Micronutritions in pregnancy ( Part 2 )

Vitamin C and E 

Vit C is water soluble , E is fat soluble. Many fruits and vegetables are rich in vit C , while vit E in found in nuts,vegetable oils,and some leafy green vegetables. Both vit C and E function synergistically to promote antioxidant defences and inhibit free radical formation .

Vit C is also involved by synthesising collagen ,a primary component of connective tissue.Vit C has an important role in mobilising iron from the stores.Vit C is actively transprted across the placenta . Vit E can across the placenta less. Oxidative stress is thought to be a key mechanism underlying the pathophysiology of several pregnancy complications including preeclampsia, preterm birth , intrauterine growth restriction and premature rupture of membrane.

Vit D : It is fat soluble and its role in maintaining calcium hemostasis and bone integrity. Extraskelatal functions of vit D are also widely recognised including in glucose metabolism , angiogenesis, inflammation, and immune function, as well as in regulating gene transcription and expression.In pregnancy the fetus relies completely on maternal vit D stores for its development.Maternal D deficiency has been associated with neonatal rickets ,as well as multipl adverse pregnancy outcomes including gestational diabetes,preeclampsia, low birht weight birht .

Overall, preventing and treating vit D deficiency in pregnancy is important for optimising maternal and fetal bone and supporting fetal growth

Calcium  Is a water soluble and essential nutritient for bone mineralization and a key intracellular component for maintaining cell membranes. It is involved in several biological process including signal transduction,muscle contraction,enzyme and hormone hemostasis ,as well as neurotransmitter release and nerve cell function.Milk and dairy products are the best sources of calcium and it can also bederived frim leafy green vegetables,nuts or fortified foods .

In pregnancy calcium is actively transported across the placenta and maternal calcium demands increase,particularly during the third trimester.Supplementation of 0.3-2 gr / day is recommend by some to preserve maternal calcium balance and bone density and to support fetal development .

Low maternal calcium intake can contribute to osteopenia, paraesthsia,muscle cramps, tetanus and tremor in the mother, as well as delayed growth, low birht weight and poor fetal mineralization. low calcium intake are also higher risk of developing hypertensive disorder of pregnancy.