what is an effect of malnutrition during pregnancy

Modest and severe maternal iron deficiency in pregnancy are associated with fetal anaemia and organ-specific hypoxia in rats. Ooi JH, Chen J, Cantorna MT. 2016;16:58. The microbiota and malnutrition: impact of nutritional status during early life. Singap Med J. 2008;67(1):1058. Early-life malnutrition may have long-lasting effects on microbe-host interactions that affect health and disease susceptibility later in life. VDR is highly expressed in the proximal colon and acts as a transcription factor responsible over 1000 genes, including the defensins, cathelicidin, claudins, TLR2, zonulin occludens, and NOD2 [158, 159]. Gut microbiota interactions with the immunomodulatory role of vitamin D in normal individuals. It is during this time that the host forms a mutualistic or immune-tolerant relationship with microbes and is thought to alter disease susceptibility (Fig. Diether NE, Willing BP. Commonly known as prebiotics or microbial-accessible carbohydrates (MACs), fibers and starches that encourage SCFA production also promote microbial diversity and resiliency. These microbes appear to be essential for host adaptation to dietary lipid changes by regulating gut epithelial processes involved in their digestion and absorption. Identifying and targeting of PLW with malnutrition is among the priorities in humanitarian emergencies. Lartey A. Maternal and child nutrition in sub-Saharan Africa: challenges and interventions. Your Kvestad I, Hysing M, Shrestha M, Ulak M, Thorne-Lyman AL, Henjum S, et al. Google Scholar. Microbiota-accessible carbohydrates suppress clostridium difficile infection in a murine model. They can also lead to stillbirth, low birthweight, wasting and developmental delays for children. Arrieta M, Stiemsma LT, Amenyogbe N, Brown EM, Finlay B. A study by McLorry et al. The gut microbiome signatures discriminate healthy from pulmonary tuberculosis patients. Woodman AG, Care AS, Mansour Y, Cherak SJ, Panahi S, Gragasin FS, et al. Impact of neonatal iron deficiency on hippocampal DNA methylation and gene transcription in a porcine biomedical model of cognitive development. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ICF International; 2006. Based on data from full-term infants in the Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort, it was found that infant exposure to frequent cleaning with household disinfectants was associated with altered gut microbial composition at age 34months and risk of being overweight by age 3 [46]. The aim of this study is therefore to help bridge the evidence gap on the magnitude and determinants of maternal nutrition in humanitarian settings in general and Ethiopian context, in particular. Crosstalk between microbiota-derived short-chain fatty acids and intestinal epithelial HIF augments tissue barrier function. CSA. Wolffenbuttel BHR, Wouters HJCM, Heiner-Fokkema MR, van der Klauw MM. The type and quantity of MACs directly alters microbial gut networks and fermentation products, such as SCFAs, wherein effects on host physiology and health have been exhaustively reviewed [109, 118, 119]. A decrease in Lactobacillaceae and Erysipelotrichaceae family members are associated with intestinal integrity dysfunction, inflammation, and increased susceptibility to enteric pathogens in mice [58, 59]. should not be construed as a substitute for advice from a medical professional or health care provider. Young men whose mothers lived in famine-affected areas of the Netherlands during early pregnancy had an increased risk of obesity . The broadly accepted SPHERE Guidelines also recommend the use of MUAC for PLW screening and entry of PLW into feeding programmes. The controversial role of Enterococcus faecalis in colorectal cancer. Cordonnier C, Le Bihan G, Emond-Rheault J-G, Garrivier A, Harel J, Jubelin G. Vitamin B12 uptake by the gut commensal bacteria bacteroides thetaiotaomicron limits the production of shiga toxin by enterohemorrhagic escherichia coli. Despite the fact that microbial contributions may be secondary to the causal agent of the disease, research on environmental enteropathy (EE) strongly suggests their presence is required for disease pathogenesis and indicates that microbes play a key role. PubMed Access to and utilization of health services (antenatal care and household visit by community health workers) and food assistance related variables (type of assistance mothers or other household members received, receipt of TSF or safety net food rations in the preceding 6 months) were also examined. In one study, the highest prevalence of underweight among mothers (44.3%) was found among women who were unskilled labourers and those who engaged in sales [25]. In: Ethiopia demographic and health survey 2000. Bourque SL, Komolova M, McCabe K, Adams MA, Nakatsu K. Perinatal iron deficiency combined with a high-fat diet causes obesity and cardiovascular dysregulation. Deiuliis JA. Reducing dietary protein in mice from 20 to 5% has