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Nutritional Requirements of Pregnant and Lactating Women

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition in Women".

Deadline for manuscript submissions: 15 August 2025 | Viewed by 6608

Special Issue Editors


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Guest Editor
Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessalonik, Greece
Interests: perinatal epidemiology; nutrition in pregnancy; nutritional epidemiology
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Special Issue Information

Dear Colleagues,

Appropriate nutrition during pregnancy and lactation is crucial for the health of both the mother and the fetus. Adequate intake of essential nutrients supports fetal development, promotes maternal well-being, and ensures the quality of breast milk. It has been well established that failure to meet nutritional requirements adversely affects the perinatal outcome and the offspring’s long-term health. Therefore, an adequate intake of energy, protein, vitamins, and minerals during pregnancy is essential. Furthermore, avoidance of alcohol and limitation of caffeine intake are recommended to protect the infant. A developmental model for the causes of disease hypothesizes that the fetal environment may have an impact on epigenetic modifications and associated gene expression, leading that way to the onset of disease in neonates and late childhood. Thus, providing high-quality, evidence-based guidance for nutritional issues in pregnancy is an important part of effective antenatal and postnatal care. Moreover, healthcare providers should offer tailored advice and support to meet the specific needs of each woman, enhancing maternal and child health outcomes. This Special Issue aims to outline key nutritional requirements and dietary recommendations for pregnant and lactating women, emphasizing the importance of balanced nutrition during these critical stages.

Dr. Ioannis Tsakiridis
Dr. Themistoklis I. Dagklis
Dr. Michael Chourdakis
Guest Editors

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Keywords

  • nutrition
  • pregnancy
  • lactation
  • fetal health
  • epigenetic modifications

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Published Papers (5 papers)

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Research

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16 pages, 414 KiB  
Article
Effects of Maternal Vitamin D Levels on Prematurity: Feasibility Study in a Multicenter Observational Pilot
by Olivia Barbosa, Ana Teresa Freitas, Marta P. Silvestre, André Moreira-Rosário, Pedro Aguiar, Ana Isabel Régua, Tatiana Madaleno, Manuela Almeida and Dulce Cruz
Nutrients 2025, 17(7), 1160; https://doi.org/10.3390/nu17071160 - 27 Mar 2025
Viewed by 281
Abstract
Background: Numerous studies have shown that hypovitaminosis D is linked to adverse maternal and infant health outcomes, such as intrauterine growth restriction, preeclampsia, cholestasis, hypertension, and gestational diabetes, all of which are potential causes of prematurity. Recognizing the significance of this issue and [...] Read more.
Background: Numerous studies have shown that hypovitaminosis D is linked to adverse maternal and infant health outcomes, such as intrauterine growth restriction, preeclampsia, cholestasis, hypertension, and gestational diabetes, all of which are potential causes of prematurity. Recognizing the significance of this issue and its impact on maternal–infant health, the VitDTracking research project was designed and registered on 4 March 2024, in the ClinicalTrials.gov database (Identifier: NCT06292195). The project includes a large-scale multicenter observational study, targeting a minimum initial sample size of 1800 participants. This paper describes the pilot study aimed at assessing the feasibility of the full-scale study. Methods: A multicenter observational pilot study was conducted in public health organizations in the Alentejo region, adhering to the research protocol. Data collection included 67 parameters: 37 obtained from a questionnaire and 30 from clinical records, with particular focus on maternal 25(OH)D levels and maternal–infant health outcomes. Feasibility was assessed through predefined outcome indicators and success criteria. Results: The pilot study enrolled 30 pregnant women and successfully met all feasibility criteria. The global recruitment rate was 73.17%, with an eligible recruitment rate of 88.2%. The refusal rate was low (11%), and adherence, retention, and completion rates were all 100%, indicating strong participant engagement. The questionnaire comprehension rate was 86.6%. Participating centers demonstrated the capacity to implement the study, adhering to the protocol with a compliance rate exceeding 90%. The study also highlighted a concerning prevalence of hypovitaminosis D and identified cases of premature birth and miscarriage. Conclusions: The pilot study confirmed the feasibility of recruitment methodologies and procedures, supporting the implementation of the large-scale observational study. The planned study will recruit approximately 1800 pregnant women to achieve an eligible cohort of 1000 samples, and a statistically significant final sample of 100 cases meeting the prematurity criterion. Full article
(This article belongs to the Special Issue Nutritional Requirements of Pregnant and Lactating Women)
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11 pages, 410 KiB  
Article
Comparative Analysis of the Frequency of Fresh and Frozen Fish Consumption Among Two Cohorts of Pregnant Women
by Angela Alibrandi, Carlo Giannetto, Agata Zirilli, Vihra Dimitrova, Giosuè Giordano Incognito, Roberta Granese, Angelina De Pascale and Maurizio Lanfranchi
Nutrients 2025, 17(3), 439; https://doi.org/10.3390/nu17030439 - 25 Jan 2025
Viewed by 785
Abstract
Objectives: today’s consumers are increasingly interested in the relationship between food and health, recognizing food as a means to meet nutritional needs and prevent diseases. A diet rich in fish is beneficial to health, potentially protecting against cancer, cardiovascular, autoimmune, neurodegenerative, and metabolic [...] Read more.
Objectives: today’s consumers are increasingly interested in the relationship between food and health, recognizing food as a means to meet nutritional needs and prevent diseases. A diet rich in fish is beneficial to health, potentially protecting against cancer, cardiovascular, autoimmune, neurodegenerative, and metabolic diseases. During pregnancy, adequate nutrition benefits both the mother and the unborn child. This study compares pregnant women from a decade ago with those recently enrolled to evaluate differences in eating styles, specifically the consumption of fresh and frozen fish. Methods: we compared 114 pregnant women from 2013 with 168 women from 2023, using the same questionnaire to evaluate their eating habits during pregnancy, focusing on fresh and frozen fish consumption. Variables for statistical analyses included age, education, profession, family size, pre-pregnancy BMI, differential BMI, and frequency of fish consumption. Results: the comparison showed an increase in fish consumption, both fresh and frozen, among pregnant women in 2023 compared to 2013, indicating greater awareness of the health benefits of fish. Changes in dietary habits were influenced by profession, education level, and family size. Women in the 2023 cohort experienced smaller weight gain during pregnancy, suggesting potential health benefits. These shifts likely result from improved nutrition education and access to healthy foods, highlighting the importance of public health efforts to enhance maternal and fetal health. Conclusions: significant changes in the dietary habits of pregnant women over a decade were observed, with increased fish consumption in 2023 compared to 2013. These findings emphasize the role of nutrition education and improved access to healthy foods in promoting maternal and fetal health. Full article
(This article belongs to the Special Issue Nutritional Requirements of Pregnant and Lactating Women)
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Review

