MATERNAL NUTRITION AND FETAL RENAL HEALTH – A SYSTEMATIC REVIEW
Main Article Content
Keywords
mother, nutrition, food, fetus, kidney, function
Abstract
Background: The kidneys are fundamental to homeostasis, which underscores how important the kidneys are to develop in fetal life. Renal organogenesis is dependent on maternal nutrition, which impacts fetal health as well as long-term renal function.
Objective: This systematic review aimed to establish a relationship between maternal nutrition and fetal renal health while making distinctions between the macronutrients, micronutrients and breastfeeding and fetal kidney health and development.
Methods: A systematic search of the literature was performed using databases (Pubmed, Scopus and Web of Science), combining keywords like "maternal nutrition," fetal kidney development," and "breastfeeding." Inclusion criteria were developed as per the PICOS framework to include suitable studies that considered maternal dietary factors and outcomes, and more specifically, fetal renal health.
Results: There is evidence that adequate maternal intake of macronutrients (carbohydrates, protein, and healthy fats) is associated with nephrogenesis. Historically, important micronutrients such as folic acid, vitamin D, zinc and magnesium, are important to renal development, and lack of these nutrients is associated with congenital anomalies and increased risk of pediatric and adult chronic kidney disease. Breastfeeding extends the healthy kidneys for neonates, developing a pathway to a lifetime of health. Socioeconomic issues often hinder breastfeeding and other health areas for vulnerable populations. The evidence still is less for this important field.
Conclusion: Maternal nutrition significantly impacts fetal kidney development and overall health. Adequate dietary intake during pregnancy, combined with supportive breastfeeding practices, can mitigate risks of kidney-related congenital defects and chronic diseases later in life. Public health interventions promoting nutritional education, diversity in maternal diets, and breastfeeding are essential for optimizing fetal development and ensuring long-term renal health in children.
References
2. Lee YQ, Collins CE, Gordon A, Rae KM, Pringle KG. The Relationship between Maternal Nutrition during Pregnancy and Offspring Kidney Structure and Function in Humans: A Systematic Review. Nutrients. 2018 Feb 21;10(2):241. doi: 10.3390/nu10020241.
3. Chen X, Zhao D, Mao X, Xia Y, Baker PN, Zhang H. Maternal Dietary Patterns and Pregnancy Outcome. Nutrients. 2016 Jun 7;8(6):351. doi: 10.3390/nu8060351.
4. Raghavan R, Dreibelbis C, Kingshipp BL, et al. Dietary patterns before and during pregnancy and maternal outcomes: a systematic review. Am J Clin Nutr 2019;109:705–728S.
5. Güngör D, Nadaud P, LaPergola CC, et al. Infant milk-feeding practices and diabetes outcomes in offspring: a systematic review. Am J Clin Nutr 2019;109:817–837S
6. Xue, L.; Chen, X.; Sun, J.; Fan, M.; Qian, H.; Li, Y.; Wang, L. Maternal Dietary Carbohydrate and Pregnancy Outcomes: Quality over Quantity. Nutrients 2024, 16, 2269. https://doi.org/10.3390/nu16142269
7. Sivasankar M, Raja I, Parthasarathy S, Suchitra S. The Protective Role of Neonatal Breastfeeding in Renal Health: A Systematic Review. J Neonatal Surg [Internet]. 2025Mar.17 [cited 2025Jul.10];14(6S):138-44. Available from: https://www.jneonatalsurg.com/index.php/jns/article/view/2216
8. Mulcahy MC, Tellez-Rojo MM, Cantoral A, Solano-González M, Baylin A, Bridges D, Peterson KE, Perng W. Maternal carbohydrate intake during pregnancy is associated with child peripubertal markers of metabolic health but not adiposity. Public Health Nutr. 2022 Sep;25(9):2541-2553. doi: 10.1017/S1368980021004614
9. Looman, M.; Schoenaker, D.; Soedamah-Muthu, S.S.; Geelen, A.; Feskens, E.J.M.; Mishra, G.D. Pre-pregnancy dietary carbohydrate quantity and quality, and risk of developing gestational diabetes: The Australian Longitudinal Study on Women’s Health. Br. J. Nutr. 2018, 120, 435–444.
