RATIONAL NUTRITION OF WOMEN DURING PHYSIOLOGICAL PREGNANCY

Анотація

Nutrition during pregnancy is one of the key modifiable factors determining the course of gestation and perinatal outcomes. The aim of this study was to summarize current scientific evidence on the characteristics of nutritional support in physiological pregnancy and to assess the role of macro- and micronutrients in shaping maternal and fetal health. The paper analyzes findings from recent systematic reviews, meta-analyses, and cohort studies, which confirm the significant impact of both the quantitative and qualitative composition of the diet on intrauterine development. It has been demonstrated that low dietary diversity and a high inflammatory potential of the maternal diet are associated with an increased risk of low birth weight and intrauterine growth restriction. The crucial role of macronutrients has been established: adequate protein intake is essential for fetal tissue growth, the quality of dietary fats influences the development of the nervous system, and carbohydrates ensure stable energy balance. Particular attention is given to micronutrients, including folates, iron, iodine, vitamin D, and choline, which are involved in organogenesis, neurodevelopment, and metabolic programming. It is substantiated that nutrient deficiencies or imbalances during pregnancy may lead to obstetric complications and adversely affect long-term child health outcomes. At the same time, rational, balanced, and diverse nutrition is considered an effective tool for the prevention of intrauterine developmental disorders. The need for an individualized approach to nutritional support for pregnant women is emphasized, taking into account metabolic demands, regional characteristics, and lifestyle factors. Thus, optimization of nutrition during pregnancy is an essential component of modern prenatal care and is aimed at improving both short-term and long-term health outcomes for the mother and child.

References

1.     Tareke, A. A., Melak, E. G., Mengistu, B. K., Hussen, J., & Molla, A. (2024). Association between maternal dietary diversity during pregnancy and birth outcomes: evidence from a systematic review and meta-analysis. BMC nutrition, 10(1), 151. https://doi.org/10.1186/s40795-024-00960-9

2.     Chen, L. W., Aubert, A. M., Shivappa, N., Bernard, J. Y., Mensink-Bout, S. M., Geraghty, A. A., … Phillips, C. M. (2021). Associations of maternal dietary inflammatory potential and quality with offspring birth outcomes: An individual participant data pooled analysis of 7 European cohorts in the ALPHABET consortium. PLoS medicine, 18(1), e1003491. https://doi.org/10.1371/journal.pmed.1003491

3.     Souza, M. D. D. C., Ferreira, L. B., & Dos Santos, L. C. (2023). Dietary Inflammatory Index during pregnancy is associated with birth weight and child anthropometry up to 10 years old: A systematic review and meta-analysis. Nutrition research (New York, N.Y.), 114, 81–97.

4.     Zhang, B., Xu, K., Mi, B., Liu, H., Wang, Y., Huo, Y., Ma, L., Liu, D., Jing, H., Liu, J., Cao, S., Dang, S., & Yan, H. (2023). Maternal Dietary Inflammatory Potential and Offspring Birth Outcomes in a Chinese Population. The Journal of nutrition, 153(5), 1512–1523. https://doi.org/10.1016/j.tjnut.2023.03.006

5.     Gete, D. G., Waller, M., & Mishra, G. D. (2020). Effects of maternal diets on preterm birth and low birth weight: a systematic review. The British journal of nutrition, 123(4), 446–461. https://doi.org/10.1017/S0007114519002897

6.     Tareke, A. A., Melak, E. G., Mengistu, B. K., Hussen, J., & Molla, A. (2024). Association between maternal dietary diversity during pregnancy and birth outcomes: evidence from a systematic review and meta-analysis. BMC nutrition, 10(1), 151. https://doi.org/10.1186/s40795-024-00960-9

7.     Salatas, C., Bronnert, A., Lawrence, R., Alexander, T., Wall, C., Bloomfield, F. H., & Lin, L. (2025). Dietary Patterns and Diet Quality before and/or during Pregnancy and How These Affect Birth Outcomes: A Systematic Review and Meta-analysis. Advances in nutrition (Bethesda, Md.), 16(10), 100490.

8.     Xue, L., Chen, X., Sun, J., Fan, M., Qian, H., Li, Y., & Wang, L. (2024). Maternal Dietary Carbohydrate and Pregnancy Outcomes: Quality over Quantity. Nutrients, 16(14), 2269. https://doi.org/10.3390/nu16142269

9.     Most, J., Dervis, S., Haman, F., Adamo, K. B., & Redman, L. M. (2019). Energy Intake Requirements in Pregnancy. Nutrients, 11(8), 1812. https://doi.org/10.3390/nu11081812

10. Perumal, N., & Gernand, A. D. (2025). Nutrition during Pregnancy and Birth Outcomes. Annals of nutrition & metabolism, 81(Suppl. 3), 19–32. https://doi.org/10.1159/000541205

11. Surita, F. G. C., Souza, R. T., Carrilho, T. R. B., Hsu, L. P. R., Mattar, R., & Kac, G. (2023). Guidelines on how to monitor gestational weight gain during antenatal care. Revista brasileira de ginecologia e obstetricia: revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia, 45(2), 104–108.

