviors associated with the development of autism and schizophrenia. There is no experience yet with COVID-19, but adverse effects on fetal brain development of most common coronaviruses are mitigated by higher choline levels. Maternal dietary supplementation of nutrients is a benign and inexpensive intervention in pregnancy to prevent life-long disability from mental illness. Use of dietary supplements in poorer, rural areas of China is below recommendations. Physicians, midwives, and public health officials in China can promote prenatal nutrient supplementation to reduce the future burden of mental illnesses that might be prevented before birth.
孕妇饮食中的产前微量营养素，包括补充剂，在胎儿大脑发育中起着至关重要的作用，可能会降低后代患精神障碍的风险。为此，人们对叶酸、维生素D、ω-3脂肪酸和胆碱进行了研究。整个孕期补充叶酸有公认的积极效果。在出生前给母亲或新生儿补充维生素D，也已证明可降低神经发育障碍的风险。孕期补充ω-3脂肪酸的作用则更不确定，尽管其对预防早产和新生儿喘息有积极作用，但最近的试验对其对认知和注意力缺陷障碍的有益效果提出了质疑。补充胆碱对认知和行为有积极影响，包括与自闭症和精神分裂症发展相关的早期行为。目前尚无关于新冠病毒的经验，但较高的胆碱水平可减轻大多数常见冠状病毒对胎儿大脑发育的不利影响。孕期补充营养物质对孕妇来说是一种良性且低成本的干预措施，可预防因精神疾病导致的终身残疾。在中国较贫困的农村地区，膳食补充剂的使用低于推荐水平。中国的医生、助产士和公共卫生官员可以推广产前营养补充，以减轻未来可能在出生前预防的精神疾病负担。