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16 pages, 3872 KiB  
Review
Neurodevelopmental Outcomes in the Offspring of Women with Vitamin D Deficiency and Women Who Received Vitamin D Supplementation During Pregnancy
by Antonia Varthaliti, Kalliopi Rodolaki, Vasilios Lygizos, Dimitrios Efthymios Vlachos, Nikolaos Thomakos, Dimos Sioutis, George Daskalakis and Vasilios Pergialiotis
Nutrients 2025, 17(6), 978; https://doi.org/10.3390/nu17060978 - 11 Mar 2025
Viewed by 461
Abstract
Vitamin D is an essential nutrient, involved in various biological processes including calcium homeostasis, bone health, immune function, and brain development. Vitamin D from the mother crosses the placenta during pregnancy, directly impacting the neurodevelopment of the fetus. Vitamin D insufficiency is a [...] Read more.
Vitamin D is an essential nutrient, involved in various biological processes including calcium homeostasis, bone health, immune function, and brain development. Vitamin D from the mother crosses the placenta during pregnancy, directly impacting the neurodevelopment of the fetus. Vitamin D insufficiency is a substantial global health problem, influencing almost 47.9% of individuals, with especially high predominance rates among pregnant women. Background/Objectives: Preclinical studies suggest that maternal vitamin D deficiency results in significant alterations in the development of the offspring’s brain. Nonetheless, randomized clinical trials in humans have produced conflicting results on the beneficial effect of high-dose vitamin D supplementation during pregnancy on neurodevelopmental outcomes. This review aims to evaluate the association of maternal prenatal vitamin D levels and vitamin D supplementation during pregnancy with offspring neurodevelopment. Methods: This study thoroughly reviewed the literature and searched throughout PubMed, ScienceDirect, Cochrane Library, and Google Scholar, adhering to PRISMA guidelines. Studies assessing maternal vitamin D levels, supplementation, and offspring neurodevelopmental outcomes were included based on predefined eligibility criteria. Results: Among 9686 screened studies, only 20 met the inclusion criteria, representing 18,283 mother–child pairs. A small, non-significant trend suggested a positive association between higher maternal vitamin D levels and offspring cognitive, language, motor, and social-emotional development. The strongest associations were observed in cognitive performance and language acquisition, though inconsistencies emerged across studies. Cord blood vitamin D levels showed no consistent effects on neurodevelopment. Maternal vitamin D supplementation during pregnancy demonstrated no reliable benefits for offspring neurodevelopment, with results varying by study design and participant characteristics. Conclusions: Large-scale, multicenter randomized trials, with standardized neurodevelopmental assessments at multiple ages are needed to define the effects of vitamin D deficiency and supplementation during pregnancy on offspring neurodevelopmental outcomes. Future research should investigate the confounding factors contributing to inconsistencies, including supplementation protocols, genetic variations, and assessment methodologies. Clarifying these aspects will enhance the understanding of maternal vitamin D’s role in fetal neurodevelopment and aid in refining prenatal supplementation guidelines. Full article
(This article belongs to the Special Issue Nutritional Requirements of Pregnant and Lactating Women)
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37 pages, 1230 KiB  
Review
Dietary Behaviour of Pregnant Women in Ethiopia: The Missing Aspect of Care
by Simegn Kassa Alamirew, Stefanie Lemke, Bernhard Freyer and Barbara Stadlmayr
Nutrients 2024, 16(19), 3227; https://doi.org/10.3390/nu16193227 - 24 Sep 2024
Viewed by 2501
Abstract
Background: Nutrition and adequate dietary intake during pregnancy strongly influence the health and well-being of the mother, as well as the physical and cognitive development of the unborn child. While previous studies have documented factors associated with the dietary behaviour of pregnant [...] Read more.
Background: Nutrition and adequate dietary intake during pregnancy strongly influence the health and well-being of the mother, as well as the physical and cognitive development of the unborn child. While previous studies have documented factors associated with the dietary behaviour of pregnant women in Ethiopia, a comprehensive overview is missing. Objective: The aim of this study was to close this research gap. Methodology: We conducted a mapping review, including 37 studies published between 2000 and 2022 in our analysis. Dietary behaviour refers to all phenomena related to food choice, eating behaviour and dietary intake. We used an innovative approach by integrating a socio-ecological framework with UNICEF’s conceptual framework on maternal and child nutrition, which specifies multidimensional individual, underlying and enabling determinants associated with the nutritional status of women. Importantly, we integrated a focus on care for women and healthy environments. Results: A total of 68 factors were identified as influencing the dietary behaviour of pregnant women, with a focus on the intra- (31/68) and interpersonal (21/68) levels, while factors at the community (11/68) and the institutional levels (5/68) were scarce. Few studies investigated socio-cultural aspects, such as gender roles, decision-making power and workload of women, psychological factors and eating practices related to food taboos. None of the studies explored the influence of resources at the institutional level. Conclusions: This attests that the focus in maternal nutrition is still placed on the individual responsibility of women, instead of addressing the structural conditions that would enable women to access resources such as land, education and nutrition information. Full article
(This article belongs to the Special Issue Nutritional Requirements of Pregnant and Lactating Women)
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Other

