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Is It Necessary Folic Acid, Vitamin B12, Vitamin D and Iodine Supplementation in Pregnancy?: Posssible Risks

Yıl 2021, , 439 - 447, 01.11.2021
https://doi.org/10.17517/ksutfd.832401

Öz

Due to the increasing nutritional requirements in the pregnancy, taking certain micronutrients as dietary supplements and thus minimizing the risks associated with deficiency is of great importance in the protection of maternal and fetal health. In pregnancy, dietary supplements are vital in severe or moderate deficiency of nutrients, also bring various risks in conditions of mild deficiency or adequate maternal nutrient storage. The effect of folic acid supplementation on prevent congenital anomalies, has been proven. In maternal period, excessive intake of folic acid may cause carcinogenicity, negatively affect the absorption of zinc, lead to delays in the diagnosis and treatment of vitamin B12 deficiency, and may be associated with the risk of childhood asthma and allergy. Vitamin B12 is another vitamin whose deficiency is associated with fetal anomalies. Although the toxic effect of vitamin B12 is not reported, a case report showing allergic reactions was found in the literature review in case of excessive intake. Vitamin D, which is beneficial in the prevention of neonatal hypocalcemia and rickets, excessive intake of the supplement may be a teratogenic effect. Iodine supplement is effective in preventing diseases such as cretinism associated with iodine insufficiency. However, it has been stated that excessive intake of iodine supplement may lead to an increase in the prevalence of thyroid dysfunction of the pregnant woman, subclinical and overt hypothyroidism during pregnancy and negatively affect the psychomotor development of the baby. The use of nutritional supplements at the recommended doses during pregnancy is appropriate, but attention should also be paid to excessive intake as well as prevention of insufficiency. In this review, the risks of excessive intake of folic acid, vitamin B12, vitamin D, and iodine supplements used in pregnancy are discussed