drastic consequences on growth stunting, intestinal permeability, and immune function resulting in intestinal inflammation with features similar to EE in humans [17]. Here are the health risks ofmalnutrition during pregnancy: Malnutrition during pregnancy effects on the baby inside the womb, too. Symptoms. The amount of protein consumed early in life may play an important role in programing metabolic function. Environmental enteric dysfunction and growth failure/stunting in global child health. Variables considered to build the regression model were age, educational status, marital status, and occupation of the mothers, annual income of the household, attending antenatal care (ANC), type of assistance received by members of the household in the preceding 3 months and receipt of TSF food rations or safety net food rations by any family members in the previous 6 months. Besides, poor nutrition during pregnancy, especially deficiencies of certain vitamins and minerals, have been associated with negative pregnancy outcomes for both the mother and the infant. In addition, it may adversely affect the developing fetus, increasing the risk of low birth weight and infant mortality ( 1 ). The influence of maternal prenatal and early childhood nutrition and maternal prenatal stress on offspring immune system development and neurodevelopmental disorders. Lozoff B, Beard J, Connor J, Barbara F, Georgieff M, Schallert T. Long-lasting neural and behavioral effects of iron deficiency in infancy. A supply of both the n-6 and n-3 PUFA is essential for growth and intestinal, neurocognitive, visual, and immune development [88, 89]. Patterson E, ODoherty RM, Murphy EF, Wall R, OSullivan O, Nilaweera K, et al. In order for vitamin D to elicit a physiological response, it must be converted in the liver and kidney to its active form, calcitriol (1,25(OH)2D3), but it must also bind with the nuclear vitamin D receptor (VDR) [157]. More recently, the profound modulatory effects of iron availability on gut microbiome composition and function have been demonstrated [139, 140], with implications for metabolic substrate production [139, 140] and risk of infection by enteropathogens in young children with ID. Ludwig DS, Hu FB, Tappy L, Brand-Miller J. Dietary carbohydrates: role of quality and quantity in chronic disease. Pathobionts are opportunistic bacteria that pose a unique challenge in malnutrition research because their pathogenicity is dictated by host diet and immune function [23]. To prevent malnutrition, women who plan to conceive should take prenatal vitamins, eat healthy food and exercise regularly. Seregin SS, Golovchenko N, Schaf B, Chen J, Pudlo NA, Mitchell J, et al. Bartelt LA, Bolick DT, Guerrant RL. Dysbiosis adds to the cycle of malnutrition through dietary fermentation by-products, pathobiont overgrowth, and epithelial oxygenation. Gehrig JL, Venkatesh S, Chang H, Hibberd MC, Kung VL, Cheng J, et al. FOIA Clark A, Mach N. Role of vitamin D in the hygiene hypothesis: the interplay between vitamin D, vitamin D receptors, gut microbiota, and immune response. Richard C, Lewis ED, Field CJ. also showed that anemia in boys and girls was associated with lower levels of butyrate-producing bacteria (Butyricicoccus in females, Coproroccus and Roseburia in males) [145]. Although the mechanism of programming is poorly defined, the effects of dietary protein may have a microbial component. Indeed, epidemiological studies show ID in childhood is associated long-lasting deficits in cognitive ability, memory, and executive function [122125]. Semba RD. Evidence shows that women with undernutrition before and during pregnancy have increased risk of metabolic disorders (i.e., gestational diabetes mellitus) and are at increased risk of complications during labor and birth. Housewives had lower odds of (AOR=0.59, 95 %CI: 0.37, 0.95) to be malnourished compared to those who engaged in as a pastoralist. Not knowing about the importance of nutrients can lead to malnutrition as the individual will not have a healthy, balanced diet. Dostal A, Chassard C, Hilty FM, Zimmermann MB, Jaeggi T, Rossi S, et al. Sibhatu Biadgilign. Data was checked for completeness, accuracy and clarity by the study core team and supervisors. The impact of PUFA on the gut microbiota is less well defined. Previous studies have established that malnourished pregnant women are at increased risk of having LBW infants [5, 6]. Andrews SC, Robinson AK, Rodrguez-Quiones F. Bacterial iron homeostasis. Matern Child Nutr. However, the development of the immune system is closely tied with that of the microbiome [85]. Created with BioRender.com. Given the fact that TSF programs target under five children and PLW with malnutrition during screenings in the selected TSF area, it is not surprising that families recently reached through this program had more mothers with malnutrition. Undernutrition, Malnutrition, Diet, Microbiome, Gastrointestinal, Disease, Health. HHS Vulnerability Disclosure, Help Although