2 articles
icronutrient deficiencies during pregnancy remain a major global public health concern, with implications for maternal health, fetal development, and long-term child outcomes. International organizations such as the WHO and FIGO have issued evidence-based guidelines on micronutrient supplementation, which are increasingly being adapted into national protocols.
This narrative review was based on literature searches in PubMed, Scopus, Web of Science, and Google Scholar, covering January 2000 to May 2025. Peer-reviewed studies, systematic reviews, and clinical guidelines from WHO, FIGO, and the Moldovan Ministry of Health were included. The review focused on iron, folic acid, iodine, calcium, vitamin D, and selected trace elements.
Iron and folic acid emerged as the most consistently recommended supplements across guidelines, with proven efficacy in reducing maternal anemia and neural tube defects. Iodine and calcium are also emphasized, particularly in regions with documented dietary insufficiency. Moldova’s antenatal care protocol largely aligns with WHO and FIGO recommendations, prioritizing targeted over universal supplementation for nutrients beyond iron and folate. Evidence on routine supplementation with multivitamin complexes remains inconclusive.
Evidence-based micronutrient supplementation is essential to optimizing pregnancy outcomes. Universal iron and folic acid supplementation remain the cornerstone of antenatal nutrition strategies. Context-specific approaches, as exemplified by the Moldovan model, can enhance implementation in resource-limited settings.
Hematological inflammatory markers may be promising diagnostic markers for assessing the severity of intrahepatic cholestasis of pregnancy. The aim of the study was to evaluate and compare the levels of hematological inflammatory markers in intrahepatic cholestasis of pregnancy.
A prospective cohort study of 142 clinical cases, divided into two groups depending on the presence of cholestasis gravidarum, was carried out. The research was conducted by assessing the level of bile acids and hematological inflammatory markers in the mother's blood, as well as by studying medical records. The IBM Statistics SPSS 21 program was used to process the statistical data. To compare categorical variables, the χ² without the Yates' continuity correction test was applied.
There was an increase in platelet-to-lymphocyte ratio in pregnant women with intrahepatic cholestasis of pregnancy compared to the control group (146.0±6.8 versus 135.2±7.3, respectively). The values of neutrophil-to-lymphocyte ratio and the average volume of platelets were similar in both groups. At the same time, the study found a decrease in the values of erythrocyte distribution among women whose pregnancy was complicated by cholestasis gravidarum.
The study showed a significant increase in platelet-to-lymphocyte ratio in women whose pregnancy was complicated by cholestasis gravidarum, as well as an increase in this indicator with increasing levels of bile acids. Thus, this ratio may be a promising diagnostic marker in assessing the severity of intrahepatic cholestasis of pregnancy.