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29 pages, 8560 KiB  
Systematic Review
Are Maternal Dietary Patterns During Pregnancy Associated with the Risk of Gestational Diabetes Mellitus? A Systematic Review of Observational Studies
by Charikleia Kyrkou, Apostolos P. Athanasiadis, Michael Chourdakis, Stefania Kada, Costas G. Biliaderis, Georgios Menexes and Alexandra-Maria Michaelidou
Nutrients 2024, 16(21), 3632; https://doi.org/10.3390/nu16213632 - 25 Oct 2024
Cited by 1 | Viewed by 1942
Abstract
Background/Objectives: Maternal nutritional status is a “key” contributor to Gestational Diabetes Mellitus (GDM). However, the role of maternal dietary patterns (DPs) during pregnancy remains poorly understood. Thus, we conducted a systematic review to assess associations between “a posteriori-derived” DPs and GDM. Methods: A [...] Read more.
Background/Objectives: Maternal nutritional status is a “key” contributor to Gestational Diabetes Mellitus (GDM). However, the role of maternal dietary patterns (DPs) during pregnancy remains poorly understood. Thus, we conducted a systematic review to assess associations between “a posteriori-derived” DPs and GDM. Methods: A systematic search was conducted in PubMed, ScienceDirect, Web of Science, and Scopus for cohort, cross-sectional, and case–control studies published until June 2024. A total of twenty-eight studies involving 39,735 pregnant women were included, and their quality was evaluated by the Newcastle–Ottawa Scale. The 91 identified DPs were classified into four categories: “Westernized”, “Nutritious”, “Plant-based”, and “Miscellaneous”. Results: Our findings do not reveal definitive associations between maternal DPs during pregnancy and GDM risk. Notably, “Westernized” DPs tended to be associated with an increased risk. However, a very small portion of patterns within this category exhibited protective associations. Conversely, “Nutritious” and “Plant-based” appear beneficial for GDM prevention in specific populations. The “Miscellaneous” category presented an almost equal distribution of DPs with both detrimental and protective associations, pinpointing the absence of a clear directional trend regarding GDM risk. Conclusions: The heterogeneity in findings can be attributed to geographic and sociocultural variations and methodological differences across studies. Thus, there is a need for more standardized research methodologies to provide more precise insights that will ultimately help develop effective and tailored dietary guidelines for GDM prevention. Full article
(This article belongs to the Special Issue Nutritional Requirements of Pregnant and Lactating Women)
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