The importance of nutrition in pregnancy and lactation: lifelong consequences
Open accessAbstract
Most women in the United States do not meet the recommendations for healthful nutrition and weight before and during pregnancy. Women and providers often ask what a healthy diet for a pregnant woman should look like. The message should be "eat better, not more." This can be achieved by basing diet on a variety of nutrient-dense, whole foods, including fruits, vegetables, legumes, whole grains, healthy fats with omega-3 fatty acids that include nuts and seeds, and fish, in place of poorer quality highly processed foods. Such a diet embodies nutritional density and is less likely to be accompanied by excessive energy intake than the standard American diet consisting of increased intakes of processed foods, fatty red meat, and sweetened foods and beverages. Women who report "prudent" or "health-conscious" eating patterns before and/or during pregnancy may have fewer pregnancy complications and adverse child health outcomes. Comprehensive nutritional supplementation (multiple micronutrients plus balanced protein energy) among women with inadequate nutrition has been associated with improved birth outcomes, including decreased rates of low birthweight. A diet that severely restricts any macronutrient class should be avoided, specifically the ketogenic diet that lacks carbohydrates, the Paleo diet because of dairy restriction, and any diet characterized by excess saturated fats. User-friendly tools to facilitate a quick evaluation of dietary patterns with clear guidance on how to address dietary inadequacies and embedded support from trained healthcare providers are urgently needed. Recent evidence has shown that although excessive gestational weight gain predicts adverse perinatal outcomes among women with normal weight, the degree of prepregnancy obesity predicts adverse perinatal outcomes to a greater degree than gestational weight gain among women with obesity. Furthermore, low body mass index and insufficient gestational weight gain are associated with poor perinatal outcomes. Observational data have shown that first-trimester gain is the strongest predictor of adverse outcomes. Interventions beginning in early pregnancy or preconception are needed to prevent downstream complications for mothers and their children. For neonates, human milk provides personalized nutrition and is associated with short- and long-term health benefits for infants and mothers. Eating a healthy diet is a way for lactating mothers to support optimal health for themselves and their infants.
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Parents' psychosocial experiences become embedded in the future child's neurobiology, and parents influence children's neurodevelopment before birth.
“As DOHaD data demonstrate, parents’ psycho-social experiences are embedded in the future child’s neurobiology. Parents affect children’s neurodevelopment before birth.”
From The transition to parenthood in obstetrics: enhancing prenatal care for 2-generation impact (2022) · cites this paper as [15]
Biological cues tied to the pregnant parent's health, lifestyle, nutrition, social circumstances, and mental state, which a co-parent can also influence, help shape the fetal brain.
“The fetal brain is shaped, in part, by adaptation to biological cues related to the pregnant parent’s well-being, lifestyle, nutritional status, social factors, and mental health (each of which a co-parent can affect).11-15”
From The transition to parenthood in obstetrics: enhancing prenatal care for 2-generation impact (2022) · cites this paper as [15]
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Self-citationKinshella, M. W., Omar, S., Scherbinsky, K., Vidler, M., Magee, L. A., von Dadelszen, P., Moore, S. E., Elango, R., & The PRECISE Conceptual Framework Working Group (2021) · Nutrients · doi:10.3390/nu13020472 · Cited by 52 · see citing works
Daily Enteral DHA Supplementation Alleviates Deficiency in Premature Infants
Baack, M. L., Puumala, S. E., Messier, S. E., Pritchett, D. K., & Harris, W. S. (2016) · Lipids · doi:10.1007/s11745-016-4130-4 · Cited by 51 · see citing works
Bulloch, R. E., Lovell, A. L., Jordan, V., McCowan, L. M. E., Thompson, J., & Wall, C. R. (2018) · Paediatric and Perinatal Epidemiology · doi:10.1111/ppe.12476 · Cited by 51 · see citing works
Placental Glucose Transfer: A Human In Vivo Study
Holme, A. M., Roland, M. C. P., Lorentzen, B., Michelsen, T. M., & Henriksen, T. (2015) · PLoS ONE · doi:10.1371/journal.pone.0117084 · Cited by 49 · see citing works
Nutritional approach to preeclampsia prevention
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Prevention of gestational diabetes mellitus: Where are we now?
