Breaking the cycles of malnutrition: are pregnancy nutrition interventions effective?

The fourth report on the world nutrition situation, published by the UN Sub-Committee on Nutrition in 2000, underlined the importance of a life-cycle approach to the global nutrition challenges (1). Foetal undernutrition results in a wide range of consequences in perinatal life, in infancy, and there is growing evidence of causal links to chronic diseases much later in life (2,3). Pregnancy is one of the logical target periods for nutrition interventions, potentially providing combined opportunities to treat or prevent maternal depletion and under-nutrition of the foetus. The literature review by David Rush probably conveys a pessimistic view on the effectiveness of nutrition interventions in pregnancy (4). However, the knowledge base is so far weak, with seemingly contradictory results. Many of the basic questions still remain: who will benefit (mother and/or foetus), from what intervention, performed when, and when will what effect be shown?