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Pregnancy as a Fundamental Determinant of Child Health: a Review

Abstract

Purpose of Review

Maternal conditions and exposures during pregnancy including over- and undernutrition are associated with poor childbirth outcomes, growth, development and chronic childhood diseases. We examined contemporary pregnancy-related determinants of child health.

Recent Findings

While maternal undernutrition remains a major contributor to low birth weight, maternal obesity affects foetal growth, birth weight, survival and is associated with childhood obesity, asthma and autistic spectrum disorders. Emerging evidence suggests that epigenetic changes, the prenatal microbiome and maternal immune activation (MIA), a neuroinflammatory process induced by diet and other exposures cause foetal programming resulting in these chronic childhood diseases.

Summary

Maternal diet is potentially a modifiable risk factor for controlling low birth weight, obesity and chronic disease in childhood. Further studies are warranted to refine guidance on dietary restriction and physical activity during pregnancy and determine how MIA and prenatal microbiota can be applied to control childhood diseases arising from programming.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. • Koletzko B, Godfrey KM, Poston L, Szajewska H, Van Goudoever JB, De Waard M, et al. Nutrition during pregnancy, lactation and early childhood and its implications for maternal and long-term child health: the early nutrition project recommendations. Ann Nutr Metab. 2019;74(2):93–106. https://doi.org/10.1159/000496471. This expert opinion based on systematic reviews examined the long-term health consequences of lifestyle, diet and growth in early life on later health, using it to update guidance on dietary practice in pregnancy.

  2. Bordeleau M, Fernández de Cossío L, Chakravarty MM, Tremblay M-È. From Maternal diet to neurodevelopmental disorders: a story of neuroinflammation. Front Cell Neurosci. 2021;14:612705. https://pubmed.ncbi.nlm.nih.gov/3353687. https://doi.org/10.3389/fncel.2020.612705.

  3. Myatt L, Powell T. Maternal adaptations to pregnancy and the role of the placenta. In: Symonds M, Ramsay M, editors. Maternal-fetal nutrition during pregnancy and lactation. Cambridge: Cambridge University Press; 2010.

    Google Scholar 

  4. Rao S, Yajnik C. Maternal diets in the developing world. In: Symonds M, Ramsay M, editors. Maternal-fetal nutrition during pregnancy and lactation. Cambridge: Cambridge University Press; 2010.

    Google Scholar 

  5. Johnson CD, Jones S, Paranjothy S. Reducing low birth weight: prioritizing action to address modifiable risk factors. J Public Health (Bangkok). 2017;39(1):122–31. https://doi.org/10.1093/pubmed/fdv212.

    Article  Google Scholar 

  6. World Health Organization. Born too soon global action rep preterm birth. 2012. https://apps.who.int/iris/bitstream/handle/10665/44864/9789241503433_eng.pdf;jsessionid=F3F5FBD905ADA9B4E7C71C6957F98E8F?sequence=1. Accessed 8 Mar 2021.

  7. Accrombessi M, Zeitlin J, Massougbodji A, Cot M, Briand V. What do we know about risk factors for fetal growth restriction in Africa at the time of sustainable development goals? A scoping review. Paediatr Perinat Epidemiol. 2018;32(2):184–96. https://doi.org/10.1111/ppe.12433.

    Article  PubMed  Google Scholar 

  8. Mousa A, Naqash A, Lim S. Macronutrient and micronutrient intake during pregnancy: an overview of recent evidence. Nutrients. 2019;11(2):443. https://doi.org/10.3390/nu11020443.

    CAS  Article  PubMed Central  Google Scholar 

  9. Jung J, Rahman MM, Rahman MS, Swe KT, Islam MR, Rahman MO, et al. Effects of hemoglobin levels during pregnancy on adverse maternal and infant outcomes: a systematic review and meta-analysis. Ann NY Acad Sci. 2019;1450(1):69–82. https://doi.org/10.1111/nyas.14112.

