Bedeutung von Mikronährstoffen bei Kinderwunsch, in Schwangerschaft und Stillzeit

Eine wissenschaftlich gesicherte Empfehlung zur Versorgung der Bevölkerung mit Mikronährstoffen ist nach wie vor schwierig. Der Beitrag fasst die aktuelle Studienlage und die praktischen Konsequenzen für die Beratung der schwangeren und stillenden Frauen zusammen. Das Kernthema der Beratung sollte allerdings immer eine gesunde und ausgewogene Ernährung sein.

• Literatur

• 1 Nationale Verzehrsstudie II (NVS II). Max Rubner-Institut, Bundesforschungsinstitut für Ernährung und Lebensmittel (Hrsg). 2008
• 2 Ronnenberg AG, Venners SA, Xu X et al. Preconceptional B-Vitamin and homocysteine status, conception and early pregnancy loss. Am J Epidemiol 2007; 166(3): 304-312
• 3 Institute of Medicine. Dietary Reference Intake for Thiamin, Riboflavin, Niacin, Vitamin B₆, Folate, Vitamin B₁₂, Pantothenic Acid, Biotin, and Choline. 1998
• 4 Institute of Medicine. Dietary Reference Intake for Vitamine C, Vitamine E, Selenium, and Carotenoids. National Academic Press; 2000
• 5 Hemni H, Endo T, Kitajima Y et al. Effects of ascorbic acid supplementation on serum progesterone levels in patients with a luteal phase defect. Fertil Steril 2003; 80: 459-461
• 6 Burris HH, Camargo CA Jr.. Vitamin d and gestational diabetes mellitus. Curr Diab Rep 01/2014; 14(1): 451
• 7 Miller BJ, Murray L, Beckmann MM et al. Dietary supplements for preventing postnatal depression. Cochrane Database Syst Rev 24.10.2013;
• 8 Bodnar LM, Catov JM, Simhan HN et al. Maternal vitamin D deficiency increases the risk of preeclampsia. J Clin Endocrinol Metab 2007; 92(9): 3517-3522
• 9 Mulligan ML, Felton SK, Riek AE et al. Implications of vitamin D deficiency in pregnancy and lactation. Am J Obstet Gynecol 2010; 202(5): 429.e1-9
• 10 European Food Safety Authority (EFSA). Tolerable Upper Intake Levels for Vitamins and Minerals. 02/2006
• 11 Deutsche Gesellschaft für Ernährung. Vitamin D. In Referenzwerte für die Nährstoffzufuhr. 1. Auflage, 4. korrigierter Nachdruck Neustadt: Neuer UmschauBuchverlag; 2012
• 12 Devereux G, Turner SW, Craig LC et al. Low maternal vitamin E intake during pregnancy is associated with asthma in 5-year-old children. Am J Respir Crit Care Med 2006; 174(5): 499-507
• 13 Cicek N, Eryilmaz OG, Sarikaya E et al. Vitamin E effect on controlled ovarian stimulation of unexplained infertile women. J Assist Reprod Genet 2012; 29(4): 325-328
• 14 Brönstrup A, Hages M, Prinz-Langenohl R, Pietrzik K. Effects of folic acid and combinations of folic acid and vitamin B-12 on plasma homocysteine concentrations in healthy, young women. Am J Clin Nutr 1998; 68(5): 1104-1110
• 15 Pietrzik K, Bailey L, Shane B. Folsäure und L-5-Methyltetrahydrofolat: Vergleich der klinischen Pharmakokinetik und Pharmakodynamik. Clin Pharmacokinet 2010; 49(8): 535-548
• 16 Czeizel AE, Dudás I. Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N Engl J Med 1992; 327(26): 1832-1835
• 17 Czeizel AE. Prevention of congenital abnormalities by periconceptional multivitamin supplementation. BMJ 1993; 306(6893): 1645-1648
• 18 Czeizel AE, Dudás I, Métneki J. Pregnancy outcomes in a randomised controlled trial of periconceptional multivitamin supplementation. Final report. Arch Gynecol Obstet 1994; 255(3): 131-139
• 19 Bailey LB, Berry RJ. Folic acid supplementation and the occurrence of congenital heart defects, orofacial clefts, multiple births, and miscarriage. Am J Clin Nutr 2005; 81(5): 1213S-1217S
