CASE

• John and Rita have just found out that they are expecting a child
once again. they are very excited, as after Rita’s two previous
miscarriages, it had seemed that the likelihood of this pregnancy
was slim. due to her history, Rita wants to make sure that she
takes all the necessary precautions to have a normal and healthy
baby. she has been taking her prenatal vitamins regularly, and has
been following a healthy diet plan. Dr. Best, their Ob/Gyn, has
advised the Clarks that although there could be complications
and risks to the fetus, based on their history of miscarriages, they
should consider prenatal testing. john has completely agreed with
Dr. best, but Rita has been hesitant. she is afraid of the risks
involved in the procedures, and could not bear the thought of
losing another baby prematurely.
 CASE

•WHAT TYPES OF PRENATAL VITAMINS ARE

USUALLY USED AND WHY?
 WHAT ARE PRENATAL VITAMINS?

• EVEN WITH A HEALTHY DIET, IMPORTANT NUTRIENTS IN

SUFFICIENT QUANTITIES NEEDED FOR PROPER FOETAL
DEVELOPMENT MAY BE MISSING. PRENATAL VITAMINS FILL IN
THE GAPS WITH ESSENTIAL VITAMINS AND MINERALS.
FOLIC ACID (VITAMIN B9)

• THIS IS A B VITAMIN ESSENTIAL FOR CELL GROWTH AND

DEVELOPMENT.
• FOLIC ACID IS PARTICULARLY IMPORTANT FOR NERVOUS
SYSTEM DEVELOPMENT AND PREVENTION OF BIRTH
DEFECTS SUCH AS SPINA BIFIDA AND ANENCEPHALY.
 VITAMIN B12

• SIMILARLY TO FOLIC ACID, VITAMIN B12 IS ESSENTIAL IN

NERVOUS SYSTEM DEVELOPMENT AND PREVENTION OF
NEURAL TUBE DEFECTS SUCH AS SPINA BIFIDA AND
ANENCEPHALY.
 IRON
• IRON IS USED BY THE BODY TO MAKE THE HAEMOGLOBIN,
PRESENT IN RED BLOOD CELLS, WHICH TRANSPORTS
OXYGEN THROUGHOUT THE BODY.
• DURING PREGNANCY, A MOTHER SUPPLIES THE
DEVELOPING FOETUS WITH OXYGENATED BLOOD,
INCREASING THE IRON DEMAND.
• LOW LEVELS OF IRON HAVE BEEN IMPLICATED IN
PREMATURE BIRTH AND LOW BIRTH WEIGHT.
 ZINC
• ZINC PLAYS A ROLE IN CELL DIVISION, GROWTH
AND HEALING.
• A DEFICIENCY IN ZINC THEREFORE HAS A
LIMITING EFFECT ON GROWTH AND HAS BEEN
LINKED TO LOW BIRTH WEIGHT AND
PREMATURITY.
 IODINE
• THIS ESSENTIAL TRACE ELEMENT IS INCORPORATED INTO
THYROID HORMONES WHICH THE MOTHER PASSES ON TO
THE FOETUS.
• THESE THYROID HORMONES PLAY A PIVOTAL ROLE IN
FOETAL ORGANOGENESIS, WITH BRAIN DEVELOPMENT
PARTICULAR.
• A DEFICIENCY IN IODINE CAN HAVE IRREVERSIBLE
ADVERSE EFFECTS ON THE CHILD’S NEUROLOGICAL
FUNCTION.
 CALCIUM
• CALCIUM IS REQUIRED BY THE FOETUS FOR PROPER BONE
DEVELOPMENT.
• A CALCIUM INSUFFICIENCY MAY RESULT IN MATERNAL BONE
LOSS AND IMPAIRED FOETAL BONE DEVELOPMENT.
• CALCIUM SUPPLEMENTATION HAS BEEN LINKED WITH
REDUCING THE RISK OF PRETERM DELIVERIES, MATERNAL
MORBIDITY AND INFANT MORTALITY.
 VITAMIN C
• VITAMIN C IS ESSENTIAL BECAUSE IT AIDS IN THE PRODUCTION OF
COLLAGEN WHICH IS A STRUCTURAL PROTEIN THAT IS THE MAIN
COMPONENT OF BONES, TENDONS AND CARTILAGE.
• IT ALSO HELPS THE BODY TO ABSORB IRON WHICH IS ESSENTIAL
FOR FOETAL DEVELOPMENT.
• VITAMIN C DEFICIENCY HAS BEEN IMPLICATED IN PREMATURE
RUPTURE OF FOETAL MEMBRANES, RESULTING IN INFANT
MORBIDITY AND MORTALITY.
 VITAMIN A