    Article  PubMed  Google Scholar 

  10. Christian P, Smith ER, Zaidi A. Addressing inequities in the global burden of maternal undernutrition: the role of targeting. BMJ Glob Heal. 2020;5(3): e002186. https://doi.org/10.1136/bmjgh-2019-002186.

    Article  Google Scholar 

  11. Langley ESC. Nutrition in early life and the programming of adult disease: a review. J Hum Nutr Diet. 2015;28:1–14. https://doi.org/10.1111/jhn.12212.

    Article  Google Scholar 

  12. Godfrey KM, Reynolds RM, Prescott SL, Nyirenda M, Jaddoe VWV, Eriksson JG, et al. Influence of maternal obesity on the long-term health of offspring. Lancet Diabetes Endocrinol. 2017;5(1):53–64. https://doi.org/10.1016/S2213-8587(16)30107-3.

    Article  PubMed  Google Scholar 

  13. Lassi ZS, Padhani ZA, Rabbani A, Rind F, Salam RA, Das JK, et al. Impact of dietary interventions during pregnancy on maternal, neonatal, and child outcomes in low-and middle-income countries. Nutrients. 2020;12(2):531. https://doi.org/10.3390/nu12020531.

    CAS  Article  PubMed Central  Google Scholar 

  14. Huang L-T. Maternal and early-life nutrition and health. Int J Environ Res Public Health. 2020;17:7982. https://doi.org/10.3390/ijerph17217982.

    Article  PubMed Central  Google Scholar 

  15. Chu SY, Kim SY, Lau J, Schmid CH, Dietz PM, Callaghan WM, et al. Maternal obesity and risk of stillbirth: a metaanalysis. Am J Obstet Gynecol. 2007;197(3):223–8. https://doi.org/10.1016/j.ajog.2007.03.027.

    Article  PubMed  Google Scholar 

  16. Katz J, Lee ACC, Kozuki N, Lawn JE, Cousens S, Blencowe H, et al. Mortality risk in preterm and small-for-gestational-age infants in low-income and middle-income countries: a pooled country analysis. Lancet. 2013;382(9890):417–25. https://doi.org/10.1016/S0140-6736(13)60993-9.

    Article  PubMed  PubMed Central  Google Scholar 

  17. WHO. Global nutrition targets 2025: policy brief series (WHO/NMH/NHD/14.2). Geneva: World Health Organization; 2014. https://apps.who.int/iris/bitstream/handle/10665/149018/WHO_NMH_NHD_14.2_eng.pdf. Accessed 31 Mar 2021.

  18. Tamburini S, Shen N, Wu HC, Clemente JC. The microbiome in early life: implications for health outcomes. Nat Med. 2016;22(7):713–22. https://doi.org/10.1038/nm.4142.

    CAS  Article  PubMed  Google Scholar 

  19. Stiemsma LT, Michels KB. The role of the microbiome in the developmental origins of health and disease. Pediatrics. 2018;141(4). https://doi.org/10.1542/peds.2017-2437.

  20. Nyangahu D, Jaspan HB. Influence of maternal microbiota during pregnancy on infant immunity. Clin Exp Immunol. 2019;198(1):47–56. https://doi.org/10.1111/cei.13331.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  21. Farpour-Lambert NJ, Ells LJ, de Tejada BM, Scott C. Obesity and weight gain in pregnancy and postpartum: an evidence review of lifestyle interventions to inform maternal and child health policies. Front Endocrinol. 2018;9:546. https://doi.org/10.3389/fendo.2018.00546.

    Article  Google Scholar 

  22. Li M, Fallin MD, Riley A, Landa R, Walker SO, Silverstein M, et al. The association of maternal obesity and diabetes with autism and other developmental disabilities. Pediatrics. 2016;137(2). https://doi.org/10.1542/peds.2015-2206.

