Micronutrient supplementation in pregnancy may prevent chronic diseases in children

Improving micronutrient supplementation for mothers during pregnancy could help reduce the prevalence of noncommunicable diseases in the next generation, according to researchers.

During pregnancy, nutritional conditions can influence epigenetic development and the risk for noncommunicable disease (NCD) later in life.

“Improving nutrition for pregnant females may ... serve the dual purpose of directly improving pregnancy outcomes and preventing NCDs in the next generation,” Mia M. Blakstad, PhD, of the department of global health and population at the Harvard TH Chan School of Public Health, and colleagues wrote. “As the double burden of disease continues to grow, population-wide efforts to scale up micronutrient supplementation to pregnant females could help prevent both undernutrition and chronic disease.”

Any public health and clinical efforts to increase prenatal micronutrient supplementation “should be prioritized,” they added.

Using secondary data sources from more than 130 countries, Blakstad and colleagues assessed the impact that prenatal supplementation with multiple micronutrients (MMS), calcium or iron and folic acid (IFA) might have on future NCDs at 50%, 75% or 90% coverage.

They also estimated cases of hypertension, diabetes and deaths from NCDs “that could be averted or delayed by scaling up prenatal micronutrient supplementation.”

The findings, published in The American Journal of Clinical Nutrition, estimated that more than 51,000 NCD-related deaths — accounting for 0.14% of all-cause mortality — per cohort of 127 million live babies could have been delayed if 90% of pregnant people received prenatal MMS. Additionally, approximately 3 million cases of diabetes and 6 million cases of hypertension could have been avoided.

Calcium supplementation at 90% produced similar results; the researchers estimated this intervention might be able to delay 51,000 deaths per birth cohort. When it came to IFA, though, the researchers wrote that “these numbers would be roughly half” at 24,000 deaths delayed per birth cohort.

“Our model suggests that substantial numbers of NCD deaths and cases of hypertension and diabetes could be prevented in future generations by scaling up micronutrient supplementation for mothers during pregnancy,” they wrote.

Notably, the approximated benefits for each child “were generally higher” for countries with a high burden of maternal anemia and adverse birth outcomes, countries with a high burden of NCDs, or both.

“Our results likely represent a lower bound of the true intergenerational impact of prenatal micronutrient supplements,” Blakstad and colleagues wrote. “Among nutrition interventions, benefits of prenatal micronutrient supplements go beyond improving child survival and human capital and include noticeable improvements in long-term NCD risk in the offspring generation. And, although impacts are small per person, the intergenerational benefits of prenatal supplementation scale up at the population level.”