NUTRITION IN

PREGNANCY
DR.A.RATHNA . M.S (O&G)
2nd YR PG
MMC &RI

2007 Thomson - Wadsworth

 Nutrition Prior to
Pregnancy
Achieve &
maintain a
healthy body
weight
Choose an
adequate &
balanced diet
Be physically
active
Avoid harmful
substances
2007 Thomson - Wadsworth
Prepregnancy Weight

Underweight or
overweight before
pregnancy presents
medical risks

2007 Thomson - Wadsworth

 Underweight

High risk of Long-term effects

having a low- Risk for obesity &
birthweight baby hypertension later
in life
Low-birthweight
Lower adult IQ
More risk for
disease Short stature
40 times more Educational
likely to die in first disadvantages
month

2007 Thomson - Wadsworth

Causes of Low-Birthweight
Mothers
Poor nutrition
Heredity
Disease conditions
Smoking
Drug & alcohol use

2007 Thomson - Wadsworth

 Overweight & Obesity

Babies Mom
Are larger More likely to need
Twice as likely to labor induced
have neural tube May need C-section
deficits More post-partum
Greater risk of hypertension,
heart defects infections, &
gestational diabetes

2007 Thomson - Wadsworth

 Healthy Support Tissues

Prepregnancy Umbilical cord

nutrition needed to Pipeline from
support growth of a placenta to fetus
healthy placenta Amniotic sac
Placenta Surrounds baby
Supply depot Cushions it with
Waste-removal fluids
system

2007 Thomson - Wadsworth

 The Events of Pregnancy

Newly fertilized Adverse influences

ovum called a can lead to
zygote Failure to implant
Implants in uterine Neural tube deficits
wall in 2 weeks Smoking
Placenta begins to Drug abuse
grow Malnutrition
Crucial time period

2007 Thomson - Wadsworth

 The Embryo & Fetus
Embryo develops Last 7 months
into a fetus Grows 50 times
At 8 weeks fetus has heavier & 20 times
Complete CNS longer
Beating heart Pregnancy
Fully formed digestive 39-41 weeks
tract duration
Well-defined fingers &
toes Infant
Beginning facial Weight 6 - 9
features pounds

2007 Thomson - Wadsworth

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 Critical Periods

Development of each organ

takes place at a certain time
(critical period)
Effects of malnutrition at a
critical period are irreversible

2007 Thomson - Wadsworth

Effects of Malnutrition
Nervous system defects of
the embryo
Childs poor dental health
Adolescents & adults
vulnerability to infection
Higher risk of diabetes,
hypertension, stroke, or
heart disease

2007 Thomson - Wadsworth

 2007 Thomson - Wadsworth
 Nutrient Needs During
Pregnancy
Some increase
Must make careful choices
Womans body
Maximizes absorption
Minimizes losses

2007 Thomson - Wadsworth

 Nutrient Needs

Energy (kcalories) Protein

Additional 340 in 2nd Additional 25 g
trimester Protein supplements
Additional 450 in 3rd are discouraged
trimester Fats
Select nutrient-dense Little room for oil,
foods margarine, & butter
Carbohydrates Need essential fatty
Additional 175 g acids
Fiber for constipation

2007 Thomson - Wadsworth

 Special Interest
Folate Vitamin B12
Role in cell Needed to assist
reproduction folate in manufacture
Increased from 400- of new cells
600 mcg/day
Found in animal
Prevents neural tube products
deficits
Spina bifida Vegans need fortified
Anencephaly foods or supplements
Supplements, fortified
foods or both

2007 Thomson - Wadsworth

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 Nutrients for Bones
Vitamin D, calcium, Increase milk
phosphorus, products
magnesium May need
Intestinal absorption supplements
of calcium doubles Calcium-fortified
early in pregnancy soy milk & orange
Final weeks, more juice
than 300 mg
transferred to fetus

2007 Thomson - Wadsworth

 Fluoride
Mineralization of teeth
begins in 5th month
Fluoride supplements
Recommended if do not
have fluoridated water
Not recommended if
have fluoridated water

2007 Thomson - Wadsworth

 Iron

Absorption of iron Iron-rich food

increases threefold Liver, oysters
Meat, fish
Fetus draws heavily
Dried fruits
on mothers stores
Legumes
Daily supplement Dark green
30 mg iron vegetables
2nd & 3rd trimester Vitamin C-rich
foods enhance
absorption

