THE ASSOCIATION OF DEFICIENCY

MICRONUTRIENTS IN PREGNANCY
AND EUGR

dr. Monica Damayani S.

dr. Arevia Mega

JUNIOR PERINA JUNI 2021

Iodine
• Iodine deficiency:
– cretinism in children
– changes in brain development that can lead to reduced mental activity
– cognitive and motor performance, showing a drop of 6.9 to 10.2 IQ points
– reduced results of alphabetization (orthography, grammar, and reading) at
9 years of age, and this persisted throughout adolescence
• Breast milk during the first 6 months of a newborn’s life is the only source of
iodine available.
• Thyroid hormones are involved in growth and development of the brain and
central nervous system from the 15th week of pregnancy onwards until 3
years of age
Selenium
• Deficiency:
– increased susceptibility to oxidative stress (retinopathy, bronchopulmonary
dysplasia, and other lung disorders)
• Excess (selenosis:above 400 µg/day): trigger cardiovascular problems,
dyslipidemias, and insulin resistance, vomiting, diarrhea, neuronal disorders,
hair loss, and infertility
Iron
• Function:
– synaptogenesis
– synthesis of neurotransmitters (e.g., dopamine, serotonin, and
noradrenalin)
– synthesis of neurotrophin
– myelinization → delayed development, reduced school performance,
behavioral disorders, ADHD, and risk of cerebrovascular accident (CVA) in
healthy young children
• The lower its available content, the more severe the damage and irreversible
• Excess:
– impair the absorption of other minerals such as copper and zinc, as it acts
directly on their transporters, so it is important to check iron
concentrations when it is supplemented
• For newborns, exclusive breastfeeding is recommended until 6 months
• Iron-deficient and obese children can develop neurodegenerative diseases
due to elevation of hepcidin, a protein regulator of iron, that is required for the
adequate functioning of neurons, and it is necessary for insulin and its
receptor signal in the brain system
Zinc
• Deficiency
– reduced natural barrier functions of the skin and mucosas
– deleterious effects on the immune system
– increased morbidity at birth
– increased severity of infectious diseases, stunted growth, and
physiological alterations (anorexia, hypogonadism, hypogeusia (reduced
sense of taste), dermatitis, dysfunctions of the immune system, and
oxidative and neuropsychological damages)
– diarrheic manifestations and predisposition to fever convulsions in children
between 6 days and 6 months of age
Calcium
• Deficiency:
– higher risk of nutritional rickets
– hypovitaminosis D, presenting pain, deformity, and fractures throughout
life that may persist through adolescence and adulthood
– Metabolic Bone Disease (MBD) is a disorder commonly observed in
newborn with very low weight (weight at birth <1.500 g), with a higher
incidence in those with extremely low weight (<1.000 g)
Magnesium
• Deficiency:
– Hypoparathyroidism, hypocalcemia, and impaired bone growth in children
• The effectiveness and safety of pre-natal Mg supplementation in the
prevention of brain paralysis → The recommended dose is 30–80 mg/day
• Mg supplementation → as an obligatory part of handling premature births
 CONCLUSION
• In the second and third trimesters of pregnancy, there is a
reserve of nutrients in the fetus that can be used after
birth
• In this phase, until the child is 3 years of age, there is
growth and development of the brain and central nervous
system, which is why there are many problems
associated with brain function under nutritional deficit,
such as hyperactivity, attention deficit, autism, speech
delay, and memory problems
THANK YOU