  23. Nehab SR, Villela LD, Soares FVM, Abranches AD, Araújo DMR, Da Silva LML, et al. Gestational weight gain and body composition of full-term newborns and infants: a cohort study. BMC Pregnancy Childbirth. 2020;20(1):1–8. https://doi.org/10.1186/s12884-020-03145-x.

    Article  Google Scholar 

  24. Mitanchez D, Chavatte-Palmer P. Review shows that maternal obesity induces serious adverse neonatal effects and is associated with childhood obesity in their offspring. Acta Paediatr Int J Paediatr. 2018;107(7):1156–65. https://doi.org/10.1111/apa.14269.

    Article  Google Scholar 

  25. Paknahad Z, Fallah A, Moravejolahkami AR. Maternal dietary patterns and their association with pregnancy outcomes. Clin Nutr Res. 2019;8(1):64. https://doi.org/10.7762/cnr.2019.8.1.64.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Bouvier D, Forest J-C, Dion-Buteau E, Bernard N, Bujold E, Pereira B, et al. Association of maternal weight and gestational weight gain with maternal and neonate outcomes: a prospective cohort study. J Clin Med. 2019;8(12):2074. https://doi.org/10.3390/jcm8122074.

    Article  PubMed Central  Google Scholar 

  27. Tanaka K, Matsushima M, Izawa T, Furukawa S, Kobayashi Y, Iwashita M. Influence of maternal obesity on fetal growth at different periods of pregnancies with normal glucose tolerance. J Obstet Gynaecol Res. 2018;44(4):691–6. https://doi.org/10.1111/jog.13575.

    CAS  Article  PubMed  Google Scholar 

  28. Li C, Zeng L, Wang D, Dang S, Chen T, Watson V, et al. Effect of maternal pre-pregnancy BMI and weekly gestational weight gain on the development of infants. Nutr J. 2019;18(1):1–12. https://doi.org/10.1186/s12937-019-0432-8.

    Article  Google Scholar 

  29. •• Heslehurst N, Vieira R, Akhter Z, Bailey H, Slack E, Ngongalah L, et al. The association between maternal body mass index and child obesity: a systematic review and meta-analysis. PLoS Med. 2019;16(6):1–20. https://doi.org/10.1371/journal.pmed.1002817. This systematic review and meta-analysis studied the effect of maternal pre-pregnancy obesity on offspring’s weight. Findings highlight a need for weight management pre-conception to control intergenerational obesity.

  30. Flynn AC, Begum S, White SL, Dalrymple K, Gill C, Alwan NA, et al. Relationships between maternal obesity and maternal and neonatal iron status. Nutrients. 2018;10(8):1–10. https://doi.org/10.3390/nu10081000.

    CAS  Article  Google Scholar 

  31. Sanchez CE, Barry C, Sabhlok A, Russell K, Majors A, Kollins SH, et al. Maternal pre-pregnancy obesity and child neurodevelopmental outcomes: a meta-analysis. Obes Rev. 2018;19(4):464–84. https://doi.org/10.1111/obr.12643.

    CAS  Article  PubMed  Google Scholar 

  32. Gutvirtz G, Wainstock T, Landau D, Sheiner E. Maternal obesity and offspring long-term infectious morbidity. J Clin Med. 2019;8(9):1466. https://doi.org/10.3390/jcm8091466.

    Article  PubMed Central  Google Scholar 

  33. Liu S, Zhou B, Wang Y, Wang K, Zhang Z, Niu W. Pre-pregnancy maternal weight and gestational weight gain increase the risk for childhood asthma and wheeze: an updated meta-analysis. Front Pediatr. 2020;8:134. https://doi.org/10.3389/fped.2020.00134.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Mirzakhani H, Carey VJ, McElrath TF, Qiu W, Hollis BW, O’Connor GT, Zeiger RS, Bacharier L, Litonjua AA, Weiss ST. Impact of preeclampsia on the relationship between maternal asthma and offspring asthma An observation from the VDAART clinical trial. Am J Respir Crit Care Med. 2019;199(1):32–42. https://doi.org/10.1164/rccm.201804-0770OC.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  35. • Gambineri A, Conforti A, Di Nisio A, Laudisio D, Muscogiuri G, Barrea L, Savastano S, Colao A; Obesity Programs of nutrition, Education, Research and Assessment (OPERA) Group. Maternal obesity: focus on offspring cardiometabolic outcomes. Int J Obes Suppl. 2020;10(1):27–34. https://doi.org/10.1038/s41367-020-0016-2. This systematic review showed a strong link between maternal pre-pregnancy obesity as well as gestational weight gain and childhood obesity and cardiometabolic disease. It reveals new potential for control.