2007 Thomson - Wadsworth

 Zinc
Needed for DNA, RNA &
protein synthesis
Deficiency predicts low
birthweight
Found in foods of high
protein content
Iron interferes with zinc
absorption
May need zinc supplements

2007 Thomson - Wadsworth

 Nutrient Supplements

Prenatal Needed for

supplements Those with poor diet
provide more High-risk pregnancies
Folate Multiple fetuses
Iron Cigarette smokers
Calcium Alcohol & drug abusers
Reduce risks of
Preterm delivery
Low birthweight
Birth defects

2007 Thomson - Wadsworth

 Food Assistance Programs

Women, Infants, Federal Food Stamps

Children (WIC) Nutrition education
Vouchers for American Dietetic
nutritious food Association
Food education American Diabetes
Iron-fortified formula Association
Local hospitals

2007 Thomson - Wadsworth

 Weight Gain
Essential for healthy pregnancy
Normal-weight woman
3 pounds first trimester
1 pound/week thereafter

2007 Thomson - Wadsworth

 Physical Activity

Very important Low-impact

Improves her fitness activities
Facilitates labor Avoid
Helps to prevent or Activities with
manage gestational potential for falls or
diabetes being hit by others
Reduces Saunas
psychological stress Steam rooms
Whirlpools

2007 Thomson - Wadsworth

 Common
Nutrition-Related Concerns

Food sensitivities
Nausea
Heartburn
Constipation

2007 Thomson - Wadsworth

Food Cravings & Aversions

Cravings Cravings &

Do not seem to aversions
reflect Probably due to
physiological Hormone-induced
needs changes in taste
Sensitivities to
smells

2007 Thomson - Wadsworth

Nonfood Cravings

Pica
Craving items such as
laundry starch, clay,
soil, or ice.
Common among
African American
women
Often associated with
iron deficiency

2007 Thomson - Wadsworth

 Other Concerns

Morning Sickness Heartburn

Comes from hormonal Fetus puts
changes in early pressure on
pregnancy womans stomach
Mild queasiness to Acid may back up
debilitating nausea Constipation
Smells often trigger it High-fiber diet
Physical activity
Plentiful fluids

2007 Thomson - Wadsworth

 Problems in Pregnancy

Gestational Hypertension
Diabetes Pre-existing
Usually resolves Risk of low-birthweight
after the birth infant
Separation of placenta
Often leads to
surgical birth & Transient
high infant Usually resolves after
the birth
birthweight

2007 Thomson - Wadsworth

 Preeclampsia

Symptoms May experience

Hypertension convulsions
Protein in the urine Eclampsia
Whole body edema Need prompt
Usually first medical attention
pregnancy
After 20 weeks

2007 Thomson - Wadsworth

 Avoid Cigarette Smoking

Nicotine & cyanide Behavioral or

are toxic to a fetus intellectual problems
later in life
Second-hand smoke
is also problematic Implicated in SIDS
(sudden infant death
Blood flow is syndrome)
restricted More complicated
Slows fetal growth births
Low birthweight

2007 Thomson - Wadsworth

 Avoid
Medicinal drugs Drugs of abuse
No over-the-counter Cross the placenta
No medicines not Impair growth &
prescribed development
No aspirin or ibuprofen in Environmental
last 3 months contaminants
Herbal supplements Lead & mercury
Almost none have been Avoid certain types
tested for safety during of fish
pregnancy

2007 Thomson - Wadsworth

 Avoid
Foodborne illness Dieting
Listeriosis Hazardous during
Can cause miscarriage, pregnancy
stillbirth
Sugar substitutes
Severe brain injury,
other infections to fetus Use in moderation
& newborn Caffeine
Vitamin-mineral Limit to one cup coffee
megadoses or two 12-oz colas
Many are toxic in excess
Need care with vitamin A

2007 Thomson - Wadsworth

 Alcohol

Fetal alcohol
syndrome (FAS)
Irreversible brain
damage
Mental retardation
Facial abnormalities
Vision abnormalities
No amount is safe

2007 Thomson - Wadsworth

 Adolescent Pregnancy

Intense nutrient Risks for

needs Low-birthweight
Often deficient Miscarriage
before pregnancy Stillbirth
Death of infant in
Encouraged to
first year
gain about 35
pounds

2007 Thomson - Wadsworth

Thank you

2007 Thomson - Wadsworth