12. Murphy, M. M., Higgins, K. A., Bi, X., & Barraj, L. M. (2021). Adequacy and Sources of Protein Intake among Pregnant Women in the United States, NHANES 2003-2012. Nutrients, 13(3), 795. https://doi.org/10.3390/nu13030795

13. Zhang, H., Senior, A. M., Saner, C., Koemel, N. A., Simpson, S. J., Raubenheimer, D., & Heitmann, B. L. (2025). Maternal protein intake during pregnancy and obesity risk in mothers and offspring: a prospective cohort study. The American journal of clinical nutrition, 121(6), 1415–1423. https://doi.org/10.1016/j.ajcnut.2025.04.011

14. Yang, J., Chang, Q., Tian, X., Zhang, B., Zeng, L., Yan, H., Dang, S., & Li, Y. H. (2022). Dietary protein intake during pregnancy and birth weight among Chinese pregnant women with low intake of protein. Nutrition & metabolism, 19(1), 43.

15. Sirico, A., Vastarella, M. G., Ruggiero, E., & Cobellis, L. (2025). Systematic Review of Nutritional Guidelines for the Management of Gestational Diabetes Mellitus: A Global Comparison. Nutrients, 17(14), 2356.

16. Herrera, E., & Ortega-Senovilla, H. (2023). Dietary Implications of Polyunsaturated Fatty Acids during Pregnancy and in Neonates. Life, 13(8), 1656.

17. Patro-Golab, B., Zalewski, B. M., Kammermeier, M., Schwingshackl, L., Koletzko, B., & International Union of Nutritional Sciences (IUNS) Task Force on Dietary Fat Quality (2023). Fat Intake and Fat Quality in Pregnant and Lactating Women, Infants, Children, and Adolescents and Related Health Outcomes: A Scoping Review of Systematic Reviews of Prospective Studies. Annals of nutrition & metabolism, 79(5), 413–422. https://doi.org/10.1159/000533757

18. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Food and Nutrition Board, & Harrison, M. (Eds.). (2020). Nutrition During Pregnancy and Lactation: Exploring New Evidence: Proceedings of a Workshop. National Academies Press (US). https://doi.org/10.17226/25841

19. Xue, L., Chen, X., Sun, J., Fan, M., Qian, H., Li, Y., & Wang, L. (2024). Maternal Dietary Carbohydrate and Pregnancy Outcomes: Quality over Quantity. Nutrients, 16(14), 2269. https://doi.org/10.3390/nu16142269

20. Hosseinpour-Niazi, S., Bakhshi, B., Mirmiran, P., Gaeini, Z., Hadaegh, F., & Azizi, F. (2023). Effect of weight change on the association between overall and source of carbohydrate intake and risk of metabolic syndrome: Tehran lipid and glucose study. Nutrition & metabolism, 20(1), 39.

21. Zhang, D. Y., Cheng, D. C., Cao, Y. N., Su, Y., Chen, L., Liu, W. Y., Yu, Y. X., & Xu, X. M. (2022). The effect of dietary fiber supplement on prevention of gestational diabetes mellitus in women with pre-pregnancy overweight/obesity: A randomized controlled trial. Frontiers in pharmacology, 13, 922015. 5

22. Pretorius, R. A., & Palmer, D. J. (2020). High-Fiber Diet during Pregnancy Characterized by More Fruit and Vegetable Consumption. Nutrients, 13(1), 35.

23. Moges, N., Sisay Chanie, E., Anteneh, R. M., Zemene, M. A., Gebeyehu, A. A., Belete, M. A., Kebede, N., … Tsega, S. S. (2024). The effect of folic acid intake on congenital anomalies. A systematic review and meta-analysis. Frontiers in pediatrics, 12, 1386846. https://doi.org/10.3389/fped.2024.1386846

24. Bjørke-Monsen, A. L., & Ueland, P. M. (2023). Folate - a scoping review for Nordic Nutrition Recommendations 2023. Food & nutrition research, 67, 10.29219/fnr.v67.10258. https://doi.org/10.29219/fnr.v67.10258

25. Hansen, R., Sejer, E. P. F., Holm, C., & Schroll, J. B. (2023). Iron supplements in pregnant women with normal iron status: A systematic review and meta-analysis. Acta obstetricia et gynecologica Scandinavica, 102(9), 1147–1158. https://doi.org/10.1111/aogs.14607

26. Ubom, A. E., Begum, F., Ramasauskaite, D., Nieto-Calvache, A. J., Oguttu, M., Nunes, I., Malel, Z. J., Beyeza-Kashesya, J., Wright, A., & FIGO Committee on Childbirth and Postpartum Hemorrhage (2025). FIGO good practice recommendations on anemia in pregnancy, to reduce the incidence and impact of postpartum hemorrhage (PPH). International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 171(3), 993–1007. https://doi.org/10.1002/ijgo.70529

27. Obianeli, C., Afifi, K., Stanworth, S., & Churchill, D. (2024). Iron Deficiency Anaemia in Pregnancy: A Narrative Review from a Clinical Perspective. Diagnostics (Basel, Switzerland), 14(20), 2306.