  36. Turner D, Monthé-Drèze C, Cherkerzian S, Gregory K, Sen S. Maternal obesity and cesarean section delivery: additional risk factors for neonatal hypoglycemia? J Perinatol. 2019;39(8):1057–64. https://doi.org/10.1038/s41372-019-0404-z.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Bish MR, Faulks F, Amir LH, Huxley RR, McIntyre HD, James R, Mnatzaganian G. Relationship between obesity and lower rates of breast feeding initiation in regional Victoria, Australia: an 8-year retrospective panel study. BMJ Open. 2021;11(2): e044884. https://doi.org/10.1136/bmjopen-2020-044884.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Heude B, Forhan A, Slama R, Douhaud L, Bedel S, Saurel-Cubizolles M-J, et al. Cohort profile: the EDEN mother-child cohort on the prenatal and early postnatal determinants of child health and development. Int J Epidemiol. 2016;45(2):353–63. https://doi.org/10.1093/ije/dyv151.

    Article  PubMed  Google Scholar 

  39. Hjort L, Martino D, Grunnet LG, Naeem H, Maksimovic J, Olsson AH, et al. Gestational diabetes and maternal obesity are associated with epigenome-wide methylation changes in children. JCI insight. 2018;3(17):1–14. https://doi.org/10.1172/jci.insight.122572.

    Article  Google Scholar 

  40. •• Peacock L, Seed PT, Dalrymple KV, White SL, Poston L, Flynn AC. The UK Pregnancies Better Eating and Activity Trial (UPBEAT); pregnancy outcomes and health behaviours by obesity class. Int J Environ Res Public Health. 2020;17(13):4712. https://doi.org/10.3390/ijerph17134712. Published 2020 Jun 30. This multicentre RCT on antenatal interventions and pregnancy outcomes in women with increasing obesity severity shows differences in outcomes among obesity subclasses and the need to refine current guidance.

  41. • Blencowe H, Krasevec J, de Onis M, Black RE, An X, Stevens GA, et al. National, regional, and worldwide estimates of low birthweight in 2015, with trends from 2000: a systematic analysis. Lancet Glob Heal. 2019;7(7):e849–60. https://doi.org/10.1016/S2214-109X(18)30565-5. This population-based data analysis to set a baseline for evaluating progress on the World Health Assembly targets for reducing LBW, depicts disparities in global distribution and a need to double progress.

  42. Demelash H, Motbainor A, Nigatu D, Gashaw K, Melese A. Risk factors for low birth weight in Bale zone hospitals, south-east Ethiopia: a case–control study. BMC Pregnancy Childbirth. 2015;15(1):1–10. https://doi.org/10.1186/s12884-015-0677-y.

    Article  Google Scholar 

  43. Bhaskar RK, Deo KK, Neupane U, Chaudhary Bhaskar S, Yadav BK, Pokharel HP, et al. A case control study on risk factors associated with low birth weight babies in eastern Nepal. Int J Pediatr. 2015;2015:807373. https://doi.org/10.1155/2015/807373.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Desta SA, Damte A, Hailu T. Maternal factors associated with low birth weight in public hospitals of Mekelle city, Ethiopia: a case-control study. Ital J Pediatr. 2020;46(1):1–9. https://doi.org/10.1186/s13052-020-00890-9.

