Exploring the Impact of Maternal Multi-Nutrient Deficiencies on Fetal Growth: Insights from a Primary Care Pregnancy Cohort
Keywords:
Multi-Nutrient Deficiencies, Fetal Growth, Maternal Nutrition, Supplementation Types, Calcium IntakeAbstract
OBJECTIVE: This study aims to examine the impact of nutritional deficiencies during pregnancy on fetal development by analyzing the relationship between nutritional status and prenatal fetal development.
METHODOLOGY: This cohort design study was conducted from April to August 2025 with a sample of 92 pregnant women from all health centres in Bogor City Indonesia. The purposive sampling technique was used to determine the sample with strict inclusion and exclusion criteria. The study variables were maternal age, body mass index, and estimated fetal weight. Several tests were used for data analysis, including ANOVA, the Kruskal–Wallis test, and linear regression.
RESULTS: The findings revealed significant differences in calcium intake (82.6%), iron (91.3%), and protein (54.3%). Between the MMA and IFA groups, there was a significant difference in calcium intake, with p-values of 0.033 and 0.024, respectively. These findings confirm that calcium intake is crucial for fetal growth. Further analysis showed that fetal weight increased significantly in the MMS group, with a ? value of 3383.64 and a p-value of 0.027.
CONCLUSION: This study confirms that calcium has a crucial role in fetal development, especially in the MMS group.
References
1. Uta M, Neamtu R, Bernad E, Mocanu AG, Gluhovschi A, Popescu A et al. The Influence of Nutritional Supplementation for Iron Deficiency Anemia on Pregnancies Associated with Sars-Cov-2 Infection. Nutrients. 2022 Feb 16; 14(4): 1–11.
2. Tan J, He G, Qi Y, Yang H, Xiong Y, Liu C et al. Prevalence of Anemia and Iron Deficiency Anemia in Chinese Pregnant Women (Iron Women): A National Cross-Sectional Survey. BMC Pregnancy Childbirth. 2020 Dec 7; 20(1): 1–12.
3. Arum P, Nurmawati I, Muna N, Muflihatin I, Mudiono Drp, Wicaksono Ap. Comparison of Mother's and Toddler's Characteristics Based on the Nutritional Status of the Toddler. Int J Health Info Syst. 2023 Jul 1; 1(2): 63–9.
4. Fatima N, Yaqoob S, Rana L, Imtiaz A, Iqbal Mj, Bashir Z et al. Micro-Nutrient Sufficiency in Mothers and Babies: Management of Deficiencies while Avoiding Overload During Pregnancy. Front Nutr. 2025; 12: 1476672.
5. Tefera Aa, Seifu D, Menon Mk, Talargia F, Belete Am. Red Blood Cell Folate Level and Associated Factors of Folate Insufficiency among Pregnant Women attending Antenatal Care During their First Trimester of Pregnancy in Addis Ababa, Ethiopia. Sage Open Med. 2022; 10: 20503121221118987.
6. Yang L, Wang W, Mao B, Qiu J, Guo H, Yi B et al. Maternal Folic Acid Supplementation, Dietary Folate Intake and Low Birth Weight: A Birth Cohort Study. Front Public Health. 2022; 10: 844150.
7. Mégier C, Dumery G, Luton D. Iodine and Thyroid Maternal and Fetal Metabolism During Pregnancy. Metabolites. 2023; 13(5): 633.
8. Li J, He Y, Ren B, Zhang Z, Meng F, Zhang X et al. The Thyroid Condition and Residual Clinical Signs in 31 Existing Endemic Neurological Cretins after 42 Years of Iodine Supplementation in China. Front Endocrinol (Lausanne). 2022; 13: 911487.
9. Kabahenda Mk, Stoecker Bj. Associations Between Maternal Dietary Intake And Nutritional Status With Fetal Growth at 14 to 26 Weeks Gestation: A Cross- Sectional Study. BMC Nutr. 2024 May 23; 10(1): 1–11.
10. Asrul Irawan Am, Yusuf Am, Harna H, Aulia A, Denaneer K, Orchidhea Kr. Maternal Characteristics and Iron Intake as a Factors of Iron Deficiency Anemia Among Pregnant Women. Int J Curr Sci Res Rev. 2024 Nov 16; 07(11): 8423–8.
11. Businge Cb, Longo-Mbenza B, Kengne Ap. Iodine Nutrition Status in Africa: Potentially High Prevalence of Iodine Deficiency in Pregnancy, even in Countries Classified as Iodine Sufficient. Public Health Nutr. 2021 Aug 3; 24(12): 3581–6.
12. Rizkia M, Ardhia D, Sari Rp. The Knowledge and Behavior of Pregnant Women in Nutrition Fulfillment: The Correlational Study. Babali Nurs Res. 2023 Oct 31; 4(4): 584–95.
13. Katenga-Kaunda LZ, Kamudoni PR, Holmboe-Ottesen G, Fjeld HE, Mdala I, Shi Z et al. Enhancing Nutrition Knowledge and Dietary Diversity among Rural Pregnant Women in Malawi: A Randomized Controlled Trial. BMC Pregnancy Childbirth. 2021 Dec 22; 21(1): 644–53.