10. Sene LdB, Scarano WR, Zapparoli A, Gontijo JAR, Boer PA (2021) Impact of gestational low-protein intake on embryonic kidney microRNA expression and in nephron progenitor cells of the male fetus. PLoS ONE 16(2): e0246289. https:// doi.org/10.1371/journal.pone.0246289
11. Armitage J.A., Lakasing L., Taylor P.D., Balachandran A.A., Jensen R.I., Dekou V., Ashton N., Nyengaard J.R., Poston L. Developmental programming of aortic and renal structure in offspring of rats fed fat-rich diets in pregnancy. J. Physiol. 2005;565:171–184. doi: 10.1113/jphysiol.2005.084947
12. Koleganova N., Piecha G., Ritz E., Becker L.E., Muller A., Weckbach M., Nyengaard J.R., Schirmacher P., Gross-Weissmann M.L. Both high and low maternal salt intake in pregnancy alter kidney development in the offspring. Am. J. Physiol. Renal Physiol. 2011;301:F344–F354. doi: 10.1152/ajprenal.00626.2010
13. Arshad, R., Sameen, A., Murtaza, M. A., Sharif, H. R., Iahtisham-Ul-Haq, Dawood, S., Ahmed, Z., Nemat, A., & Manzoor, M. F. (2022). Impact of vitamin D on maternal and fetal health: A review. Food Science & Nutrition, 10, 3230–3240. https://doi.org/10.1002/fsn3.2948
14. Tomat AL, Costa MA, Girgulsky LC, Veiras L, Weisstaub AR, Inserra F, Balaszczuk AM, Arranz CT. Zinc deficiency during growth: influence on renal function and morphology. Life Sci. 2007 Mar 13;80(14):1292-302. doi: 10.1016/j.lfs.2006.12.035.
15. Fanni D, Gerosa C, Nurchi VM, Manchia M, Saba L, Coghe F, Crisponi G, Gibo Y, Van Eyken P, Fanos V, Faa G. The Role of Magnesium in Pregnancy and in Fetal Programming of Adult Diseases. Biol Trace Elem Res. 2021 Oct;199(10):3647-3657. doi: 10.1007/s12011-020-02513-0.
16. Greenberg JA, Bell SJ, Ausdal WV. Omega-3 Fatty Acid supplementation during pregnancy. Rev Obstet Gynecol. 2008 Fall;1(4):162-9
17. Middleton P, Gomersall JC, Gould JF, Shepherd E, Olsen SF, Makrides M. Omega-3 fatty acid addition during pregnancy. Cochrane Database Syst Rev. 2018 Nov 15;11(11):CD003402. doi: 10.1002/14651858.CD003402
18. García-Montero C, Fraile-Martinez O, De Leon-Oliva D, Boaru DL, Garcia-Puente LM, De León-Luis JA, Bravo C, Diaz-Pedrero R, Lopez-Gonzalez L, Álvarez-Mon M, García-Honduvilla N, Saez MA, Ortega MA. Exploring the Role of Mediterranean and Westernized Diets and Their Main Nutrients in the Modulation of Oxidative Stress in the Placenta: A Narrative Review. Antioxidants (Basel). 2023 Oct 26;12(11):1918. doi: 10.3390/antiox12111918.
19. Obesity in Pregnancy: ACOG Practice Bulletin, Number 230. Obstet Gynecol. 2021 Jun 01;137(6):e128-e144.
20. Nguyen PH, Kachwaha S, Tran LM, Sanghvi T, Ghosh S, Kulkarni B, Beesabathuni K, Menon P, Sethi V. Maternal Diets in India: Gaps, Barriers, and Opportunities. Nutrients. 2021 Oct 9;13(10):3534. doi: 10.3390/nu13103534.
21. Hales CN, Barker DJ. The thrifty phenotype hypothesis. Br Med Bull. 2001;60:5-20. doi: 10.1093/bmb/60.1.5.
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Dhivya, R
Assistant professor, Department of obstetrics and gynaecology, Aarupadai Veedu Medical College and Hospital, Vinayaka Missions Research foundation (VMRF)university, Pondicherry, India. https://orcid.org/0009-0000-8881-1315
M Sivasankar
Professor, Department of Nephrology, Mahatma Gandhi Medical college and research institute, Sri Balaji Vidyapeeth (deemed to be university) Pondicherry India. Orcid ID: https://orcid.org/0000-0002-8718-6391
M.R. Suchitra
Assistant Professor, Department of chemistry and biosciences, SASTRA(SRC) Kumbakonam , India. https://orcid.org/0000-0001-6055-7589