    Article  Google Scholar 

  45. Kaur S, Ng CM, Badon SE, Jalil RA, Maykanathan D, Yim HS, et al. Risk factors for low birth weight among rural and urban Malaysian women. BMC Public Health. 2019;19(4):539. https://doi.org/10.1186/s12889-019-6864-4.

    Article  PubMed  PubMed Central  Google Scholar 

  46. • Alemu B, Gashu D. Association of maternal anthropometry, hemoglobin and serum zinc concentration during pregnancy with birth weight. Early Hum Dev. 2020;142:104949. https://doi.org/10.1016/j.earlhumdev.2019.104949. A cross-sectional study on maternal variables and birth weight showing greater odds of LBW in women with MUAC < 23 cm in the 1st trimester, and those not taking iron-folic acid supplement in the 2nd trimester.

  47. Quansah DY, Boateng D. Maternal dietary diversity and pattern during pregnancy is associated with low infant birth weight in the Cape Coast metropolitan hospital, Ghana: a hospital based cross-sectional study. Heliyon. 2020;6(5): e03923. https://doi.org/10.1016/j.heliyon.2020.e03923.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Ahmed S, Hassen K, Wakayo T. A health facility based case-control study on determinants of low birth weight in Dassie town, northeast Ethiopia: the role of nutritional factors. Nutr J. 2018;17(1):1–10. https://doi.org/10.1186/s12937-018-0409-z.

    CAS  Article  Google Scholar 

  49. Ancira-Moreno M, Vadillo-Ortega F, Rivera-Dommarco JÁ, Sánchez BN, Pasteris J, Batis C, et al. Gestational weight gain trajectories over pregnancy and their association with maternal diet quality: results from the PRINCESA cohort. Nutrition. 2019;65:158–66. https://doi.org/10.1016/j.nut.2019.02.002.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Moghimi M, Ashrafzadeh S, Rassi S, Naseh A. Maternal zinc deficiency and congenital anomalies in newborns. Pediatr Int. 2017;59(4):443–6. https://doi.org/10.1111/ped.13176.

    Article  PubMed  Google Scholar 

  51. Okala SG, Sise EA, Sosseh F, Prentice AM, Woollett LA, Moore SE. Maternal plasma lipid levels across pregnancy and the risks of small-for-gestational age and low birth weight: a cohort study from rural Gambia. BMC Pregnancy Childbirth. 2020;20(1):1–16. https://doi.org/10.1186/s12884-020-2834-1.

    CAS  Article  Google Scholar 

  52. Dahlui M, Azahar N, Oche OM, Aziz NA. Risk factors for low birth weight in Nigeria: evidence from the 2013 Nigeria Demographic and Health Survey. Glob Health Action. 2016;9(1):28822. https://doi.org/10.3402/gha.v9.28822.

    Article  PubMed  Google Scholar 

  53. Agbozo F, Abubakari A, Der J, Jahn A. Prevalence of low birth weight, macrosomia and stillbirth and their relationship to associated maternal risk factors in Hohoe Municipality, Ghana. Midwifery. 2016;40:200–6. https://doi.org/10.1016/j.midw.2016.06.016.

    Article  PubMed  Google Scholar 

  54. Kumari N, Algur K, Chokhandre PK, Salve PS. Low birth weight among tribal in India: evidence from National Family Health Survey-4. Clin Epidemiol Glob Heal. 2021;9:360–6. https://doi.org/10.1016/j.cegh.2020.10.010.

    CAS  Article  Google Scholar 

  55. Idris I, Sheryan M, Ghazali Q, Nawi A. Reproductive and behavioural risk factors of low birth weight among newborns in Al Thawra Hospital, Sana’a, Yemen. East Mediterr Heal J. 2020;26(11):1415–9. https://doi.org/10.26719/emhj.20.061.