28. Cancado, R. D., Leite, L. A. C., & Muñoz, M. (2025). Defining Global Thresholds for Serum Ferritin: A Challenging Mission in Establishing the Iron Deficiency Diagnosis in This Era of Striving for Health Equity. Diagnostics, 15(3), 289. https://doi.org/10.3390/diagnostics15030289

29. Moreno-Reyes, R., Fuentes Peña, C., Nuñez, J. F., Sánchez, M. B., Carvajal, J. J., Roble, K., Mendoza-León, M. J., Rangel-Ramírez, M. A., & Jara, E. L. (2025). Critical Role of Iodine and Thyroid Hormones During Pregnancy. International Journal of Molecular Sciences, 26(21), 10247.

30. Croce, L., Chiovato, L., Tonacchera, M., Petrosino, E., Tanda, M. L., Moleti, M., Magri, F., Olivieri, A., Pearce, E. N., & Rotondi, M. (2023). Iodine status and supplementation in pregnancy: an overview of the evidence provided by meta-analyses. Reviews in endocrine & metabolic disorders, 24(2), 241–250.

31. Candido, A. C., Azevedo, F. M., Silva, D. L. F., Ribeiro, S. A. V., & Castro Franceschini, S. D. C. (2023). Effects of iodine supplementation on thyroid function parameter: Systematic review and meta-analysis. Journal of trace elements in medicine and biology: organ of the Society for Minerals and Trace Elements (GMS), 80, 127275. https://doi.org/10.1016/j.jtemb.2023.127275

32. World Health Organization (2020). WHO antenatal care recommendations for a positive pregnancy experience: nutritional interventions update: vitamin D supplements during pregnancy. https://www.ncbi.nlm.nih.gov/books/NBK560395/

33. Luo, T., Lin, Y., Lu, J., Lian, X., Guo, Y., Han, L., & Guo, Y. (2022). Effects of vitamin D supplementation during pregnancy on bone health and offspring growth: A systematic review and meta-analysis of randomized controlled trials. PloS one, 17(10), e0276016. https://doi.org/10.1371/journal.pone.0276016

34. Maugeri, A., Barchitta, M., Blanco, I., & Agodi, A. (2019). Effects of Vitamin D Supplementation During Pregnancy on Birth Size: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients, 11(2), 442.

35. Moghib, K., Ghanm, T. I., Abunamoos, A., Rajabi, M., Moawad, S. M., Mohsen, A., Kasem, S., Elsayed, K., Sayed, M., Dawoud, A. I., Salomon, I., Elmaghreby, A., Ismail, M., & Amer, A. (2024). Efficacy of vitamin D supplementation on the incidence of preeclampsia: a systematic review and meta-analysis. BMC pregnancy and childbirth, 24(1), 852. https://doi.org/10.1186/s12884-024-07081-y

36. Yang, W. C., Chitale, R., O'Callaghan, K. M., Sudfeld, C. R., & Smith, E. R. (2025). The Effects of Vitamin D Supplementation During Pregnancy on Maternal, Neonatal, and Infant Health: A Systematic Review and Meta-analysis. Nutrition reviews, 83(3), e892–e903. https://doi.org/10.1093/nutrit/nuae065

37. Obeid, R., Derbyshire, E., & Schön, C. (2022). Association between Maternal Choline, Fetal Brain Development, and Child Neurocognition: Systematic Review and Meta-Analysis of Human Studies. Advances in nutrition (Bethesda, Md.), 13(6), 2445–2457. https://doi.org/10.1093/advances/nmac082

38. Zuk, E., Nikrandt, G., & Chmurzynska, A. (2024). Dietary choline intake in European and non-european populations: current status and future trends-a narrative review. Nutrition journal, 23(1), 68. https://doi.org/10.1186/s12937-024-00970-0

39. Jaiswal, A., Dewani, D., Reddy, L. S., & Patel, A. (2023). Choline Supplementation in Pregnancy: Current Evidence and Implications. Cureus, 15(11), e48538. https://doi.org/10.7759/cureus.48538

40. Korsmo, H. W., Jiang, X., & Caudill, M. A. (2019). Choline: Exploring the Growing Science on Its Benefits for Moms and Babies. Nutrients, 11(8), 1823.