• VITAMIN A IS CRUCIAL IN SIGNALLING TRANSDUCTION

PATHWAYS AND REGULATING FOETAL DEVELOPMENT.
• BOTH THE LACK AND EXCESS OF VITAMIN A MAY RESULT IN
SEVERE CONGENITAL MALFORMATIONS AND EVEN DEATH.
 DOCOSAHAENOIC ACID (DHA)
• DURING FETAL DEVELOPMENT, DOCOSAHAENOIC ACID (DHA)
IS CRUCIAL FOR STRUCTURAL AND FUNCTIONAL INTEGRITY
OF THE CENTRAL NERVOUS SYSTEM AND RETINA.
• THERE IS EVIDENCE WHICH SHOWS THAT DHA CAN REDUCE
PRETERM BIRTHS AND LOW BIRTH WEIGHT.
CONGENITAL MALFORMATIONS
Nutrient Daily Recommended Amount
Calcium 1,300 mg (18 and under); 1,000 mg (19-50)
Iron 27mg
Vitamin A 750 micrograms (18 and under); 770
micrograms (19-50)
Vitamin D 600 International Units (IU)
Folic Acid (Vitamin B9) 600 micrograms
Vitamin B12 2.6 micrograms
Iodine 220 micrograms
Vitamin C 80 mg (18 and under); 85 mg (19-50)
Docosahexaenoic acid (DHA) 800-1000 mg
Zinc 12 mg (18 and under); 11mg (19-50)
 CASE

•WHAT COMPRIZES A HEALTHY PRENATAL

DIET AND WHAT SHOULD BE EXCLUDED?
• WHATEVER A WOMAN EATS AND DRINKS DURING PREGNANCY
IS HER BABY'S MAIN SOURCE OF NOURISHMENT.
• IT IS THEREFORE RECOMMENDED THAT AN EXPECTING
MOTHER CHOOSES A VARIETY OF HEALTHY FOODS AND
BEVERAGES SO AS TO PROVIDE THE IMPORTANT
NUTRIENTS A BABY NEEDS FOR GROWTH AND
DEVELOPMENT.
 FOOD SOURCES: LEAFY GREEN
FOLIC ACID VEGETABLES, FORTIFIED OR
(VITAMIN B9) ENRICHED CEREALS, BREADS AND
PASTAS, BEANS, CITRUS FRUITS.
 FOOD SOURCES: MILK, YOGURT,
CALCIUM CHEESE, SARDINES OR SALMON WITH
BONES, SOME LEAFY GREENS (KALE, BOK
CHOY).
 CALCIUM