Kaynakça

  • 1. Richard K, Holland O, Landers K, Vanderlelie JJ, Hofstee P, Cuffe JS, et al. Effects of maternal micronutrient supplementation on placental function. Placenta. 2017;54:38-44.
  • 2. Gernand AD, Schulze KJ, Stewart CP, West Jr KP, Christian P. Micronutrient deficiencies in pregnancy worldwide: health effects and prevention. Nature Reviews Endocrinology. 2016;12(5):274.
  • 3. Berti C, Biesalski H, Gärtner R, Lapillonne A, Pietrzik K, Poston L, et al. Micronutrients in pregnancy: current knowledge and unresolved questions. Clinical nutrition. 2011;30(6):689-701.
  • 4. Christian P, Stewart CP. Maternal micronutrient deficiency, fetal development, and the risk of chronic disease. The Journal of nutrition. 2010;140(3):437-445.
  • 5. Ho A, Flynn AC, Pasupathy D. Nutrition in pregnancy. Obstetrics, Gynaecology & Reproductive Medicine. 2016;26(9):259-264.
  • 6. Procter SB, Campbell CG. Position of the Academy of Nutrition and Dietetics: nutrition and lifestyle for a healthy pregnancy outcome. Journal of the Academy of Nutrition and Dietetics. 2014;114(7):1099-1103.
  • 7. Plećaš D, Plešinac S, Kontić-Vučinić O. Nutrition in pregnancy: basic principles and recommendations. Srpski arhiv za celokupno lekarstvo. 2014;142(1-2):125-130.
  • 8. T.C. Sağlık Bakanlığı. Türkiye Beslenme Rehberi (TÜBER): T.C. Sağlık Bakanlığı, Türkiye Halk Sağlığı Kurumu, 2015. Erişim Adresi: https://dosyasb.saglik.gov.tr/Eklenti/10915,tuber-turkiye-beslenme-rehberipdf.pdf.
  • 9. World Health Organization (WHO). WHO recommendation on daily oral iron and folic acid supplementation 2016. Erişim Adresi: https://extranet.who.int/rhl/topics/preconception-pregnancy-childbirth-and-postpartum-care/antenatal-care/who-recommendation-daily-oral-iron-and-folic-acid-supplementation.
  • 10. EFSA Panel on Dietetic Products, Nutrition and Allergies), 2014. Scientific Opinion on Dietary Reference Values for folate. EFSA Journal 2014; 12 (11): 3893.
  • 11. Antony AC. In utero physiology: role of folic acid in nutrient delivery and fetal development. The American journal of clinical nutrition. 2007;85(2):598-603.
  • 12. Khan KM, Jialal I. Folic acid (folate) deficiency. StatPearls [Internet]: StatPearls Publishing; 2019.
  • 13. Jing Y, Zheng YZ, Cao LJ, Liu YY, Wen L, Huang GW. Periconceptional folic acid supplementation in Chinese women: a cross-sectional study. Biomedical and Environmental Sciences. 2017;30(10):737-748.
  • 14. Obeid R, Murphy M, Solé-Navais P, Yajnik C. Cobalamin status from pregnancy to early childhood: lessons from global experience. Advances in Nutrition. 2017;8(6):971-979.
  • 15. Aksu H, Sevil Ü, Yurtsev E, Güvendiren G. Nöral tüp defektleri ve folik asit. Maltepe Üniversitesi Hemşirelik Bilim ve Sanat Dergisi. 2010;2:1992.
  • 16. Li K, Wahlqvist ML, Li D. Nutrition, one-carbon metabolism and neural tube defects: a review. Nutrients. 2016;8(11):741.
  • 17. Gaskins AJ, Rich-Edwards JW, Hauser R, Williams PL, Gillman MW, Ginsburg ES, et al. Maternal prepregnancy folate intake and risk of spontaneous abortion and stillbirth. Obstetrics and gynecology. 2014;124(1):23.
  • 18. Forges T, Monnier-Barbarino P, Alberto J, Gueant-Rodriguez R, Daval J, Gueant J. Impact of folate and homocysteine metabolism on human reproductive health. Human reproduction update. 2007;13(3):225-238.
  • 19. Czeizel AE, Vereczkey A, Szabó I. Folic acid in pregnant women associated with reduced prevalence of severe congenital heart defects in their children: a national population-based case–control study. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2015;193:34-39.
  • 20. Mao B, Qiu J, Zhao N, Shao Y, Dai W, He X, et al. Maternal folic acid supplementation and dietary folate intake and congenital heart defects. PloS one. 2017;12(11).
  • 21. Fekete K, Berti C, Cetin I, Hermoso M, Koletzko BV, Decsi T. Perinatal folate supply: relevance in health outcome parameters. Maternal & child nutrition. 2010;6:23-38.
  • 22. Rosenquist TH. Folate, homocysteine and the cardiac neural crest. Developmental Dynamics. 2013;242(3):201-218.
  • 23. Cantarella CD, Ragusa D, Giammanco M, Tosi S. Folate deficiency as predisposing factor for childhood leukaemia: a review of the literature. Genes & nutrition. 2017;12(1):14.
  • 24. Duthie SJ. Folate and cancer: how DNA damage, repair and methylation impact on colon carcinogenesis. Journal of inherited metabolic disease. 2011;34(1):101-109.
  • 25. Figueiredo JC, Grau MV, Haile RW, Sandler RS, Summers RW, Bresalier RS, et al. Folic acid and risk of prostate cancer: results from a randomized clinical trial. Journal of the National Cancer Institute. 2009;101(6):432-435.
  • 26. Charles D, Ness AR, Campbell D, Smith GD, Hall MH. Taking folate in pregnancy and risk of maternal breast cancer. Bmj. 2004;329(7479):1375-1376.
  • 27. Hotz C, Brown KH. International Zinc Nutrition Consultative Group (IZiNCG) technical document 1: assessment of the risk of zinc deficiency in populations and options for its control. 2004.
  • 28. Ghishan FK, Said HM, Wilson PC, Murrell JE, Greene HL. Intestinal transport of zinc and folic acid: a mutual inhibitory effect. The American journal of clinical nutrition. 1986;43(2):258-262.
  • 29. Green TJ, Skeaff CM, Whiting SJ, Gibson RS. Effect of folic acid supplementation on plasma zinc concentrations of young women. Nutrition. 2003;19(6):522-523.
  • 30. Hansen M, Samman S, Madsen LT, Jensen M, Sørensen SS, Sandström B. Folic acid enrichment of bread does not appear to affect zinc absorption in young women. The American journal of clinical nutrition. 2001;74(1):125-129.
  • 31. Smulders Y, Smith D, Kok R, Teerlink T, Swinkels D, Stehouwer C, et al. Cellular folate vitamer distribution during and after correction of vitamin B12 deficiency: a case for the methylfolate trap. British journal of haematology. 2006;132(5):623-629.
  • 32. Cuskelly GJ, Mooney KM, Young IS. Folate and vitamin B 12: friendly or enemy nutrients for the elderly*: Symposium on ‘Micronutrients through the life cycle’. Proceedings of the Nutrition Society. 2007;66(4):548-558.