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Higher Gestational Choline Levels in Maternal Infection Are Protective for Infant Brain Development
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Self-citationChildhood pregnancy (10-14 years old) and risk of stillbirth in singletons and twins
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Infant milk-feeding practices and diabetes outcomes in offspring: a systematic review
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Harris, W. S., Luo, J., Pottala, J. V., Margolis, K. L., Espeland, M. A., & Robinson, J. G. (2016) · PLoS ONE · doi:10.1371/journal.pone.0147894 · Cited by 45 · see citing works
Achieving Appropriate Gestational Weight Gain: The Role of Healthcare Provider Advice
Deputy, N. P., Sharma, A. J., Kim, S. Y., & Olson, C. K. (2018) · Journal of Women s Health · doi:10.1089/jwh.2017.6514 · Cited by 44 · see citing works
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Low Gestational Weight Gain and Risk of Adverse Perinatal Outcomes in Obese and Severely Obese Women
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Self-citationDevelopmental Origins of Disease: Emerging Prenatal Risk Factors and Future Disease Risk
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15. Management of Diabetes in Pregnancy: <i>Standards of Care in Diabetes—2024</i>
American Diabetes Association Professional Practice Committee, ElSayed, N. A., Aleppo, G., Bannuru, R. R., Bruemmer, D., Collins, B. S., Ekhlaspour, L., Hilliard, M. E., Johnson, E. L., Khunti, K., et al. (2024) · Diabetes Care · doi:10.2337/dc24-s015 · Cited by 232 · see citing works
Sustainable and Health-Protecting Food Ingredients from Bioprocessed Food by-Products and Wastes
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The transition to parenthood in obstetrics: enhancing prenatal care for 2-generation impact
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- Authors
- Marshall, N. E., Abrams, B., Barbour, L. A., Catalano, P., Christian, P., Friedman, J. E., Hay, W. W., Hernandez, T. L., Krebs, N. F., Oken, E., Purnell, J. Q., Roberts, J. M., Soltani, H., Wallace, J., & Thornburg, K. L.
- Affiliations
- Oregon Health & Science University (US)
- University of California, Berkeley (US)
- University of Colorado Anschutz (US)
- Tufts University (US)
- Johns Hopkins University (US)
- University of Oklahoma Health Sciences Center (US)
- University of Colorado Denver (US)
- Harvard University (US)
- University of Pittsburgh (US)
- Sheffield Hallam University (GB)
- University of Aberdeen (GB)
- ORCID
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 2022-05
- Volume
- 226
- Issue
- 5
- Pages
- 607-632
- ISSN
- 0002-9378 (ISSN-L)
- PMC
- PMC9182711
- OpenAlex
- W4200045503
- Cited by
- 709
- References
- 238
- Citations by year
- 2026: 146 · 2025: 218 · 2024: 201 · 2023: 112 · 2022: 31 · 2021: 1
- FWCI
- 15.36
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion, cc-by-nc-nd)
- SHURA (Sheffield Hallam University Research Archive) (Sheffield Hallam University) (acceptedVersion)
- Aberdeen University Research Archive (Aberdeen University) (submittedVersion)
- Funders
- Academy of Nutrition and Dietetics
- National Institutes of Health
- University of Michigan
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Keywords
- maternal nutrition, pregnancy, lactation, gestational weight gain, pre-pregnancy obesity, low body mass index, ketogenic diet, paleodiet, dietary habits, omega-3 fatty acids, processed foods, prenatal micronutrient supplementation, low birth weight, perinatal outcomes, breast milk, preconception care
- MeSH terms
- Gestational Weight Gain, Diet, Female, Humans, Lactation, Male, Nutritional Status, Obesity, Pregnancy, Vegetables, Weight Gain
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