• PRODUCTS ARE ALSO FORTIFIED WITH VITAMIN D, ANOTHER

NUTRIENT THAT WORKS WITH CALCIUM TO DEVELOP A BABY'S
BONES AND TEETH.
 FOOD SOURCES MEAT, POULTRY,
IRON FISH, DRIED BEANS AND PEAS,
IRON-FORTIFIED CEREAL
 IRON
• TO INCREASE THE ABSORPTION OF IRON, INCLUDE A GOOD
SOURCE OF VITAMIN C AT THE SAME MEAL WHEN EATING
IRON-RICH FOODS.
FOR EXAMPLE, HAVE A GLASS OF ORANGE JUICE AT
BREAKFAST WITH AN IRON-FORTIFIED CEREAL.
PROTEIN
• MORE PROTEIN IS NEEDED
DURING PREGNANCY, BUT
MOST WOMEN DON’T HAVE
PROBLEMS GETTING
ENOUGH PROTEIN-RICH
FOODS IN THEIR DIETS
 IRON
• FOOD INFECTIONS TO INCREASE THE ABSORPTION OF IRON,
INCLUDE A GOOD SOURCE OF VITAMIN C AT THE SAME MEAL
WHEN EATING IRON-RICH FOODS.
FOR EXAMPLE, HAVE A GLASS OF ORANGE JUICE AT
BREAKFAST WITH AN IRON-FORTIFIED CEREAL.
• CAFFEINE: CONSUMING FEWER THAN 200 MG OF CAFFEINE A DAY,
WHICH IS THE AMOUNT FOUND IN ONE 12-OUNCE CUP OF COFFEE
• FISH: FISH IS A GOOD SOURCE OF LEAN PROTEIN, AND SOME FISH,
INCLUDING SALMON AND SARDINES, ALSO CONTAIN OMEGA-3
FATTY ACIDS, A HEALTHY FAT THAT’ S GOOD FOR THE HEART.
• HOWEVER, THEY SHOULD LIMIT ALBACORE OR TUNA, WHICH HAS
HIGH LEVELS OF MERCURY, TO NO MORE THAN 6 OUNCES A WEEK.
MERCURY IS A METAL THAT CAN BE HARMFUL TO A BABY’ S
DEVELOPING BRAIN.
• CANNED LIGHT TUNA HAS LESS MERCURY THAN ALBACORE, TUNA AND
IS SAFER TO EAT DURING PREGNANCY.
 ALCOHOL
• ALCOHOL IN THE MOTHER’ S BLOOD CAN PASS DIRECTLY
TO THE BABY THROUGH THE UMBILICAL CORD.
• HEAVY USE OF ALCOHOL DURING PREGNANCY HAS BEEN
LINKED WITH FOETAL ALCOHOL SPECTRUM
DISORDERS.
• A GROUP OF CONDITIONS THAT CAN INCLUDE: PHYSICAL
PROBLEMS, AS WELL AS LEARNING AND BEHAVIOURAL
DIFFICULTIES IN BABIES AND CHILDREN.
 FISH
• FISH WITH HIGH LEVELS OF MERCURY
• THIS INCLUDES SEAFOOD SUCH AS SWORDFISH,
SHARK, KING MACKEREL, MARLIN, AND TILEFISH
WHICH ARE HIGH IN LEVELS OF METHYL MERCURY.
• METHYL MERCURY IS A TOXIC CHEMICAL THAT CAN
PASS THROUGH THE PLACENTA AND CAN BE
HARMFUL TO AN UNBORN BABY’S DEVELOPING
BRAIN, KIDNEYS AND NERVOUS SYSTEM.
• PREGNANT WOMEN ARE AT HIGH RISK FOR GETTING
SICK FROM TWO DIFFERENT TYPES OF FOOD
POISONING:
• LISTERIOSIS, CAUSED BY THE LISTERIA BACTERIA
• TOXOPLASMOSIS, AN INFECTION CAUSED BY A
PARASITE
 LISTERIA

INFECTION MAY CAUSE

MISCARRIAGE,
STILLBIRTH, PRETERM
LABOUR, AND ILLNESS
OR DEATH IN NEW-
BORNS.
 UNPASTEURIZED FOODS
• TO AVOID LISTERIOSIS, IT IS ADVISED TO AVOID THE FOLLOWING FOODS
DURING PREGNANCY:
• UNPASTEURIZED (RAW) MILK AND FOODS MADE FROM IT
• HOT DOGS, LUNCHEON MEATS AND COLD CUTS UNLESS
HEATED TO STEAMING HOT BEFORE EATING TO KILL ANY
BACTERIA.
• STORE-BOUGHT DELI SALADS, SUCH AS HAM SALAD, CHICKEN
SALAD, TUNA SALAD AND SEAFOOD SALAD.
• UNPASTEURIZED REFRIGERATED MEAT SPREADS OR PATES.
 TOXOPLASMA
• A MOTHER CAN PASS A
TOXOPLASMA INFECTION ON
TO HER BABY, WHICH CAN
CAUSE PROBLEMS SUCH AS
BLINDNESS AND MENTAL
DISABILITY LATER IN LIFE.
 RAW MEAT
• THE FOLLOWING FOODS SHOULD BE AVOIDED DURING
PREGNANCY:
• RARE, RAW OR UNDERCOOKED MEATS AND POULTRY.
• RAW FISH, SUCH AS SUSHI, SASHIMI, CEVICHES AND
CARPACCIO.
• RAW AND UNDERCOOKED SHELLFISH, SUCH AS CLAMS,
MUSSELS, OYSTERS AND SCALLOPS.
 OTHERS
• SOME FOODS MAY INCREASE A PREGNANT WOMAN’S RISK FOR OTHER TYPES
OF FOOD POISONING, INCLUDING ILLNESS CAUSED BY SALMONELLA AND E.
COLI BACTERIA.
• RAW OR UNDERCOOKED EGGS, SUCH AS SOFT-COOKED, RUNNY OR POACHED
EGGS.
• FOODS CONTAINING UNDERCOOKED EGGS, SUCH AS RAW COOKIE DOUGH
OR CAKE BATTER, TIRAMISU,
• CHOCOLATE MOUSSE, HOMEMADE ICE CREAM, HOMEMADE EGGNOG,
HOLLANDAISE SAUCE.
• RAW OR UNDERCOOKED SPROUTS, SUCH AS ALFALFA, CLOVER.