  • 33. Wiens D, DeSoto MC. Is high folic acid intake a risk factor for autism?—a review. Brain sciences. 2017;7(11):149.
  • 34. Gao Y, Sheng C, Xie R-h, Sun W, Asztalos E, Moddemann D, et al. New perspective on impact of folic acid supplementation during pregnancy on neurodevelopment/autism in the offspring children–a systematic review. PloS one. 2016;11(11).
  • 35. Kiefte-de Jong JC, Timmermans S, Jaddoe VW, Hofman A, Tiemeier H, Steegers EA, et al. High circulating folate and vitamin B-12 concentrations in women during pregnancy are associated with increased prevalence of atopic dermatitis in their offspring. The Journal of nutrition. 2012;142(4):731-738.
  • 36. Li W, Xu B, Cao Y, Shao Y, Wu W, Zhou J, et al. Association of maternal folate intake during pregnancy with infant asthma risk. Scientific reports. 2019;9(1):1-8.
  • 37. Whitrow MJ, Moore VM, Rumbold AR, Davies MJ. Effect of supplemental folic acid in pregnancy on childhood asthma: a prospective birth cohort study. American journal of epidemiology. 2009;170(12):1486-1493.
  • 38. Yang L, Jiang L, Bi M, Jia X, Wang Y, He C, et al. High dose of maternal folic acid supplementation is associated to infant asthma. Food and Chemical Toxicology. 2015;75:88-93.
  • 39. Martinussen MP, Risnes KR, Jacobsen GW, Bracken MB. Folic acid supplementation in early pregnancy and asthma in children aged 6 years. American journal of obstetrics and gynecology. 2012;206(1):1-7.
  • 40. Magdelijns FJ, Mommers M, Penders J, Smits L, Thijs C. Folic acid use in pregnancy and the development of atopy, asthma, and lung function in childhood. Pediatrics. 2011;128(1):135-144.
  • 41. Bekkers MB, Elstgeest LE, Scholtens S, Haveman-Nies A, de Jongste JC, Kerkhof M, et al. Maternal use of folic acid supplements during pregnancy, and childhood respiratory health and atopy. European Respiratory Journal. 2012;39(6):1468-1474.
  • 42. Dunstan J, West C, McCarthy S, Metcalfe J, Meldrum S, Oddy W, et al. The relationship between maternal folate status in pregnancy, cord blood folate levels, and allergic outcomes in early childhood. Allergy. 2012;67(1):50-57.
  • 43. Stabler SP. Vitamin B12 deficiency. New England Journal of Medicine. 2013;368(2):149-60.
  • 44. EFSA Panel on Dietetic Products N, Allergies. Scientific opinion on dietary reference values for cobalamin (vitamin B12). EFSA Journal. 2015;13(7):4150.
  • 45. Simpson JL, Bailey LB, Pietrzik K, Shane B, Holzgreve W. Micronutrients and women of reproductive potential: required dietary intake and consequences of dietary deficiency or excess. Part I–Folate, Vitamin B12, Vitamin B6. The Journal of Maternal-Fetal & Neonatal Medicine. 2010;23(12):1323-1343.
  • 46. Coşkun A, Özdemir Ö. Gebelikte vitamin-mineral kullanımı ve beslenmenin irdelenmesi. Türk Jinekoloji ve Obstetrik Derneği Dergisi. 2009;6(3):155-170.
  • 47. Aslaner H. Vitamin B12 Eksikliği ve Tedavisi. Klinik Tıp Aile Hekimliği.10(6):18-24.
  • 48. Acılmıs YG, Dikensoy E, Kutlar AI, Balat O, Cebesoy FB, Ozturk E, et al. Homocysteine, folic acid and vitamin B12 levels in maternal and umbilical cord plasma and homocysteine levels in placenta in pregnant women with pre‐eclampsia. Journal of Obstetrics and Gynaecology Research. 2011;37(1):45-50.
  • 49. Muthayya S, Dwarkanath P, Mhaskar M, Mhaskar R, Thomas A, Duggan C, et al. The relationship of neonatal serum vitamin B 12 status with birth weight. Asia Pacific journal of clinical nutrition. 2006;15(4).
  • 50. Hogeveen M, Blom HJ, Den Heijer M. Maternal homocysteine and small-for-gestational-age offspring: systematic review and meta-analysis. The American journal of clinical nutrition. 2012;95(1):130-136.
  • 51. Obeid R, Oexle K, Rißmann A, Pietrzik K, Koletzko B. Folate status and health: challenges and opportunities. Journal of perinatal medicine. 2016;44(3):261-268.
  • 52. Puri M, Kaur L, Walia GK, Mukhopadhhyay R, Sachdeva MP, Trivedi SS, et al. MTHFR C677T polymorphism, folate, vitamin B12 and homocysteine in recurrent pregnancy losses: a case control study among North Indian women. Journal of perinatal medicine. 2013;41(5):549-554.
  • 53. Morales-Gutierrez J, Díaz-Cortés S, Montoya-Giraldo MA, Zuluaga AF. Toxicity induced by multiple high doses of vitamin B12 during pernicious anemia treatment: a case report. Clinical Toxicology. 2020;58(2):129-131.
  • 54. World Health Organization/Food and Agriculture Organization (WHO/FAO) Vitamin and mineral requirements in human nutrition: report of a joint FAO/WHO expert consultation, 2004. Erişim Adresi: https://apps.who.int/iris/bitstream/handle/10665/42716/9241546123.pdf?ua=1.
  • 55. Hu L, Zhang Y, Wang X, You L, Xu P, Cui X, et al. Maternal Vitamin D Status and Risk of Gestational Diabetes: a Meta-Analysis. Cell Physiol Biochem. 2018;45(1):291-300.
  • 56. Hollis BW, Johnson D, Hulsey TC, Ebeling M, Wagner CL. Vitamin D supplementation during pregnancy: double‐blind, randomized clinical trial of safety and effectiveness. Journal of bone and mineral research. 2011;26(10):2341-2357.
  • 57. Karras SN, Wagner CL, Castracane VD. Understanding vitamin D metabolism in pregnancy: from physiology to pathophysiology and clinical outcomes. Metabolism. 2018;86:112-23.
  • 58. Amegah AK, Klevor MK, Wagner CL. Maternal vitamin D insufficiency and risk of adverse pregnancy and birth outcomes: a systematic review and meta-analysis of longitudinal studies. PLoS One. 2017;12(3).
  • 59. Arnold DL, Enquobahrie DA, Qiu C, Huang J, Grote N, VanderStoep A, et al. Early pregnancy maternal vitamin D concentrations and risk of gestational diabetes mellitus. Paediatric and perinatal epidemiology. 2015;29(3):200-210.
  • 60. Wang H, Xiao Y, Zhang L, Gao Q. Maternal early pregnancy vitamin D status in relation to low birth weight and small-for-gestational-age offspring. The Journal of steroid biochemistry and molecular biology. 2018;175:146-150.
  • 61. Sørensen IM, Joner G, Jenum PA, Eskild A, Brunborg C, Torjesen PA, et al. Vitamin D‐binding protein and 25‐hydroxyvitamin D during pregnancy in mothers whose children later developed type 1 diabetes. Diabetes/metabolism research and reviews. 2016;32(8):883-890.
