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Micronutrients Deficiency and Their Associations with Pregnancy Outcomes: A Review

Authors Walle BM, Adekunle AO, Arowojolu AO, Dugul TT, Mebiratie AL

Received 12 August 2020

Accepted for publication 16 October 2020

Published 5 November 2020 Volume 2020:12 Pages 237—254

DOI https://doi.org/10.2147/NDS.S274646

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Chandrika Piyathilake


Birhanie Muluken Walle,1,2 Adeyemi O Adekunle,3 Ayodele O Arowojolu,3 Tesfaye Tolessa Dugul,2 Akiloge Lake Mebiratie4

1Department of Obstetrics and Gynecology, Pan African University Life and Earth Sciences Institutes, College of Medicine, University of Ibadan, Ibadan, Nigeria; 2Department of Medical Physiology, College of Medicine and Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 3Department of Obstetrics and Gynecology, College of Medicine, University College Hospital, University of Ibadan, Ibadan, Nigeria; 4Department of Obstetrics and Gynecology, College of Health Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia

Correspondence: Birhanie Muluken Walle Email muluken.walle@aau.edu.et

Abstract: Micronutrients are vitamins, minerals and trace elements that are used in minute doses as cofactors, antioxidants and modulators of gene transcription homeostasis. MMNs may have a role in averting or treating adverse pregnancy outcomes and maternal complications. In 2016, WHO suggested the use of iron-folic acid (IFA) rather than multiple micronutrients (MMNs) during pregnancy owing to some feared adverse outcomes like perinatal mortalities. However, this effect is debatable as such complications could be also due to genetic or environmental factors. Therefore, this appraisal should provide appropriate information and guidance to health workers, scholars and policymakers. This review includes large sample-sized studies with a special focus on developing countries like Ethiopia. The articles were selected using systematic searching with Boolean operators, advanced search techniques, snowballing and search limits. Mendeley was used as a reference management tool where the source of databases and references were PubMed, AJOL, Google Scholar, IRIS, Summon, DOAJ, Cochrane Library, Oxford Medicine Online, WHO reproductive health libraries majorly from the Hinari program. Articles from BMC, American Society for Nutrition, Lancet, Elsevier, John Wiley and Sons LTD, PLoS One, Springer and Nature Publishing Groups were also used. The results showed that there are no variations in adverse effects between MMNs and IFA. Moreover, MMNs are valuable in anemic pregnant women with lower preconception weight as it increases maternal weight and reduces low birth weight and anemia more than IFA. Therefore, MMNs may have greater health benefits than IFA for the offspring by minimizing fetal complications and the cost of their treatment, resulting from the MMN deficiency state.

Keywords: multiple micronutrients, IFA, adverse birth outcomes, pregnancy, mortalities

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