• 20 Shaw GM, Lammer EJ, Wasserman CR et al. Risks of orofacial clefts in children born to women using multivitamins containing folic acid periconceptionally. Lancet 1995; 346(8972): 393-396
• 21 Steegers-Theunissen RP, Obermann-Borst SA, Kremer D et al. Periconceptional maternal folic acid use of 400 microg per day is related to increased methylation of the IGF2 gene in the very young child. PLoS One 2009; 4(11) e7845
• 22 Sauberlich HE, Kretsch MJ, Skala JH et al. Folate requirement and metabolism in nonpregnant women. Am J Clin Nutr 1987; 46(6): 1016-1028
• 23 Nelen WL, Blom HJ, Steegers EA et al. Homocysteine and folate levels as risk factors for recurrent early pregnancy loss. Obstet Gynecol 2000; 95(4): 519-524
• 24 Peña-Rosas JP, Viteri FE. Effects and safety of preventive oral iron or iron+folic acid supplementation for women during pregnancy. Cochrane Database Syst Rev 2009; 4 CD004736
• 25 Bühling KJ. Schilddrüse und Schwangerschaft. Gynakol Geburtsmed Gynakol Endokrinol 2010; 6(1): 44-56
• 26 Bühling KJ, Schaff J, Bertram H et al. Supply of iodine during pregnancy – an inventory in Berlin, Germany. Z Geburtshilfe Neonatol 2003; 207(1): 12-16
• 27 Haddow JE, Palomaki GE, Allan WC et al. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. N Engl J Med 1999; 341(8): 549-555
• 28 www.efsa.europa.eu Expert Group on Vitamins and Minerals. Safe Upper Levels for Vitamins and Minerals. 05/2003
• 29 Oster O, Prellwitz W. The daily dietary selenium intake of West German adults. Biol Trace Elem Res 1989; 20(1–2): 1-14
• 30 Patelarou E, Giourgouli G, Lykeridou A et al. Association between biomarker-quantified antioxidant status during pregnancy and infancy and allergic disease during early childhood: a systematic review. Nutr Rev 2011; 69(11): 627-641
• 31 Herbert V. Recommended dietary intakes (RDI) of iron in humans. Am J Clin Nutr 1987; 45(4): 679-686
• 32 Liu Z, Qiu L, Chen YM, Su YX. Effect of milk and calcium supplementation on bone density and bone turnover in pregnant Chinese women: a randomized controlled trail. Arch Gynecol Obstet 2011; 283(2): 205-211
• 33 Hofmeyr GJ, Atallah AN, Duley L. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev 2006; 3 CD001059
• 34 Hammiche F, Vujkovic M, Wijburg W et al. Increased preconception omega-3 polyunsaturated fatty acid intake improves embryo morphology. Fertil Steril 2011; 95: 1820-1823
• 35 Dunstan JA, Simmer K, Dixon G et al. Cognitive assessment of children at age 2(1/2) years after maternal fish oil supplementation in pregnancy: a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed 2008; 93(1): F45-50
• 36 Hibbeln JR, Davis JM, Steer C et al. Maternal seafood consumption in pregnancy and neurodevelopmental outcomes in childhood (ALSPAC study): an observational cohort study. Lancet 2007; 369(9561): 578-585
• 37 Olsen SF, Østerdal ML, Salvig JD et al. Duration of pregnancy in relation to fish oil supplementation and habitual fish intake: a randomised clinical trial with fish oil. Eur J Clin Nutr 2007; 61(8): 976-985
• 38 Furuhjelm C, Warstedt K, Larsson J et al. Fish oil supplementation in pregnancy and lactation may decrease the risk of infant allergy. Acta Paediatr 2009; 98(9): 1461-1467
• 39 Bühling KJ. Versorgung mit Mikronährstoffen bei Kinderwunsch, in der Schwangerschaft und in der Stillzeit. Gynäkol Geburtsmed Gynäkol Endokrinol 2012; 8(1): 38-58