14. Anelli Gm, Parisi F, Sarno L, Fornaciari O, Carlea A, Coco C et al. Associations Between Maternal Dietary Patterns, Biomarkers, and Delivery Outcomes In Healthy Singleton Pregnancies: Multicenter Italian Gift Study. Nutrients. 2022 Sep 2;14(17):1–15.
15. Benson CS, Shah A, Frise MC, Frise CJ. Iron Deficiency Anaemia In Pregnancy: A Contemporary Review. Obstet Med. 2021 Jun 7; 14(2): 67–76.
16. G?ug?utsi V, Pouliakis A, Argyrios T, Tolia M, Nazos NA, Panagopoulos P et al. The Critical Role of the Early Evaluation of Iron and Vitamin B12 Deficiency in Pregnancy. Cureus. 2024; 16(8): e67592.
17. Srivastav A, Kshirsagar S, Adhav T, Ganu G, Shah A. Efficacy and Safety of Microsomal Ferric Pyrophosphate Supplement for Iron Deficiency Anemia in Pregnancy. Cureus. 2024; 16(3): e57108.
18. Derman RJ, Goudar SS, Thind S, Bhandari S, Aghai ZH, Auerbach M et al. Rapidiron: Reducing Anaemia in Pregnancy in India - A 3-Arm, Randomized-Controlled Trial Comparing the Effectiveness of Oral Iron with Single-Dose Intravenous Iron in the Treatment of Iron Deficiency Anaemia in Pregnant Women and Reducing Low Birth Weight Deliveries. Trials. 2021; 22(1): 649.
19. El-Kholy E, Ahmed M, Shalaby S, El- Abedin M, Shaban R. Effect Of Nutritional Program on Anemic Status and Pregnancy Outcome among Pregnant Women Suffering from Iron Deficiency Anemia. Tanta Scientif Nurs J. 2021 Aug 1; 22(3): 33–60.
20. Anwar F, Mosley MT, Jasbi P, Chi J, Gu H, Jadavji NM. Maternal Dietary Deficiencies in Folic Acid and Choline Change Metabolites Levels in Offspring After Ischemic Stroke. Metabolites. 2024 Oct 16; 14(10): 1–17.
21. Oh C, Keats E, Bhutta Z. Vitamin And Mineral Supplementation During Pregnancy On Maternal, Birth, Child Health And Development Outcomes In Low- And Middle-Income Countries: A Systematic Review and Meta-Analysis. Nutrients. 2020 Feb 14; 12(2): 1–30.
22. Kamlungkuea T, Kaewchung C, Sublon N, Tanyongmasakul N, Butsart S, Winijchai P et al. Pregnancy Outcomes Among Women With Treated Iron Deficiency Anemia: A Retrospective Cohort Study. Nutrients. 2025; 17(19): 3168.
23. Ashfaq S, Sajid U, Khan S, Saleem Y, Batool Sf, Zafar S et al. Effect Of Moringa Oleifera Leaves Powder On Hemoglobin Level In Second-Trimester Pregnant Women Of Karachi, Pakistan. Int J Endors Health Sci Res. 2024; 12(1): 39–45.
24. Santander Ballestín S, Giménez Campos Mi, Ballestín Ballestín J, Luesma Bartolomé Mj. Is Supplementation With Micronutrients Still Necessary During Pregnancy? A Review. Nutrients. 2021 Sep 8; 13(9): 1–30.
25. Baloch DRS. Role Of Trace Elements In Pregnant Women With Malaria: A Case-Control Study. J Health Rehabil Res. 2024 Aug 9; 4(3): 1–6.
26. Wells JCK, Marphatia AA, Manandhar DS, Cortina-Borja M, Reid AM, Saville NS. Associations Of Age At Marriage And First Pregnancy With Maternal Nutritional Status In Nepal. Evol Med Public Health. 2022 Jan 5; 10(1): 325–38.
27. Murphy D, Heary C, Hennessy M, O'Reilly MD, Hennessy E. A Systematic Review Of Help-Seeking Interventions For Parents Of Adolescents. J Adolesc Health. 2022 Jan; 70(1): 16–27.
28. Kinshella MLW, Omar S, Scherbinsky K, Vidler M, Magee LA, Von Dadelszen P et al. Maternal Nutritional Risk Factors For Pre-Eclampsia Incidence: Findings From A Narrative Scoping Review. Reprod Health. 2022 Sep 5; 19(1): 1–13.
29. Gerede A, Papasozomenou P, Stavros S, Potiris A, Domali E, Nikolettos N et al. Calcium Supplementation in Pregnancy: A Systematic Review of Clinical Studies. Medicina (B Aires). 2025; 61(7): 1195.
30. Oh C, Keats EC, Bhutta ZA. Vitamin and Mineral Supplementation During Pregnancy on Maternal, Birth, Child Health and Development Outcomes in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis. Nutrients. 2020; 12(2): 491.
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