Gene–Nutrient Interactions and Maternal-Fetal Health in Sub-Saharan Africa: Current Evidence and Future Policy Directions

In Sub-Saharan Africa (SSA), maternal and fetal health remains threatened by high rates of maternal mortality, micronutrient deficiencies, anemia, low birth weight, preterm birth and childhood stunting. The study of interactions between nutrients and the genome, known as nutrigenomics, has emerged as a promising approach to understand biological variability in pregnancy outcomes and to advance precision nutrition. Nevertheless, data from African populations are still scarce, despite the region’s exceptional genetic diversity and heavy burden of maternal and child health problems related to nutrition. A narrative review was performed to synthesize current evidence on gene-nutrient interactions and their implications for maternal-fetal health in SSA. Literature published in the English language from January 2010 to July 2026 was identified through searches of PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar. These searches were complemented by screening reference lists and reports from international organizations. Eligible publications included original research articles, systematic reviews, meta-analyses, randomized controlled trials, cohort studies and policy documents that related to nutrigenomics, nutrigenetics, epigenetics, maternal nutrition, fetal development and precision nutrition. Evidence was thematically synthesized. This review shows that maternal nutrition and genetic variation can interact to impact pregnancy outcomes through mechanisms related to folate metabolism (MTHFR), iron metabolism (HFE), vitamin D signaling (VDR), micronutrient metabolism and nutrition-sensitive epigenetic regulation. The Developmental Origins of Health and Disease (DOHaD) paradigm suggests that maternal nutritional exposures during critical developmental windows influence fetal programming via DNA methylation, histone modification, and other epigenetic processes . Current nutrigenomic evidence from SSA remains geographically limited and hampered by poor genomic infrastructure, lack of funding, limited biobanking capacity, shortage of skilled researchers and underrepresentation of African populations in genomic databases. Nevertheless, progress in genomic technologies, digital health and artificial intelligence offer opportunities to advance precision nutrition research and develop context-specific maternal nutrition policies. Nutrigenomics has huge potential to improve maternal and fetal health in SSA using personalised nutrition approaches and evidence-based maternal health interventions. African-led nutrigenomics research, development of genomic infrastructure, promotion of regional collaboration and inclusion of gene–nutrient evidence in maternal health policies are necessary to improve pregnancy outcomes and reduce the long-term burden of nutrition-related diseases. Future investments in precision nutrition should prioritise African populations to equitably translate genomics advances to maternal and child healthcare.