Women of child-bearing age should work towards maintaining an optimum nutritional status to minimise the health risks to both the mother and the baby. A deficiency in folic acid in the preconception stage and the first trimester of the pregnancy increases the chances of neural tube defects. Adequate intake of folic acid supplementation before pregnancy and in the first trimester can almost negate the risk of neural tube defects. Anaemia and iron deficiency contribute to poor cognitive and physical development in children and increase the chances of maternal death.

Undernourished women are at greater risk of developing hypertensive disorders like eclampsia or pre-eclampsia during pregnancy. Women who are overweight or obese face the risk of stillbirth, difficult delivery, haemorrhage and birth defects. Infants of overweight women tend to be bigger and maybe at increased risk of developing obesity and type 2 diabetes as children and adolescents.

Iodine is essential for the healthy brain development of the fetus and young child and calcium supplementation improves calcium intake and reduces the risk of the woman developing hypertensive disorders during pregnancy.

The adverse consequences of folic acid and iron insufficiency can be combated with iron and folic acid supplementation. If the mother is underweight, nutrient-dense supplementary foods should be included in the diet along with continuous nutritional monitoring. Overweight and obese women also need nutritional counselling to lower caloric intake and increase physical activity. Blood glucose levels have to be kept under control for mothers with diabetes mellitus. Consuming iodized salt can help in removing the risks associated with iodine deficiency.

Health problems	Issues to maternal health	Issues to infant health
Folic acid insufficiency	–	Neural tube defects, other birth defects.
Iron-deficiency anaemia	Maternal morbidities and mortality.	Child mortality, low birth weight, preterm birth, low child cognition (intelligence quotient).
Maternal underweight, combined with low stature	Complications during pregnancy and delivery, nutrient deficiencies (potentially resulting in obstetric complications).	Preterm birth, low birth weight, stillbirth, type 2 diabetes and cardiovascular disease in later life.
Maternal overweight and obesity	Pre-existing type 2 diabetes, hypertensive disease of pregnancy, gestational diabetes, hypertensive and thromboembolic disorders, postpartum haemorrhage and anaemia, caesarean delivery, induction of labour, instrumental delivery, shoulder dystocia.	Birth defects, neural tube defects, preterm delivery, stillbirth, macrosomia.
Untreated diabetes mellitus (type 2 and gestational)	Type 2 diabetes, spontaneous abortion, worsening of existing microvascular complications, urinary tract and other infections, preterm labour, obstetric trauma, caesarean section, hypertension, pre-eclampsia, gestational diabetes mellitus, obstetric trauma, caesarean section.	Birth defects, stillbirth, macrosomia with shoulder dystocia/nerve palsy if delivered vaginally, hypoglycaemia after birth, type 2 diabetes in later life.
Iodine	–	Abortion, stillbirth, mental retardation, cretinism, increased neonatal/infant mortality, goiter, hypothyroidism.
Calcium	Maternal eclampsia, pre-eclampsia.	–

Health problems	Preventive interventions
Consequences of folic acid insufficiency	Iron and folic acid supplementation (e.g. food fortification, administration of tablets, use of micronutrient powders containing folic acid); information; education.
Consequences of anaemia and iron deficiency	Iron and folic acid supplementation (e.g. food fortification, use of micronutrient powders containing iron); screening for anaemia; information; education.
Underweight	Nutrition education (counselling about risks to own health and future pregnancies); nutritional monitoring; provision of energy and nutrient-dense supplementary foods.
Overweight and obesity	Nutrition education (counselling about risks to own health and future pregnancies); nutritional monitoring; nutrition counselling (lower caloric intake, increase physical activity, structured weight-loss programme, continued breastfeeding); community-based prevention programmes (e.g. increasing opportunities to physical exercise and to healthy foods).
Diabetes mellitus	Information and education; community-wide or national screening among populations at high risk; blood glucose monitoring, management of diabetes (glycaemic control before, during and after pregnancy); exercise; nutritional counselling (screening for pre-existing type 2 diabetes and every 1–3 years after gestational diabetes).
Iodine deficiency	Salt iodization.