  • 62. Gürz AA, İğde FAA, Dikici MF. D Vitamininin Fetal ve Maternal Etkileri. Konuralp Medical Journal/Konuralp Tip Dergisi. 2015;7(1).
  • 63. Rosen CJ, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, et al. IOM committee members respond to Endocrine Society vitamin D guideline. The Journal of Clinical Endocrinology & Metabolism. 2012;97(4):1146-1152.
  • 64. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism. 2011;96(7):1911-1930.
  • 65. Pludowski P, Holick MF, Grant WB, Konstantynowicz J, Mascarenhas MR, Haq A, et al. Vitamin D supplementation guidelines. The Journal of steroid biochemistry and molecular biology. 2018;175:125-35.
  • 66. T.C. Sağlık Bakanlığı. Gebelere D Vitamini Destek Programı 2011. Erişim Adresi: https://www.saglik.gov.tr/TR,11158/gebelere-d-vitamini-destek-programi.html.
  • 67. World Health Organization (WHO). Vitamin D supplementation in pregnant women 2012. Erişim Adresi: http://www.who.int/nutrition/publications/micronutrients/guidelines/vit_d_supp_ pregnant_women/en/.
  • 68. Palacios C, Kostiuk LK, Peña‐Rosas JP. Vitamin D supplementation for women during pregnancy. Cochrane Database of Systematic Reviews. 2019(7).
  • 69. Institute of Medicine (IOM). Vitamin D Fact Sheet for Health Professionals 2010. Erişim Adresi: https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/#en26.
  • 70. Roth DE, Al Mahmud A, Raqib R, Akhtar E, Perumal N, Pezzack B, et al. Randomized placebo-controlled trial of high-dose prenatal third-trimester vitamin D3 supplementation in Bangladesh: the AViDD trial. Nutrition journal. 2013;12(1):47.
  • 71. Enkhmaa D, Tanz L, Ganmaa D, Enkhtur S, Oyun-Erdene B, Stuart J, et al. Randomized trial of three doses of vitamin D to reduce deficiency in pregnant Mongolian women. EBioMedicine. 2019;39:510-519.
  • 72. De‐Regil LM, Palacios C, Lombardo LK, Peña‐Rosas JP. Vitamin D supplementation for women during pregnancy. Cochrane Database of Systematic Reviews. 2016(1).
  • 73. Trofimiuk-Mudlner M, Hubalewska-Dydejczyk A. Iodine deficiency and iodine prophylaxis in pregnancy. Recent patents on endocrine, metabolic & immune drug discovery. 2016;10(2):85-95.
  • 74. Chittimoju SB, Pearce EN. Iodine deficiency and supplementation in pregnancy. Clinical obstetrics and gynecology. 2019;62(2):330-338.
  • 75. Hamrosi MA, Wallace EM, Riley MD. Iodine status in pregnant women living in Melbourne differs by ethnic group. Asia Pacific journal of clinical nutrition. 2005;14(1).
  • 76. Qian M, Wang D, Watkins WE, Gebski V, Yan YQ, Li M, et al. The effects of iodine on intelligence in children: a meta-analysis of studies conducted in China. Asia Pacific journal of clinical nutrition. 2005;14(1):32-42.
  • 77. Zimmermann MB. Iodine deficiency in pregnancy and the effects of maternal iodine supplementation on the offspring: a review. The American journal of clinical nutrition. 2009;89(2):668-672.
  • 78. Hynes KL, Otahal P, Hay I, Burgess JR. Mild iodine deficiency during pregnancy is associated with reduced educational outcomes in the offspring: 9-year follow-up of the gestational iodine cohort. The Journal of Clinical Endocrinology & Metabolism. 2013;98(5):1954-1962.
  • 79. Harding KB, Peña‐Rosas JP, Webster AC, Yap CM, Payne BA, Ota E, et al. Iodine supplementation for women during the preconception, pregnancy and postpartum period. Cochrane Database of Systematic Reviews. 2017(3).
  • 80. Santiago P, Velasco I, Muela JA, Sánchez B, Martínez J, Rodriguez A, et al. Infant neurocognitive development is independent of the use of iodised salt or iodine supplements given during pregnancy. British journal of nutrition. 2013;110(5):831-839.
  • 81. Secretariat W, Andersson M, De Benoist B, Delange F, Zupan J. Prevention and control of iodine deficiency in pregnant and lactating women and in children less than 2-years-old: conclusions and recommendations of the Technical Consultation. Public health nutrition. 2007;10(12A):1606-1611.
  • 82. Leung AM, Pearce EN, Braverman LE. Iodine nutrition in pregnancy and lactation. Endocrinology and Metabolism Clinics. 2011;40(4):765-777.
  • 83. Becker DV, Braverman LE, Delange F, Dunn JT, Franklyn JA, Hollowell JG, et al. Iodine supplementation for pregnancy and lactation—United States and Canada: recommendations of the American Thyroid Association. Thyroid. 2006;16(10):949-951.
  • 84. Murcia M, Rebagliato M, Iniguez C, Lopez-Espinosa M-J, Estarlich M, Plaza B, et al. Effect of iodine supplementation during pregnancy on infant neurodevelopment at 1 year of age. American journal of epidemiology. 2011;173(7):804-812.
  • 85. Rebagliato M, Murcia M, Espada M, Álvarez-Pedrerol M, Bolúmar F, Vioque J, et al. Iodine intake and maternal thyroid function during pregnancy. Epidemiology. 2010:62-9.
  • 86. Zimmermann MB. The adverse effects of mild-to-moderate iodine deficiency during pregnancy and childhood: a review. Thyroid. 2007;17(9):829-835.
  • 87. Velasco I, Carreira M, Santiago P, Muela JA, García-Fuentes E, Sanchez-Munoz B, et al. Effect of iodine prophylaxis during pregnancy on neurocognitive development of children during the first two years of life. The Journal of Clinical Endocrinology & Metabolism. 2009;94(9):3234-3241.
  • 88. Amiri P, Hamzavi Zarghani N, Nazeri P, Ghofranipour F, Karimi M, Amouzegar A, et al. Can an educational intervention improve iodine nutrition status in pregnant women? A randomized controlled trial. Thyroid. 2017;27(3):418-425.
  • 89. Çan G, Ökten A, Green J. The role of local mass media in promoting the consumption of iodized table salt. Health Education Research. 2001;16(5):603-607.
  • 90. Russell R, Beard JL, Cousins RJ, Dunn JT, Ferland G, Hambidge K, et al. Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. A Report of the Panel on Micronutrients, Subcommittees on Upper Reference Levels of Nutrients and of Interpretation and Uses of Dietary Reference Intakes, and the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes Food and Nutrition Board Institute of Medicine. 2001.

