Mother Infant Research Institute, Tufts Medical Center, Boston, MA, USA.
Mother Infant Research Institute, Tufts Medical Center, Boston, MA, USA.
Clin Ther. 2021 Feb;43(2):226-245. doi: 10.1016/j.clinthera.2020.11.017. Epub 2020 Dec 23.
Maternal nutrition is a key modifier of fetal growth and development. However, many maternal diets in the United States do not meet nutritional recommendations. Dietary supplementation is therefore necessary to meet nutritional goals. The effects of many supplements on placental development and function are poorly understood. In this review, we address the therapeutic potential of maternal dietary supplementation on placental development and function in both healthy and complicated pregnancies.
This is a narrative review of original research articles published between February 1970 and July 2020 on dietary supplements consumed during pregnancy and placental outcomes (including nutrient uptake, metabolism and delivery, as well as growth and efficiency). Impacts of placental changes on fetal outcomes were also reviewed. Both human and animal studies were included.
We found evidence of a potential therapeutic benefit of several supplements on maternal and fetal outcomes via their placental impacts. Our review supports a role for probiotics as a placental therapeutic, with effects that include improved inflammation and lipid metabolism, which may prevent preterm birth and poor placental efficiency. Supplementation with omega-3 fatty acids (as found in fish oil) during pregnancy tempers the negative effects of maternal obesity but may have little placental impact in healthy lean women. The beneficial effects of choline supplementation on maternal health and fetal growth are largely attributable to its placental impacts. l-arginine supplementation has a potent provascularization effect on the placenta, which may underlie its fetal growth-promoting properties.
The placenta is exquisitely sensitive to dietary supplements. Pregnant women should consult their health care practitioner before continuing or initiating use of a dietary supplement. Because little is known about impacts of many supplements on placental and long-term offspring health, more research is required before robust clinical recommendations can be made.
母体营养是胎儿生长和发育的关键调节剂。然而，美国许多孕妇饮食不符合营养建议。因此，需要膳食补充剂来达到营养目标。许多补充剂对胎盘发育和功能的影响知之甚少。在这篇综述中，我们探讨了母体饮食补充剂对健康和复杂妊娠中胎盘发育和功能的治疗潜力。
这是一篇对 1970 年 2 月至 2020 年 7 月间发表的关于妊娠期间食用的膳食补充剂和胎盘结果（包括营养摄取、代谢和输送，以及生长和效率）的原始研究文章的叙述性综述。还回顾了胎盘变化对胎儿结局的影响。纳入了人类和动物研究。
我们发现，通过对胎盘的影响，几种补充剂对母婴结局有潜在的治疗益处。我们的综述支持益生菌作为胎盘治疗剂的作用，其作用包括改善炎症和脂质代谢，从而预防早产和胎盘效率低下。在肥胖的孕妇中补充欧米伽-3 脂肪酸（存在于鱼油中）可以减轻母体肥胖的负面影响，但在健康的瘦女性中对胎盘的影响可能很小。胆碱补充对母体健康和胎儿生长的有益影响主要归因于其对胎盘的影响。精氨酸补充对胎盘有很强的促血管生成作用，这可能是其促进胎儿生长的特性的基础。
胎盘对膳食补充剂非常敏感。孕妇在继续或开始使用膳食补充剂之前应咨询他们的医疗保健从业者。由于对许多补充剂对胎盘和长期后代健康的影响知之甚少，因此在提出可靠的临床建议之前，还需要进行更多的研究。