disease causality has not been directly attributed to the microbiota, researchers hypothesized that early-life exposure and assembly of microbes in the gut influences host development [2, 3]. Increasing vitamin D status through nutrition, supplementation, or sun exposure will modulate the gastrointestinal microbiota by supporting the gut environment and normalizing autoimmune responses [169]. Jaeggi T, Kortman GAM, Moretti D, Chassard C, Holding P, Dostal A, et al. In: M. F, editor. It has different climatic zones ranging from semi-arid to afro-alpine moorland, which makes the zone conducive for the existence of various flora and fauna within a relatively small area. Using mouse models, researchers confirmed that a combination of diet and Enterobacteriaceae, Enterococcus, and Bacteroidetes members are required for EE pathogenesis. Maurer AD, Reimer RA. 2. Overall, the mean MUAC measurement was 22.6cm (with standard deviation of 2.47cm). It can lead to serious health issues, including. Paediatr Perinat Epidemiol. Small Intestine microbiota regulate host digestive and absorptive adaptive responses to dietary lipids. of trials conducted over the past 10years in developing countries [43] documented a modest effect of WASH interventions on most anthropometric parameters and studies were of low-quality evidence. Accordingly, three variables were found to be associated with acute malnutrition as measured by MUAC (taking 20.9cm as a criterion), in both the bivariate and multivariable analyses: attending antenatal care (ANC), benefiting from targeted supplementary feeding (TSF) in a form of food rations and occupational status of mothers. Numerous microbes have been identified as major contributors of gut dysbiosis and inflammation linked to disease, including commensal Escherichia coli strains [24], Helicobacter hepaticus [25], Bilophila wadsworthia [26], Bacteroides fragilis [27], Fusobacterium nucleatum [28], Enterococcus faecalis [29], and Akkermansia muciniphila [30]. Apart from the two-day training and field practice, supervisors reviewed the collected data daily in order to identify errors, omissions and inconsistencies. Am J Clin Nutr. The cross-sectional nature of the data used for this study makes it difficult to elucidate causality among variables and some variables may be missed like feeding practices, diversity, disease conditions, among others. When maternal nutritional status is compromised by alcohol and drugs of abuse the supply of essential nutrients are not available for the fetus; this can result in fetal abnormalities like Intrauterine Growth Restriction (IUGR) or Fetal Alcohol Spectrum Disorder (FASD). Although the gut microbiota is recognized as an important pathophysiologic factor in the development and sustainment of malnutrition, there are few studies that have specifically examined their impact in relation to dietary fat. Microbiota regulate intestinal absorption and metabolism of fatty acids in the zebrafish. Rashes Changes in skin pigmentation Thin hair that is tightly curled and pulls out easily Achy joints Bones that are soft and tender Gums that bleed easily Tongue that may be swollen or shriveled and cracked Night blindness Increased sensitivity to light and glare Diagnosis The Diagnostic and Statistical Manual of Mental Disorders describes it as a compulsive and persistent eating disorder [1] for at least one month that affects black women four times as much as white women. Malnutrition during pregnancy can cause several health problems in both the mother-to-be and her developing baby. Yao CK, Muir JG, Gibson PR. Litvak Y, Byndloss MX, Bumler AJ. The evidence in human infants is even more sparse. The actual location of the start of the survey in each area was decided based on random walk approach by spinning a pen to select the direction of the first household. Measurements were recorded to the nearest 0.1cm. Maize and cassava are other popular protein sources in developing countries that are poor sources of tryptophan and lysine [75]. In multivariable logistic regression analysis, those mothers who did not received antenatal care (ANC) during their pregnancy were 1.83 times more likely (AOR=1.83, 95%CI: 1.10, 3.02) to be malnourished (MUAC <21cm) as compared to mothers who received ANC. A total of 900 pregnant and lactating mothers were measured using MUAC tape. BMC Womens Health. PubMed Central A low-protein diet during pregnancy and lactation leads to increased inflammatory status as determined by the expression of microRNAs (miRNAs), and levels of inflammatory IL-6 and TNF- markers in mice [37]. There is growing evidence for a potential role of a disrupted microbiota in metabolic disorders induced by n-3 PUFA deficiency. Malnutrition refers to deficiencies or excesses in nutrient intake, imbalance of essential nutrients or impaired nutrient utilization. Lewis RM, Petry CJ, Ozanne SE, Hales CN. Gambling L, Dunford S, Wallace DI, Zuur G, Solanky N, Srai SKS, et al. Effects of microbiota-directed foods in gnotobiotic