Gebelikte Folik Asit, B12 Vitamini, D Vitamini ve İyot Destekleri Kullanmak Gerekli Midir? Olası Riskler

Yıl 2021, , 439 - 447, 01.11.2021
https://doi.org/10.17517/ksutfd.832401

Öz

Gebelik sürecinde artan gereksinimler dolayısıyla; özellikle bazı mikro besin ögelerinin besin desteği olarak alınması ve böylece yetersizlik ile ilişkili risklerinin en aza indirilmesi, maternal ve fetal sağlığın korunmasında büyük öneme sahiptir. Gebelikte, besin ögelerinin ciddi veya orta düzeyde yetersizliğinde, hayat kurtarıcı nitelikte olan destekler; hafif yetersizlik veya maternal depoların yeterli olduğu koşullarda, çeşitli riskleri de beraberinde getirmektedir. Doğumsal anomalilerin önlenmesinde etkisi kanıtlanmış olan folik asitin maternal dönemde fazla alımı durumunda kanserojeniteyi tetikleyebileceği, çinko emilimini olumsuz etkileyebileceği, B12 vitamini eksikliğinin tanısında ve tedavisinde gecikmelere yol açabileceği, çocukluk çağı astım, alerji riski ile ilişkili olabileceği görülmüştür. Eksikliği fetal anomaliler ile ilişkilendirilen bir diğer vitamin olan B12’nin toksik etkisi bildirilmemekle birlikte literatür taramasında fazla alımı durumunda alerjik reaksiyonlar gösteren bir vaka raporuna rastlanmıştır. Yenidoğan hipokalsemisi ve raşitizmin önlenmesinde etkili D vitamini desteğinin fazla alımı teratojen etki gösterebilir. İyot yetersizliği ile ilişkili kretenizm gibi hastalıkların önlenmesinde etkili olan iyot desteğinin fazla alımının gebenin tiroid disfonksiyonuna, gebelikteki subklinik ve aşikâr hipotiroidizm prevalansında artışa yol açabileceği ve bebeğin psikomotor gelişimini olumsuz etkileyebileceği belirtilmiştir. Gebelikte önerilen dozlarda besin desteklerinin kullanımı uygundur ancak yetersizliğin önlenmesi kadar fazla alım konusunda da dikkatli olunmalıdır. Bu derlemede; gebelikte yaygın olarak kullanılan folik asit, B12 vitamini, D vitamini ve iyot besin desteklerinin fazla alımına ilişkin riskler tartışılmıştır.

