Association Between Iron, Folate, and Zinc Deficiencies During Pregnancy and Low Birth Weight: Systematic Review of Cohort Studies.

CONTEXT: Iron, folate, and zinc deficiencies during the gestational period may be associated with negative perinatal outcomes, such as low birth weight (LBW), but these relationships are not yet fully established in the scientific literature and require further investigation. OBJECTIVE: To systematically review the scientific production to investigate the association between iron, folate, and zinc deficiencies during pregnancy and LBW. DATA SOURCES: The search was carried out using high-sensitivity descriptors in the English, Portuguese, and Spanish languages, combined with Boolean operators, adapted to each of the following indexed databases: MEDLINE via PubMed, Embase, LILACS via BVS, CENTRAL, and Web of Science. The eligibility criteria followed the PECOS (population, exposure, comparator, outcome, study) strategy. DATA EXTRACTION: Data extraction was performed using an Excel spreadsheet with the study variables of interest. Subsequently, the information was analyzed and summarized in a table. The Newcastle-Ottawa Scale was used to perform the risk-of-bias analysis. DATA ANALYSIS: A total of 21 042 references were identified, of which 7169 related to folate, 6969 to iron, and 6904 to zinc. After eligibility criteria application, 37 articles were included in this study, of which 18 referred to zinc nutritional status, 10 related to iron, and 9 related to folate. Studies of iron (40%), folate (66.66%), and zinc (50%) revealed a positive association between deficiencies of these micronutrients and LBW. The overall methodological quality of the studies included in this review was considered high. CONCLUSIONS: Iron, folate, and zinc deficiencies are still present during gestation. Nevertheless, the association between deficiencies of these micronutrients and LBW is still contradictory, and more studies are needed, as is efficient nutritional monitoring before and during gestation. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42021284683.

Polymorphism in the vitamin D receptor gene is associated with maternal vitamin D concentration and neonatal outcomes: A Brazilian cohort study.

OBJECTIVES: This study evaluated the associations between single-nucleotide polymorphisms (SNPs) of the vitamin D receptor (VDR) gene, maternal vitamin D concentration, and gestational outcomes. METHODS: The cohort consisted of 270 pregnant women who received prenatal services at basic public healthcare centers in the city of Santo Antônio de Jesus, Bahia, Brazil. For statistical analysis, multiple linear regression was used. RESULTS: A mean of 72.62 (SD = 31.51) nmol/L for 25-hydroxyvitamin D (25(OH)D) concentrations was found. The mean birth weight was 3.340 g (SD = 0.545 g), and the mean duration of gestation was 38.66 (SD = 1.83) weeks. Pregnant women who were homozygous for the low-frequency allele GG of SNP TaqI had a higher concentration of vitamin D during gestation (ß = 14.09 nmol/L; 95% CI = 0.85, 27.34) than the higher frequency homozygotes AA (ß = 3.33 nmol/L; 95% CI = -4.37, 11.05). The children of heterozygous women for the ApaI SNP (GA) were born with a lower weight (ß = -131.99 g, 95% CI = -258.50, -5.47, P = .04). The heterozygote genotype of the SNP TaqI (CA) decreased the risk of short duration of gestation (ß = 0.54 weeks, 95% CI = 0.09, 0.99, P = .01), and the homozygote for the lower frequency allele in the SNP ApaI (CC) showed a negative effect, decreasing the duration of gestation (ß = -0.69 weeks, 95% CI = -1.35, -0.26, P = .04). CONCLUSIONS: The VDR gene is an important genetic predictor of a higher concentration of vitamin D during gestation, low birth weight, and decreasing duration of gestation.