    Article  Google Scholar 

  56. Shokri M, Karimi P, Zamanifar H, Kazemi F, Azami M, Badfar G. Epidemiology of low birth weight in Iran: a systematic review and meta-analysis. Heliyon. 2020;6(5): e03787. https://doi.org/10.1016/j.heliyon.2020.e03787.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Agorinya IA, Kanmiki EW, Nonterah EA, Tediosi F, Akazili J, Welaga P, et al. Socio-demographic determinants of low birth weight: evidence from the Kassena-Nankana districts of the upper east region of Ghana. PLoS ONE. 2018;13(11): e0206207. https://doi.org/10.1371/journal.pone.0206207.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  58. Beetham KS, Giles C, Noetel M, Clifton V, Jones JC, Naughton G. The effects of vigorous intensity exercise in the third trimester of pregnancy: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2019;19(1):1–18. https://doi.org/10.1186/s12884-019-2441-1.

    Article  Google Scholar 

  59. Buen M, Amaral E, Souza RT, Passini R Jr, Lajos GJ, Tedesco RP, Nomura ML, Dias TZ, Rehder PM, Sousa MH, Cecatti JG, Brazilian Multicentre Study on Preterm Birth Study Group†. Maternal work and spontaneous preterm birth: a multicenter observational study in Brazil. Sci Rep. 2020;10(1):9684. https://doi.org/10.1038/s41598-020-66231-2.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  60. Stylianou-Riga P, Kouis P, Kinni P, Rigas A, Papadouri T, Yiallouros PK, Theodorou M. Maternal socioeconomic factors and the risk of premature birth and low birth weight in Cyprus: a case-control study. Reprod Health. 2018;15(1):157. https://doi.org/10.1186/s12978-018-0603-7.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Xi C, Luo M, Wang T, Wang Y, Wang S, Guo L, et al. Association between maternal lifestyle factors and low birth weight in preterm and term births: a case-control study. Reprod Health. 2020;17(1):1–9. https://doi.org/10.1186/s12978-020-00932-9.

    Article  Google Scholar 

  62. Muchemi OM, Echoka E, Makokha A. Factors associated with low birth weight among neonates born at Olkalou District Hospital, central region, Kenya. Pan Afr Med J. 2015;20:108. https://doi.org/10.11604/pamj.2015.20.108.4831.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Bekkar B, Pacheco S, Basu R, DeNicola N. Association of air pollution and heat exposure with preterm birth, low birth weight, and stillbirth in the US: a systematic review. JAMA Netw open. 2020;3(6):e208243–e208243. https://doi.org/10.1001/jamanetworkopen.2020.8243.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Middleton P, Gomersall JC, Gould JF, Shepherd E, Olsen SF, Makrides M. Omega‐3 fatty acid addition during pregnancy. Cochrane Database Syst Rev. 2018;(11). https://doi.org/10.1002/14651858.CD003402.pub3.

  65. Pascal A, Naulaers G, Ortibus E, Oostra A, De Coen K, Michel S, et al. Neurodevelopmental outcomes of very preterm and very-low-birthweight infants in a population-based clinical cohort with a definite perinatal treatment policy. Eur J Paediatr Neurol. 2020;28:133–41. https://doi.org/10.1016/j.ejpn.2020.06.007.

    Article  PubMed  Google Scholar 

  66. Pascal A, Govaert P, Oostra A, Naulaers G, Ortibus E, Van den Broeck C. Neurodevelopmental outcome in very preterm and very-low-birthweight infants born over the past decade: a meta-analytic review. Dev Med Child Neurol. 2018;60(4):342–55. https://doi.org/10.1111/dmcn.13675.

    Article  PubMed  Google Scholar 

  67. Sacchi C, Marino C, Nosarti C, Vieno A, Visentin S, Simonelli A. Association of intrauterine growth restriction and small for gestational age status with childhood cognitive outcomes: a systematic review and meta-analysis. JAMA Pediatr. 2020;174(8):772–81. https://doi.org/10.1001/jamapediatrics.2020.1097.