Kaynakça

  • 1. Richard K, Holland O, Landers K, Vanderlelie JJ, Hofstee P, Cuffe JS, et al. Effects of maternal micronutrient supplementation on placental function. Placenta. 2017;54:38-44.
  • 2. Gernand AD, Schulze KJ, Stewart CP, West Jr KP, Christian P. Micronutrient deficiencies in pregnancy worldwide: health effects and prevention. Nature Reviews Endocrinology. 2016;12(5):274.
  • 3. Berti C, Biesalski H, Gärtner R, Lapillonne A, Pietrzik K, Poston L, et al. Micronutrients in pregnancy: current knowledge and unresolved questions. Clinical nutrition. 2011;30(6):689-701.
  • 4. Christian P, Stewart CP. Maternal micronutrient deficiency, fetal development, and the risk of chronic disease. The Journal of nutrition. 2010;140(3):437-445.
  • 5. Ho A, Flynn AC, Pasupathy D. Nutrition in pregnancy. Obstetrics, Gynaecology & Reproductive Medicine. 2016;26(9):259-264.
  • 6. Procter SB, Campbell CG. Position of the Academy of Nutrition and Dietetics: nutrition and lifestyle for a healthy pregnancy outcome. Journal of the Academy of Nutrition and Dietetics. 2014;114(7):1099-1103.
  • 7. Plećaš D, Plešinac S, Kontić-Vučinić O. Nutrition in pregnancy: basic principles and recommendations. Srpski arhiv za celokupno lekarstvo. 2014;142(1-2):125-130.
  • 8. T.C. Sağlık Bakanlığı. Türkiye Beslenme Rehberi (TÜBER): T.C. Sağlık Bakanlığı, Türkiye Halk Sağlığı Kurumu, 2015. Erişim Adresi: https://dosyasb.saglik.gov.tr/Eklenti/10915,tuber-turkiye-beslenme-rehberipdf.pdf.
  • 9. World Health Organization (WHO). WHO recommendation on daily oral iron and folic acid supplementation 2016. Erişim Adresi: https://extranet.who.int/rhl/topics/preconception-pregnancy-childbirth-and-postpartum-care/antenatal-care/who-recommendation-daily-oral-iron-and-folic-acid-supplementation.
  • 10. EFSA Panel on Dietetic Products, Nutrition and Allergies), 2014. Scientific Opinion on Dietary Reference Values for folate. EFSA Journal 2014; 12 (11): 3893.
  • 11. Antony AC. In utero physiology: role of folic acid in nutrient delivery and fetal development. The American journal of clinical nutrition. 2007;85(2):598-603.
  • 12. Khan KM, Jialal I. Folic acid (folate) deficiency. StatPearls [Internet]: StatPearls Publishing; 2019.
  • 13. Jing Y, Zheng YZ, Cao LJ, Liu YY, Wen L, Huang GW. Periconceptional folic acid supplementation in Chinese women: a cross-sectional study. Biomedical and Environmental Sciences. 2017;30(10):737-748.
  • 14. Obeid R, Murphy M, Solé-Navais P, Yajnik C. Cobalamin status from pregnancy to early childhood: lessons from global experience. Advances in Nutrition. 2017;8(6):971-979.
  • 15. Aksu H, Sevil Ü, Yurtsev E, Güvendiren G. Nöral tüp defektleri ve folik asit. Maltepe Üniversitesi Hemşirelik Bilim ve Sanat Dergisi. 2010;2:1992.
  • 16. Li K, Wahlqvist ML, Li D. Nutrition, one-carbon metabolism and neural tube defects: a review. Nutrients. 2016;8(11):741.
  • 17. Gaskins AJ, Rich-Edwards JW, Hauser R, Williams PL, Gillman MW, Ginsburg ES, et al. Maternal prepregnancy folate intake and risk of spontaneous abortion and stillbirth. Obstetrics and gynecology. 2014;124(1):23.
  • 18. Forges T, Monnier-Barbarino P, Alberto J, Gueant-Rodriguez R, Daval J, Gueant J. Impact of folate and homocysteine metabolism on human reproductive health. Human reproduction update. 2007;13(3):225-238.
  • 19. Czeizel AE, Vereczkey A, Szabó I. Folic acid in pregnant women associated with reduced prevalence of severe congenital heart defects in their children: a national population-based case–control study. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2015;193:34-39.
  • 20. Mao B, Qiu J, Zhao N, Shao Y, Dai W, He X, et al. Maternal folic acid supplementation and dietary folate intake and congenital heart defects. PloS one. 2017;12(11).
  • 21. Fekete K, Berti C, Cetin I, Hermoso M, Koletzko BV, Decsi T. Perinatal folate supply: relevance in health outcome parameters. Maternal & child nutrition. 2010;6:23-38.
  • 22. Rosenquist TH. Folate, homocysteine and the cardiac neural crest. Developmental Dynamics. 2013;242(3):201-218.
  • 23. Cantarella CD, Ragusa D, Giammanco M, Tosi S. Folate deficiency as predisposing factor for childhood leukaemia: a review of the literature. Genes & nutrition. 2017;12(1):14.
  • 24. Duthie SJ. Folate and cancer: how DNA damage, repair and methylation impact on colon carcinogenesis. Journal of inherited metabolic disease. 2011;34(1):101-109.
  • 25. Figueiredo JC, Grau MV, Haile RW, Sandler RS, Summers RW, Bresalier RS, et al. Folic acid and risk of prostate cancer: results from a randomized clinical trial. Journal of the National Cancer Institute. 2009;101(6):432-435.
  • 26. Charles D, Ness AR, Campbell D, Smith GD, Hall MH. Taking folate in pregnancy and risk of maternal breast cancer. Bmj. 2004;329(7479):1375-1376.
  • 27. Hotz C, Brown KH. International Zinc Nutrition Consultative Group (IZiNCG) technical document 1: assessment of the risk of zinc deficiency in populations and options for its control. 2004.
  • 28. Ghishan FK, Said HM, Wilson PC, Murrell JE, Greene HL. Intestinal transport of zinc and folic acid: a mutual inhibitory effect. The American journal of clinical nutrition. 1986;43(2):258-262.
  • 29. Green TJ, Skeaff CM, Whiting SJ, Gibson RS. Effect of folic acid supplementation on plasma zinc concentrations of young women. Nutrition. 2003;19(6):522-523.
  • 30. Hansen M, Samman S, Madsen LT, Jensen M, Sørensen SS, Sandström B. Folic acid enrichment of bread does not appear to affect zinc absorption in young women. The American journal of clinical nutrition. 2001;74(1):125-129.
  • 31. Smulders Y, Smith D, Kok R, Teerlink T, Swinkels D, Stehouwer C, et al. Cellular folate vitamer distribution during and after correction of vitamin B12 deficiency: a case for the methylfolate trap. British journal of haematology. 2006;132(5):623-629.
  • 32. Cuskelly GJ, Mooney KM, Young IS. Folate and vitamin B 12: friendly or enemy nutrients for the elderly*: Symposium on ‘Micronutrients through the life cycle’. Proceedings of the Nutrition Society. 2007;66(4):548-558.
  • 33. Wiens D, DeSoto MC. Is high folic acid intake a risk factor for autism?—a review. Brain sciences. 2017;7(11):149.
