Micronutrient Deficiencies in Pregnancy: Bridging Gaps between Global Guidelines and Community Practices


Authors : Dr. Harini P Shetty; Dr. Manjula S Patil; Dr. Kavitha Lakshmi Easwaran; Dr. Shwetha S Yadav; Dr. Swetha Vinjamuri; Dr.Venugopal Reddy.I

Volume/Issue : Volume 10 - 2025, Issue 3 - March


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DOI : https://doi.org/10.38124/ijisrt/25mar1109

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Abstract : Background: Micronutrient deficiencies (MNDs) during pregnancy, including deficiencies in iron, folate, vitamin D, iodine, and zinc, remain a critical public health challenge, particularly in low- and middle-income countries (LMICs). Despite the availability of international guidelines from organizations such as the World Health Organization (WHO) and UNICEF, the implementation of these guidelines at the community level remains inconsistent, leading to persistent gaps in maternal and neonatal health outcomes.  Aim: This review aims to explore the disparities between international guidelines and their actual implementation in community settings, identify barriers to effective micronutrient supplementation, and propose sustainable, culturally sensitive solutions to address these gaps.  Methods: A comprehensive narrative review of 150 peer-reviewed articles published between 2013 and 2024 was conducted. Databases such as PubMed, Cochrane, and Scopus were searched, and national health surveys were reviewed to provide a global perspective. The PRISMA guidelines and CASP checklists were employed to ensure methodological rigor.  Results: The review identified several key challenges, including variable coverage of micronutrient supplementation (30–70% in LMICs), cultural myths, logistical issues, and supply chain inefficiencies. Effective strategies to address these challenges include food fortification, community education, digital health interventions, and innovative technological tools.  Conclusion: Addressing micronutrient deficiencies in pregnancy requires a multisectoral approach that integrates health system strengthening, culturally sensitive interventions, and robust supply chain mechanisms. Policymakers must prioritize maternal nutrition within universal health coverage (UHC) frameworks to ensure sustainable improvements in maternal and neonatal health outcomes.

Keywords : Micronutrient Deficiencies, Iodine, Cretinism, Maternal Health, Pregnancy, Iron-Folic Acid, Vitamin D, Zinc, Public Health, Equity.

References :

  1. WHO. (2020). WHO guideline: Daily iron and folic acid supplementation in pregnant women. Geneva: WHO.
  2. UNICEF. (2023). Nutrition-Sensitive Approaches in Fragile Settings. New York: UNICEF.
  3. Zimmermann, M. B. (2009). Iodine deficiency in pregnancy. Lancet, 374, 1126-1137.
  4. Andersson, M., & Zimmermann, M. B. (2012). Global iodine nutrition. Adv Nutr, 3, 341-345.
  5. Bhutta, Z. A., et al. (2013). Maternal and child nutrition. Lancet, 382, 452-477.
  6. Osendarp, S. J. M., et al. (2021). Nutrition policy analysis. Food Nutr Bull, 42, 78-89.
  7. National Family Health Survey (NFHS-6), 2024. India.
  8. Black, R. E., et al. (2013). Maternal nutrition outcomes. Lancet, 382, 427-451.
  9. Haider, B. A., & Bhutta, Z. A. (2017). Micronutrient supplementation. Cochrane Database Syst Rev, CD004905.
  10. Christian, P., et al. (2013). Micronutrient supplementation impacts in Nepal. JAMA Pediatr, 167, 660-666.
  11. Allen, L. H. (2000). Anemia effects on pregnancy. Am J Clin Nutr, 71, 1280S-1284S.

Background: Micronutrient deficiencies (MNDs) during pregnancy, including deficiencies in iron, folate, vitamin D, iodine, and zinc, remain a critical public health challenge, particularly in low- and middle-income countries (LMICs). Despite the availability of international guidelines from organizations such as the World Health Organization (WHO) and UNICEF, the implementation of these guidelines at the community level remains inconsistent, leading to persistent gaps in maternal and neonatal health outcomes.  Aim: This review aims to explore the disparities between international guidelines and their actual implementation in community settings, identify barriers to effective micronutrient supplementation, and propose sustainable, culturally sensitive solutions to address these gaps.  Methods: A comprehensive narrative review of 150 peer-reviewed articles published between 2013 and 2024 was conducted. Databases such as PubMed, Cochrane, and Scopus were searched, and national health surveys were reviewed to provide a global perspective. The PRISMA guidelines and CASP checklists were employed to ensure methodological rigor.  Results: The review identified several key challenges, including variable coverage of micronutrient supplementation (30–70% in LMICs), cultural myths, logistical issues, and supply chain inefficiencies. Effective strategies to address these challenges include food fortification, community education, digital health interventions, and innovative technological tools.  Conclusion: Addressing micronutrient deficiencies in pregnancy requires a multisectoral approach that integrates health system strengthening, culturally sensitive interventions, and robust supply chain mechanisms. Policymakers must prioritize maternal nutrition within universal health coverage (UHC) frameworks to ensure sustainable improvements in maternal and neonatal health outcomes.

Keywords : Micronutrient Deficiencies, Iodine, Cretinism, Maternal Health, Pregnancy, Iron-Folic Acid, Vitamin D, Zinc, Public Health, Equity.

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