    Article  PubMed  Google Scholar 

  68. Colombo J, Shaddy DJ, Gustafson K, Gajewski BJ, Thodosoff JM, Kerling E, et al. The Kansas University DHA Outcomes Study (KUDOS) clinical trial: long-term behavioral follow-up of the effects of prenatal DHA supplementation. Am J Clin Nutr. 2019;109(5):1380–92. https://doi.org/10.1093/ajcn/nqz018.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Khandelwal S, Kondal D, Chaudhry M, Patil K, Swamy MK, Metgud D, et al. Effect of maternal docosahexaenoic acid (DHA) supplementation on offspring neurodevelopment at 12 months in India: a randomized controlled trial. Nutrients. 2020;12(10):3041. https://doi.org/10.3390/nu12103041.

    CAS  Article  PubMed Central  Google Scholar 

  70. Conway MC, McSorley EM, Mulhern MS, Strain JJ, van Wijngaarden E, Yeates AJ. Influence of fatty acid desaturase (FADS) genotype on maternal and childpolyunsaturated fatty acids (PUFA) status and child health outcomes: a systematic review. Nutr Rev. 2020;78(8):627–46. https://doi.org/10.1093/nutrit/nuz086.

    Article  PubMed  PubMed Central  Google Scholar 

  71. •• Wiegersma AM, Dalman C, Lee BK, Karlsson H, Gardner RM. Association of prenatal maternal anemia with neurodevelopmental disorders. JAMA psychiatry. 2019;76(12):1294–304. https://doi.org/10.1001/jamapsychiatry.2019.2309. This prospective cohort study on maternal anemia found that offspring of mothers diagnosed with anemia within the first 30 weeks of pregnancy had more ASD, ADHD and ID, stressing importance of early diagnosis.

  72. • Han VX, Patel S, Jones HF, Nielsen TC, Mohammad SS, Hofer MJ, et al. Maternal acute and chronic inflammation in pregnancy is associated with common neurodevelopmental disorders: a systematic review. Transl Psychiatry. 2021;11(1):1–12. https://doi.org/10.1038/s41398-021-01198-wThis systematic review is among the few human studies supporting the MIA hypothesis that maternal factors that contribute to systemic chronic inflammatory states are associated with neurodevelopmental disorders.

  73. Sordillo JE, Korrick S, Laranjo N, Carey V, Weinstock GM, Gold DR, et al. Association of the infant gut microbiome with early childhood neurodevelopmental outcomes: an ancillary study to the VDAART randomized clinical trial. JAMA Netw open. 2019;2(3):e190905–e190905. https://doi.org/10.1001/jamanetworkopen.2019.0905.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Rothenberg SE, Chen Q, Shen J, Nong Y, Nong H, Trinh EP, et al. Neurodevelopment correlates with gut microbiota in a cross-sectional analysis of children at 3 years of age in rural China. Sci Rep. 2021;11(1):1–11. https://doi.org/10.1038/s41598-021-86761-7.

    CAS  Article  Google Scholar 

  75. Taylor RM, Fealy SM, Bisquera A, Smith R, Collins CE, Evans T-J, et al. Effects of nutritional interventions during pregnancy on infant and child cognitive outcomes: a systematic review and meta-analysis. Nutrients. 2017;9(11):1265. https://doi.org/10.3390/nu9111265.

    CAS  Article  PubMed Central  Google Scholar 

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Correspondence to Edem Magdalene Afua Tette.

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Edem M. A. Tette, Freda D. Intiful, Anita A. Asare and Juliana Y. Enos declare no conflict of interest.

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Tette, E.M.A., Intiful, F.D., Asare, A.A. et al. Pregnancy as a Fundamental Determinant of Child Health: a Review. Curr Nutr Rep 11, 457–485 (2022). https://doi.org/10.1007/s13668-022-00416-1

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Keywords

  • Pregnancy
  • Child health
  • Maternal nutrition
  • Low birth weight
  • Maternal immune activation
  • Prenatal microbiome