  • 34. Gao Y, Sheng C, Xie R-h, Sun W, Asztalos E, Moddemann D, et al. New perspective on impact of folic acid supplementation during pregnancy on neurodevelopment/autism in the offspring children–a systematic review. PloS one. 2016;11(11).
  • 35. Kiefte-de Jong JC, Timmermans S, Jaddoe VW, Hofman A, Tiemeier H, Steegers EA, et al. High circulating folate and vitamin B-12 concentrations in women during pregnancy are associated with increased prevalence of atopic dermatitis in their offspring. The Journal of nutrition. 2012;142(4):731-738.
  • 36. Li W, Xu B, Cao Y, Shao Y, Wu W, Zhou J, et al. Association of maternal folate intake during pregnancy with infant asthma risk. Scientific reports. 2019;9(1):1-8.
  • 37. Whitrow MJ, Moore VM, Rumbold AR, Davies MJ. Effect of supplemental folic acid in pregnancy on childhood asthma: a prospective birth cohort study. American journal of epidemiology. 2009;170(12):1486-1493.
  • 38. Yang L, Jiang L, Bi M, Jia X, Wang Y, He C, et al. High dose of maternal folic acid supplementation is associated to infant asthma. Food and Chemical Toxicology. 2015;75:88-93.
  • 39. Martinussen MP, Risnes KR, Jacobsen GW, Bracken MB. Folic acid supplementation in early pregnancy and asthma in children aged 6 years. American journal of obstetrics and gynecology. 2012;206(1):1-7.
  • 40. Magdelijns FJ, Mommers M, Penders J, Smits L, Thijs C. Folic acid use in pregnancy and the development of atopy, asthma, and lung function in childhood. Pediatrics. 2011;128(1):135-144.
  • 41. Bekkers MB, Elstgeest LE, Scholtens S, Haveman-Nies A, de Jongste JC, Kerkhof M, et al. Maternal use of folic acid supplements during pregnancy, and childhood respiratory health and atopy. European Respiratory Journal. 2012;39(6):1468-1474.
  • 42. Dunstan J, West C, McCarthy S, Metcalfe J, Meldrum S, Oddy W, et al. The relationship between maternal folate status in pregnancy, cord blood folate levels, and allergic outcomes in early childhood. Allergy. 2012;67(1):50-57.
  • 43. Stabler SP. Vitamin B12 deficiency. New England Journal of Medicine. 2013;368(2):149-60.
  • 44. EFSA Panel on Dietetic Products N, Allergies. Scientific opinion on dietary reference values for cobalamin (vitamin B12). EFSA Journal. 2015;13(7):4150.
  • 45. Simpson JL, Bailey LB, Pietrzik K, Shane B, Holzgreve W. Micronutrients and women of reproductive potential: required dietary intake and consequences of dietary deficiency or excess. Part I–Folate, Vitamin B12, Vitamin B6. The Journal of Maternal-Fetal & Neonatal Medicine. 2010;23(12):1323-1343.
  • 46. Coşkun A, Özdemir Ö. Gebelikte vitamin-mineral kullanımı ve beslenmenin irdelenmesi. Türk Jinekoloji ve Obstetrik Derneği Dergisi. 2009;6(3):155-170.
  • 47. Aslaner H. Vitamin B12 Eksikliği ve Tedavisi. Klinik Tıp Aile Hekimliği.10(6):18-24.
  • 48. Acılmıs YG, Dikensoy E, Kutlar AI, Balat O, Cebesoy FB, Ozturk E, et al. Homocysteine, folic acid and vitamin B12 levels in maternal and umbilical cord plasma and homocysteine levels in placenta in pregnant women with pre‐eclampsia. Journal of Obstetrics and Gynaecology Research. 2011;37(1):45-50.
  • 49. Muthayya S, Dwarkanath P, Mhaskar M, Mhaskar R, Thomas A, Duggan C, et al. The relationship of neonatal serum vitamin B 12 status with birth weight. Asia Pacific journal of clinical nutrition. 2006;15(4).
  • 50. Hogeveen M, Blom HJ, Den Heijer M. Maternal homocysteine and small-for-gestational-age offspring: systematic review and meta-analysis. The American journal of clinical nutrition. 2012;95(1):130-136.
  • 51. Obeid R, Oexle K, Rißmann A, Pietrzik K, Koletzko B. Folate status and health: challenges and opportunities. Journal of perinatal medicine. 2016;44(3):261-268.
  • 52. Puri M, Kaur L, Walia GK, Mukhopadhhyay R, Sachdeva MP, Trivedi SS, et al. MTHFR C677T polymorphism, folate, vitamin B12 and homocysteine in recurrent pregnancy losses: a case control study among North Indian women. Journal of perinatal medicine. 2013;41(5):549-554.
  • 53. Morales-Gutierrez J, Díaz-Cortés S, Montoya-Giraldo MA, Zuluaga AF. Toxicity induced by multiple high doses of vitamin B12 during pernicious anemia treatment: a case report. Clinical Toxicology. 2020;58(2):129-131.
  • 54. World Health Organization/Food and Agriculture Organization (WHO/FAO) Vitamin and mineral requirements in human nutrition: report of a joint FAO/WHO expert consultation, 2004. Erişim Adresi: https://apps.who.int/iris/bitstream/handle/10665/42716/9241546123.pdf?ua=1.
  • 55. Hu L, Zhang Y, Wang X, You L, Xu P, Cui X, et al. Maternal Vitamin D Status and Risk of Gestational Diabetes: a Meta-Analysis. Cell Physiol Biochem. 2018;45(1):291-300.
  • 56. Hollis BW, Johnson D, Hulsey TC, Ebeling M, Wagner CL. Vitamin D supplementation during pregnancy: double‐blind, randomized clinical trial of safety and effectiveness. Journal of bone and mineral research. 2011;26(10):2341-2357.
  • 57. Karras SN, Wagner CL, Castracane VD. Understanding vitamin D metabolism in pregnancy: from physiology to pathophysiology and clinical outcomes. Metabolism. 2018;86:112-23.
  • 58. Amegah AK, Klevor MK, Wagner CL. Maternal vitamin D insufficiency and risk of adverse pregnancy and birth outcomes: a systematic review and meta-analysis of longitudinal studies. PLoS One. 2017;12(3).
  • 59. Arnold DL, Enquobahrie DA, Qiu C, Huang J, Grote N, VanderStoep A, et al. Early pregnancy maternal vitamin D concentrations and risk of gestational diabetes mellitus. Paediatric and perinatal epidemiology. 2015;29(3):200-210.
  • 60. Wang H, Xiao Y, Zhang L, Gao Q. Maternal early pregnancy vitamin D status in relation to low birth weight and small-for-gestational-age offspring. The Journal of steroid biochemistry and molecular biology. 2018;175:146-150.
  • 61. Sørensen IM, Joner G, Jenum PA, Eskild A, Brunborg C, Torjesen PA, et al. Vitamin D‐binding protein and 25‐hydroxyvitamin D during pregnancy in mothers whose children later developed type 1 diabetes. Diabetes/metabolism research and reviews. 2016;32(8):883-890.
  • 62. Gürz AA, İğde FAA, Dikici MF. D Vitamininin Fetal ve Maternal Etkileri. Konuralp Medical Journal/Konuralp Tip Dergisi. 2015;7(1).
  • 63. Rosen CJ, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, et al. IOM committee members respond to Endocrine Society vitamin D guideline. The Journal of Clinical Endocrinology & Metabolism. 2012;97(4):1146-1152.
