The impact of folate supplementation in pregnancy on neonatal immune parameters and infective outcomes has not been investigated. life nutrition on biochemical immune markers and clinical infectious diseases outcomes in neonates. Potential Mechanisms for Nutritional MM-102 TFA Influences on the Developing Neonatal Immune System Studies in older children and adults have demonstrated the important influence that different nutrients have on the immune system. These effects, and the impacts of deficiencies on susceptibility to infectious diseases, are summarized in Table ?Table1.1. Although the influence of nutrients on the developing immune system and in early neonatal life may be similar to that of older children and adults, the impact of the nutritional state of MM-102 TFA the mother on the neonatal immune system is less well described. Table 1 Nutrients and their effects on immunity. effects on the hypothalamicCpituitaryCadrenal (HPA) axis (see below). actions on its own HPA axis. would impact on the neonatal immune system. Studies in animals support a link between maternal macro/micronutrient deficiency and reduced thymic size and function (86C88), which may not be fully reversible by later improvements in nutrition (89). is difficult to assess. A recent systematic review of vitamin D supplementation in pregnancy and early life did not show any reduction in the risk of persistent wheeze, eczema, or asthma, though the quality of available evidence was Mouse monoclonal to LSD1/AOF2 low (174). Vitamin A Vitamin A deficiency is associated with increased susceptibility particularly to diarrhea, respiratory infections, and measles (27). Infants born to mothers with low serum retinol had increased all-cause neonatal mortality in a study in Malawi (175). Nepali infants MM-102 TFA born to mothers with xeropthalmia (the clinical manifestation of severe vitamin A deficiency) had a 63% increased mortality within the first 6?months of life, which was reduced following maternal supplementation (176). However, large randomized controlled trials of vitamin A supplementation including more than 310,000 motherCinfant pairs have failed to show benefits for perinatal and all-cause neonatal mortality on systematic MM-102 TFA review, despite reductions in maternal night-blindness and possible reductions in maternal infections (177). There is some evidence, though, that vitamin A supplementation of women may lead to long-term enhancement of natural antibody levels in offspring, perhaps acting through impacts on early lymphopoiesis (178). This suggests that long-term alterations to the neonatal immune system may occur following vitamin A supplementation, but that more sensitive outcome measures are required to identify these changes than all-cause neonatal mortality. Iron Fetal iron acquisition occurs actively across the placenta, mainly in the last trimester of pregnancy, and is highly regulated (179, 180). Direct correlations between maternal and fetal iron status are not consistently seen, as neonatal iron levels are likely to be preserved at the expense of maternal stores, but severe maternal anemia is associated with reductions in neonatal iron (181). Iron deficiency is thought to be the most prevalent micronutrient deficiency worldwide (182). It occurs particularly in low-income countries where diets tend to be low in absorbable iron and parasitic burden can be high. Systematic reviews support the use of daily or intermittent iron supplementation during pregnancy for improvement of maternal iron status and reduction in anemia (182, 183). However, no evidence for improvements in other maternal or neonatal outcomes has been found. There is a current paucity of evidence regarding specific impacts, whether beneficial or detrimental, of maternal oral iron supplementation on neonatal infection risks (184). Similarly, studies investigating a direct impact of fetal iron status on immune system ontogeny are lacking. B-Vitamins, Including Folic Acid Folate (vitamin B9) has been widely studied as a pregnancy supplement, due to its role in the reduction of neural-tube defects. A systematic review of 31 studies, mainly carried out in Europe in the 1960s and 1970s, showed a modest increase in birth weight (136?g) following MM-102 TFA maternal folate supplementation, but no reduction in preterm birth, still-birth, or neonatal death (all cause) (185). The impact of folate supplementation in pregnancy on neonatal immune parameters and infective outcomes has not been investigated. More recently, concerns have been raised that folate supplementation given beyond the first.