Nutrition in Pregnancy: A Comparative Review of Major Guidelines

Importance: Nutrition patterns in pregnancy play a decisive role in the well-being of the mother and the fetus. Objective: The aim of this review was to summarize and compare guidelines and recommendations on nutrition in pregnancy. Evidence Acquisition: A descriptive review of major guidelines on antenatal nutrition was conducted, including the most recently published guidelines, namely, by the Australian Government Department of Health (2018); the Canadian Nutrition Working Group and Society of Obstetricians and Gynaecologists of Canada (2016); the World Health Organization (2016); the Institute of Obstetricians and Gynaecologists, Royal College of Physicians of Ireland (2016); the International Federation of Gynecology and Obstetrics (2015); the Academy of Nutrition and Dietetics (2014); and the National Institute for Health and Care Excellence (2008). Results: There is almost universal agreement regarding macronutrient requirements during pregnancy. The WHO, FIGO, and the NICE guidelines make no recommendation on fluid intake. Almost all guidelines state that weight gain during pregnancy should be closely monitored. Folic acid supplementation is universally recommended from the preconception period, but there are controversies regarding other vitamins' supplementation. Multiple micronutrient supplementation could be an option in specific settings according only to the FIGO. Probiotics are not routinely recommended in pregnancy. Conclusions: There is wide agreement among the reviewed guidelines regarding nutrition in pregnancy, but still there are controversies. Evaluation and classification of influential guidelines can be beneficial for establishing a universal consensus on nutrition during pregnancy, in order to achieve more favorable perinatal outcomes. Target Audience: Obstetricians and gynecologists, family physicians Learning Objectives: After participating in this activity, the learner should be better able to identify all aspects of recommended macronutrients intake during pregnancy; assess the need for vitamin supplementation in pregnancy; and describe potential micronutrient supplementation in the antenatal period, in order to achieve a favorable perinatal outcome.