  • 64. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism. 2011;96(7):1911-1930.
  • 65. Pludowski P, Holick MF, Grant WB, Konstantynowicz J, Mascarenhas MR, Haq A, et al. Vitamin D supplementation guidelines. The Journal of steroid biochemistry and molecular biology. 2018;175:125-35.
  • 66. T.C. Sağlık Bakanlığı. Gebelere D Vitamini Destek Programı 2011. Erişim Adresi: https://www.saglik.gov.tr/TR,11158/gebelere-d-vitamini-destek-programi.html.
  • 67. World Health Organization (WHO). Vitamin D supplementation in pregnant women 2012. Erişim Adresi: http://www.who.int/nutrition/publications/micronutrients/guidelines/vit_d_supp_ pregnant_women/en/.
  • 68. Palacios C, Kostiuk LK, Peña‐Rosas JP. Vitamin D supplementation for women during pregnancy. Cochrane Database of Systematic Reviews. 2019(7).
  • 69. Institute of Medicine (IOM). Vitamin D Fact Sheet for Health Professionals 2010. Erişim Adresi: https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/#en26.
  • 70. Roth DE, Al Mahmud A, Raqib R, Akhtar E, Perumal N, Pezzack B, et al. Randomized placebo-controlled trial of high-dose prenatal third-trimester vitamin D3 supplementation in Bangladesh: the AViDD trial. Nutrition journal. 2013;12(1):47.
  • 71. Enkhmaa D, Tanz L, Ganmaa D, Enkhtur S, Oyun-Erdene B, Stuart J, et al. Randomized trial of three doses of vitamin D to reduce deficiency in pregnant Mongolian women. EBioMedicine. 2019;39:510-519.
  • 72. De‐Regil LM, Palacios C, Lombardo LK, Peña‐Rosas JP. Vitamin D supplementation for women during pregnancy. Cochrane Database of Systematic Reviews. 2016(1).
  • 73. Trofimiuk-Mudlner M, Hubalewska-Dydejczyk A. Iodine deficiency and iodine prophylaxis in pregnancy. Recent patents on endocrine, metabolic & immune drug discovery. 2016;10(2):85-95.
  • 74. Chittimoju SB, Pearce EN. Iodine deficiency and supplementation in pregnancy. Clinical obstetrics and gynecology. 2019;62(2):330-338.
  • 75. Hamrosi MA, Wallace EM, Riley MD. Iodine status in pregnant women living in Melbourne differs by ethnic group. Asia Pacific journal of clinical nutrition. 2005;14(1).
  • 76. Qian M, Wang D, Watkins WE, Gebski V, Yan YQ, Li M, et al. The effects of iodine on intelligence in children: a meta-analysis of studies conducted in China. Asia Pacific journal of clinical nutrition. 2005;14(1):32-42.
  • 77. Zimmermann MB. Iodine deficiency in pregnancy and the effects of maternal iodine supplementation on the offspring: a review. The American journal of clinical nutrition. 2009;89(2):668-672.
  • 78. Hynes KL, Otahal P, Hay I, Burgess JR. Mild iodine deficiency during pregnancy is associated with reduced educational outcomes in the offspring: 9-year follow-up of the gestational iodine cohort. The Journal of Clinical Endocrinology & Metabolism. 2013;98(5):1954-1962.
  • 79. Harding KB, Peña‐Rosas JP, Webster AC, Yap CM, Payne BA, Ota E, et al. Iodine supplementation for women during the preconception, pregnancy and postpartum period. Cochrane Database of Systematic Reviews. 2017(3).
  • 80. Santiago P, Velasco I, Muela JA, Sánchez B, Martínez J, Rodriguez A, et al. Infant neurocognitive development is independent of the use of iodised salt or iodine supplements given during pregnancy. British journal of nutrition. 2013;110(5):831-839.
  • 81. Secretariat W, Andersson M, De Benoist B, Delange F, Zupan J. Prevention and control of iodine deficiency in pregnant and lactating women and in children less than 2-years-old: conclusions and recommendations of the Technical Consultation. Public health nutrition. 2007;10(12A):1606-1611.
  • 82. Leung AM, Pearce EN, Braverman LE. Iodine nutrition in pregnancy and lactation. Endocrinology and Metabolism Clinics. 2011;40(4):765-777.
  • 83. Becker DV, Braverman LE, Delange F, Dunn JT, Franklyn JA, Hollowell JG, et al. Iodine supplementation for pregnancy and lactation—United States and Canada: recommendations of the American Thyroid Association. Thyroid. 2006;16(10):949-951.
  • 84. Murcia M, Rebagliato M, Iniguez C, Lopez-Espinosa M-J, Estarlich M, Plaza B, et al. Effect of iodine supplementation during pregnancy on infant neurodevelopment at 1 year of age. American journal of epidemiology. 2011;173(7):804-812.
  • 85. Rebagliato M, Murcia M, Espada M, Álvarez-Pedrerol M, Bolúmar F, Vioque J, et al. Iodine intake and maternal thyroid function during pregnancy. Epidemiology. 2010:62-9.
  • 86. Zimmermann MB. The adverse effects of mild-to-moderate iodine deficiency during pregnancy and childhood: a review. Thyroid. 2007;17(9):829-835.
  • 87. Velasco I, Carreira M, Santiago P, Muela JA, García-Fuentes E, Sanchez-Munoz B, et al. Effect of iodine prophylaxis during pregnancy on neurocognitive development of children during the first two years of life. The Journal of Clinical Endocrinology & Metabolism. 2009;94(9):3234-3241.
  • 88. Amiri P, Hamzavi Zarghani N, Nazeri P, Ghofranipour F, Karimi M, Amouzegar A, et al. Can an educational intervention improve iodine nutrition status in pregnant women? A randomized controlled trial. Thyroid. 2017;27(3):418-425.
  • 89. Çan G, Ökten A, Green J. The role of local mass media in promoting the consumption of iodized table salt. Health Education Research. 2001;16(5):603-607.
  • 90. Russell R, Beard JL, Cousins RJ, Dunn JT, Ferland G, Hambidge K, et al. Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. A Report of the Panel on Micronutrients, Subcommittees on Upper Reference Levels of Nutrients and of Interpretation and Uses of Dietary Reference Intakes, and the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes Food and Nutrition Board Institute of Medicine. 2001.
Toplam 90 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Derlemeler
Yazarlar

Hilal Şimşek 0000-0002-2744-1610

Yasemin Karaağaç 0000-0002-2757-2485

Esra Tunçer 0000-0001-7151-842X

Hülya Yardımcı 0000-0002-2664-4176

Yayımlanma Tarihi 1 Kasım 2021
Gönderilme Tarihi 28 Kasım 2020
Kabul Tarihi 30 Ocak 2021
Yayımlandığı Sayı Yıl 2021

Kaynak Göster

AMA Şimşek H, Karaağaç Y, Tunçer E, Yardımcı H. Gebelikte Folik Asit, B12 Vitamini, D Vitamini ve İyot Destekleri Kullanmak Gerekli Midir? Olası Riskler. KSÜ Tıp Fak Der. Kasım 2021;16(3):439-447. doi:10.17517/ksutfd.832401