Prenatal Nutritional Factors and Neurodevelopmental Disorders: A Narrative Review
Abstract
:1. Introduction
2. Preventive Nutrition
3. Neurodevelopmental Disorders
- Intellectual disability (intellectual development disorder);
- Communication disorders;
- Autism spectrum disorder;
- Attention deficit/hyperactivity disorder;
- Specific learning disorder;
- Movement disorders;
- Other neurodevelopmental disorders.
4. Etiology and Risk Factors
- Complications of pregnancy and childbirth;
- Prematurity;
- Low birth weight;
- Exposure to alcohol, drugs, or other toxic substances during pregnancy;
- Low socio-economic level of parents;
- Situation of early emotional deficiency;
- High parental age (>35 years).
4.1. Genetic and Epigenetic Factors
- DNA methylation.
- miRNAs or microRNAs, small sequences of 20–25 RNA nucleotides, organized as a single strand, not coding for any protein but having the function of regulating the translation of target genes through downregulation mechanisms. They induce gene silencing through binding to complementary sequences on target mRNA molecules, resulting in repression of translation or degradation of the target molecule.
4.2. Environmental Factors
- Heavy metals can alter many body functions, causing neurological and behavioral damage, which we will analyze later. A meta-analysis found a 60% increased risk of ASD due to exposure to high levels of inorganic mercury [40].
- Organophosphates are associated with a 60% increased risk of developing ASD [41]. This category includes non-persistent organic pollutants (phthalates and bisphenol A) and persistent organic pollutants (DDT, PCBs, and PBDEs). Exposure to these substances seems to alter calcium-related signaling pathways, leading to alterations in dendritic growth and anomalies in neuronal connectivity, both typical of ASD.
- Epigenetic/genetic mechanisms (discussed previously).
- Immune dysregulation and neuroinflammation—in fact, the interaction between the immune system and nerve cells is essential for neurodevelopment. For example, IL-6 and INF-γ regulate dendritic growth and synaptogenesis through signal transduction mechanisms and the MAPK pathway.
- Oxidative stress and mitochondrial dysfunction through an imbalance between free radicals and antioxidants leading to the alteration of ATP levels in nervous cells.
- Endocrine alterations, such as hormonal imbalances.
- Alterations of neurotransmitters (such as serotonin, glutamate, and GABA) and cell signaling pathways.
5. Prenatal Nutritional Factors
- The maternal diet before pregnancy allows to optimize nutritional status in order to maintain a healthy pregnancy and support fetal development [48].
- Maternal nutrition during the conception period is important for gametes’ function and health and for placental development [49]. For example, the first 2–3 weeks from conception represent a period of rapid development in which the embryo undergoes multiple processes (neuronal migration, synaptic formation, apoptosis) for fetal brain development, constituting a highly sensitive period to possible environmental disturbances that could predispose the fetus to develop neurodevelopmental disorders in the postnatal period.
- Behavioral and psychiatric disorders (ASD, ADHD, anxiety, depression, schizophrenia);
- Cognitive alterations (intellectual disability, language disorders, learning, and memory disorders);
- Neural tube defects;
- Visual alterations;
- Motor deficits;
- Neural molecular dysfunctions (synaptic alterations, neurotransmitters’ metabolism, myelination, cell differentiation, axonal growth, dendritic arborization, anti-inflammatory regulation, oxidative stress, death neuronal, vascular function, synaptic plasticity, neurogenesis, astrocytic alterations);
- Structural changes (reduction of brain volume, spina bifida, hydrocephalus, alteration of the hypothalamic and hippocampal pathways).
- Vitamins and minerals, such as vitamins B12, A, E, D, K, folic acid, iron, copper, creatine, choline, zinc, and iodine;
- Macronutrients such as polyunsaturated fatty acids (PUFAs) and proteins;
- General maternal nutritional status, such as obesity, overnutrition (high fat–HFD—and hypercaloric diets), and undernutrition;
- Other nutrients, such as gangliosides and caffeine.
5.1. Dietary Habits
5.1.1. Undernutrition
5.1.2. Overnutrition
5.2. Nutrients
5.2.1. Fatty Acids
5.2.2. Proteins
5.2.3. Folates
5.2.4. Iron
5.2.5. Iodine
5.2.6. Copper
5.2.7. Creatine
5.2.8. Choline
5.2.9. Zinc
5.2.10. Vitamin B12
5.2.11. Vitamin B6
5.2.12. Vitamin D
5.2.13. Vitamin A
5.2.14. Vitamin E and K
5.2.15. Gangliosides
5.2.16. Caffeine
5.3. Heavy Metals
5.3.1. Lead
5.3.2. Mercury
5.3.3. Cadmium
5.3.4. Manganese
5.3.5. Nickel
5.3.6. Arsenic
6. Postnatal Nutritional Factors
7. Conclusions
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- An increased protein requirement (different in the three trimesters of pregnancy);
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- A carbohydrate intake of at least 175 g/day, reducing monosaccharides and disaccharides (<10% of total carbohydrate);
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- An increased DHA requirement of 100–200 mg/day;
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- Supplementation of folic acid (400 g/day) from 30 days before conception;
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- Iodine requirement of 200–250 g/die.
Author Contributions
Funding
Conflicts of Interest
References
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Nutrients | Alterations | Functions |
---|---|---|
PUFAs |
|
|
Proteins |
|
|
Folate |
|
|
Iron |
|
|
Iodine |
|
|
Zinc |
|
|
Vitamin D |
|
|
Vitamin B12 |
|
|
Vitamin B6 |
|
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Choline |
|
|
Heavy Metals | Alterations | Pathogenetic Mechanisms |
---|---|---|
Lead |
|
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Mercury |
|
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Cadmium |
|
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Manganese |
|
|
Nichel |
|
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Arsenic |
|
|
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Cernigliaro, F.; Santangelo, A.; Nardello, R.; Lo Cascio, S.; D’Agostino, S.; Correnti, E.; Marchese, F.; Pitino, R.; Valdese, S.; Rizzo, C.; et al. Prenatal Nutritional Factors and Neurodevelopmental Disorders: A Narrative Review. Life 2024, 14, 1084. https://doi.org/10.3390/life14091084
Cernigliaro F, Santangelo A, Nardello R, Lo Cascio S, D’Agostino S, Correnti E, Marchese F, Pitino R, Valdese S, Rizzo C, et al. Prenatal Nutritional Factors and Neurodevelopmental Disorders: A Narrative Review. Life. 2024; 14(9):1084. https://doi.org/10.3390/life14091084
Chicago/Turabian StyleCernigliaro, Federica, Andrea Santangelo, Rosaria Nardello, Salvatore Lo Cascio, Sofia D’Agostino, Edvige Correnti, Francesca Marchese, Renata Pitino, Silvia Valdese, Carmelo Rizzo, and et al. 2024. "Prenatal Nutritional Factors and Neurodevelopmental Disorders: A Narrative Review" Life 14, no. 9: 1084. https://doi.org/10.3390/life14091084