Vitamins and minerals, education, and self-care need during preconception to 1000 days of life in Southeast Asia: An expert panel opinion

Abstract

Addressing maternal malnutrition and its drivers is paramount in Southeast Asia. This article summarizes the key clinical learnings and evidence-based opinions from the experts to understand the need for vitamins and minerals supplementation, education, and self-care from preconception to the first 1000 days of life, which warranted further attention since COVID-19 pandemic. Evidence describing the importance of vitamins and minerals during preconception, pregnancy, and lactation stages was identified using literature databases. A pre-meeting survey was conducted to determine the current practices and challenges in Southeast Asia. Based on the literature review and clinical experience, experts defined the topics, and an online meeting was held on 13th July 2021. During the meeting, nine experts from Southeast Asia provided evidence-based opinion on the vitamins and minerals supplementation, education, and self-care need during preconception, pregnancy, and lactation stages. The expert opinions underpin maternal malnutrition as a prevalent issue and discuss appropriate interventions and prevention strategies for women in Southeast Asia. The recent pandemic further impacted nutrition status, pregnancy, and neonatal health outcomes. The expert panel emphasized a need to improve existing inadequacies in education, self-care, and social support, and discussed the role of policymakers in addressing the barriers to dietary changes. As inadequacies in regular vitamins and minerals supplementation, education, and self-care for women of reproductive age implicate maternal and child health outcomes, there is an urgent need for addressing malnutrition concerns in this population. Thus, a strong partnership between policymakers, healthcare professionals, and other relevant sectors is required.

Keywords: Preconception; Southeast Asia; postpartum; pregnancy; vitamins and minerals supplementation.

Figure 1.

RNI for nonpregnant and women from conception to 1000 days of life. e: Iron recommendation in pregnancy depends on anemic conditions. In the non-anemic pregnant woman, during the second half of pregnancy, daily supplements of 100 mg of iron (e.g., as ferrous sulfate) is adequate; however, higher doses are usually required for anemic women. RAE: retinol activity equivalent; RNI: recommended nutrient intake; right arrow (→): change in doses with time. *RNI regional values and international values. **Safe intake is used in place of RNI for vitamin A (international values). #Moderate bioavailability values are taken for iron and zinc.

Figure 2.

Potential risks of nutritional insufficiencies during pregnancy and lactation. GDM: gestational diabetes mellitus; NTD: neural tube defect; LBW: low birth weight.