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Nutrition in pregnancy 

Nutrition in pregnancy

Chapter:
Nutrition in pregnancy
Author(s):

David J. Williams

DOI:
10.1093/med/9780199204854.003.1402
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date: 24 April 2017

Nutritional requirements for healthy pregnancy vary according to a woman’s prepregnancy nutritional state and her access to food during pregnancy: there is no unifying nutritional advice that is appropriate for all pregnant women throughout the world, or even within nations.

The well-nourished mother—maternal adaptation to pregnancy requires few dietary changes during pregnancy. She should eat one or two portions of sea fish per week to -ensure intake of n-3 long-chain polyunsaturated fatty acids sufficient to provide at least 200 mg of docosahexaenoic acid per day, which is needed for the healthy development of the fetal central nervous system. Supplemental folic acid (400 µg/day) during the first trimester reduces the risk of neural tube defects, but with this exception extra vitamins and micronutrients are not necessary for well-nourished, healthy pregnant women who eat a balanced diet, and excessive amounts of some micronutrients can actually be harmful to the fetus. Thiamine replacement is essential for women with hyperemesis gravidarum.

The chronically undernourished pregnant woman—needs a balanced diet that is supplemented with (1) vitamins—including folic acid, vitamins A, B1 (thiamine) and others; and (2) micronutrients—iron, zinc, iodine. and others, to ensure that the fetus fulfils its growth potential. However, although protein and energy supplements given to such women of small stature and pelvis size improve fetal growth and perinatal outcome, they can lead to obstructed labour, a significant cause of maternal and perinatal death in the developing world.

Overeating and obesity—pregnancy complications due to poor nutrition in high-income countries tend to follow from these causes. Those who gain excessive weight in pregnancy double their risk of a poor outcome and increase their likelihood of postpartum weight retention, and women who retain weight after their first pregnancy have an increased risk of gestational diabetes, pre-eclampsia, caesarean delivery, stillbirth, and large for gestational age babies in subsequent pregnancies. Obesity during pregnancy fuels obesity in the next generation.

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