Perspective: Treatment of undernutrition in pregnancy requires adequate food and inflammation control.

Undernutrition in pregnancy remains a substantial problem worldwide, disproportionately affecting women living in low- and middle-income countries where food insecurity and limited access to high-quality nutrition exacerbate maternal and fetal health risks. Undernutrition during this critical time in the lifecycle can have adverse effects on both the pregnant woman and on her offspring. Despite the widespread recognition of this issue, current international guidelines provide insufficient direction on optimal nutritional management strategies. Most clinical trial evidence have yielded inconclusive results. This perspective synthesizes evidence on current management strategies in addressing macronutrient and micronutrient deficiencies in pregnancy. Additionally, we examine the critical role of inflammation in moderating the effectiveness of nutritional interventions and discuss emerging strategies that integrate infection control with nutrition to optimize maternal and neonatal outcomes. Given the limitations of existing management strategies, there is an urgent need for more comprehensive, evidence-based guidelines to improve pregnancy outcomes for undernourished women worldwide. STATEMENT OF SIGNIFICANCE: The perspective provides evidence that undernutrition in pregnancy remains an important problem globally and current management strategies remain insufficient. Based on these findings, the perspective urges further research and international support to identify optimal strategies to manage this serious condition.