animals and undernourished children. In normal years, the woreda receives annual rainfall in the range of 4251300mm. Stool samples and biopsies obtained from the gastrointestinal tract of 15 healthy adults taken before and after supplementation with high doses of vitamin D3 showed higher microbial richness and enrichment with Proteobacteria in biopsies; no significant changes to the microbial composition in stool samples [165]. Pediatrics. MicroRNAs as regulators of metabolic disease: pathophysiologic significance and emerging role as biomarkers and therapeutics. OLeary F, Samman S. Vitamin B12 in health and disease. Two experienced data entry clerks were involved in the process after receiving orientation on the survey questionnaires. Koletzko B, von Kries R, Closa R, Monasterolo RC, Escribano J, Subas JE, et al. CJF wrote the fat section. Tuchscherer M, Otten W, Kanitz E, Grbner M, Tuchscherer A, Bellmann O, et al. Using national level data collected from 180 countries, Ghosh and colleagues concluded that dietary utilizable protein provides a better index of protein inadequacies than total crude protein intake alone [56]. Impact of dietary fatty acids on metabolic activity and host intestinal microbiota composition in C57BL/6J mice. Wealth status, mid upper arm circumference (MUAC) and antenatal care (ANC) are determinants for low birth weight in Kersa, Ethiopia. were able to show that a higher proportion of Enterobacteriaceae members relative to Akkermansia municiphila and Clostridium scindens in malnourished Malawian children was indicative of a pathogenic community related to malnutrition [21]. Functional characterization of IgA-targeted bacterial taxa from undernourished Malawian children that produce diet-dependent enteropathy. Yaikhomba T, Poswal L, Goyal S. Assessment of iron, folate and vitamin B12 status in severe acute malnutrition. CAS Ethiopian emergency nutrition coordination unit. 2011. The production of SCFAs, specially butyrate, provides direct energy to gut epithelial cells and promotes intestinal homeostasis by maintaining a hypoxic environment, mucus production, and antimicrobial peptide secretion [112116]. In animal studies which typically use VDR KO (knock-out) mice, microbial dysbiosis has been reported, characterized by a greater abundance of Proteobacteria, Bacteroides spp. Early-life protein restriction post-weaning in mice led to temporary glucose intolerance following nutritional recovery but did not increase susceptibility to diet-induced liver steatosis and insulin resistance later in life [60]. This results in diarrhea, weight loss, other nutritional deficiencies, and gut dysbiosis [80]. The English version of the designed questionnaire was translated into the local language of Oromiffa and checked to ensure equivalence between the English and Oromiffa versions. 1972;18(3):18791. MUAC of each woman was measured at the mid-point between the tips of the shoulder and elbow of the left arm using non-elastic, non-stretchable MUAC tapes. During the first 6months of life, protein intake has been shown to be 6670% higher in formula-fed (FF) than in breastfed (BF) infants leading to greater weight gains in infants from 3 to 9months [69]. Magnitude and determinants of malnutrition among pregnant women in eastern Ethiopia: evidence from rural, community-based setting. In multivariable logistic regression analysis, those mothers who did not received antenatal care (ANC) during their pregnancy had 1.83 higher odds of (adjusted odds ratio[AOR]=1.83, 95% confidence interval [CI]:1.10,3.02) to be malnourished (MUAC <21cm) as compared to mothers who received ANC. Roba KT, O'Connor TP, Belachew T, O'Brien NM. Vitamin B-12 status in infancy is positively associated with development and cognitive functioning 5 y later in Nepalese children. This is partly due to the fact that infant formula contains higher concentrations of protein than human breast milk. Dao MC, Everard A, Aron-Wisnewsky J, Sokolovska N, Prifti E, Verger EO, et al. 2014;2(8):188. reported that low iron conditions reduced butyrate-producing bacteria (e.g., Roseburia spp., Eubacteria rectale, Clostridium cluster IV members, and Bacterioides spp.) Descriptive statistics were used to assess basic respondent characteristics. Past studies from development settings in Ethiopia have reported a prevalence of 19.1% with a more lenient criterion of MUAC <22cm [22], clearly indicating that malnutrition rates could be higher during emergencies even after a period of interventions. Sears CL, Geis AL, Housseau F. Bacteroides fragilis subverts mucosal biology: from symbiont to colon carcinogenesis. Controlling the microbiota with targeted dietary interventions, particularly in cases of malnutrition, may prove to be a vital therapeutic option in preventative healthcare. In malnourished children, vitamin B12 deficiency is more common than folate and iron deficiency and can lead to long-term brain damage [173, 174].
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