Nutrition and pregnancy 3055427 221306869 2008-06-23T23:16:56Z DOI bot 6652755 Citation maintenance. Initiated by [[User:Fconaway|Fconaway]]. You can [[WP:DOI|use this bot]] yourself! Please [[User:DOI_bot/bugs|report any bugs]]. [[Image:Pregnant woman eating.jpg|thumb|180px|Pregnant woman eating strawberries, grapes, orange slices, and apple.]] '''Nutrition and pregnancy''' refers to the nutrient intake, and dietary planning that is undertook before, during and after pregnancy. All dietary advice relating to pregnancy-related nutrition is noted by Mary E. Barasi as one of the major factors in determining the future well-being of a child conceived, some factors of a diet are even noted to reduce childhood morbidity and mortality due to helping the supply of nutrients to the mother. {{ref|mary_e_barasi}} In a precursory study into the link between nutrition and pregnancy in 1950 women who consumed minimal amounts over the eight week period had a higher mortality or disorder rate concerning their offspring than women who ate regularly, because children born to well-fed mothers had less restriction within the womb. {{ref|rasmussen_k}} Not only have physical disorders been linked with ill-nutrition before and during pregnancy, but neurological disorders and handicaps are a risk that is run by mothers who are mal-nourished, a condition which can also lead to the child becoming more susceptible to later degenerative disease(s). {{ref|mary_e_barasi}} The following sections refer to the pertinence of nutrition throughout pregnancy, and are thoroughly researched enough to be usable for mothers or couples planning on conceiving. ==Nutrition before pregnancy== ===Factors mitigating against pre-pregnancy nutrition=== It is known that good nutrition before pregnancy is important because of the amount of "resources" childbirth requires. The process of pre-pregnancy nutrition is a process of "building up" the immune system in preparation of pregnancy, and is known as being one of the major factors in determining the success rate of conceiving healthy children. As with most situations, the most important factor in pre-pregnancy nutrition is ensuring that the mother is healthy and without any major factors which could worsen the chances of conceiving, factors such as [[anorexia nervosa|anorexia]] or [[bulimia nervosa|bulimia]] are thought to be direct links with infertility; the minimum [[body mass index]] for conceiving mothers being 20.8. This is also seen to be true with [[obese]] women with a BMI above 30 which is a direct result of decrementing amounts of [[insulin]] activity and sex hormones may reduce the viability of the [[ovum]]. The ideal range of weight for women wishing to conceive children is thought to be optimal at body mass indexes between 20 and 26. If this, again, is used in conjunction with good nutrition and diet before pregnancy in terms of a normal balanced diet, then reserves of [[micronutrients]], providing materials for pregnancy, would also be maximised.{{ref|mary_e_barasi}} :''For more information on how BMI is calculated, please refer to the [[body mass index]] article.'' ===Major benefactors in pre-pregnancy diets=== As with most diets, there are chances of over-supplementing, however, as general advice, both state and medical recommendations are that mothers follow instructions listed on particular vitamin packaging as to the correct or recommended daily allowance (RDA). * [[Magnesium]] and [[zinc]] supplementation for the binding of hormones at their receptor sites. * [[Folic acid]] supplementation, or dietary requirement of foods containing it for the regular growth of the [[ovarian follicle|follicle]]. * Regular [[Vitamin D]] supplementation decreases the chances of [[deficiency|deficiencies]] in adolescence. More importantly, it is known to reduce the likelihood of [[rickets]] with [[pelvis|pelvic]] malformations which make normal delivery impossible. * Regular [[Vitamin B12]] supplementation, again is known to reduce the chances of infertility and ill health. ==Nutrition during pregnancy== ===Factors mitigating against nutrition during pregnancy=== As it is known, the embryo at conception, and in the subsequent weeks afterwards is the time when it is at its most vulnerable, as it is the time when the organs and systems develop within. The energy used to create these systems comes from the energy and nutrients in the mother's circulation, and around the lining of the womb, such is the reason why correct nutrient intake during pregnancy is so important. During the early stages of pregnancy, the placenta is not formed yet, so there is no mechanism to protect the embryo from the deficiencies which may be inherent in the mother's circulation, so it is critical that the correct amount of nutrients and energy are consumed. One problem that was found in trials with pregnant women is that deficiencies in folic acid contributed towards [[neural tube defects|neural tube defection]]; women who had 4&nbsp;mg of folic acid in their systems due to supplementing 3 months before childbirth significantly reduced the risk of NTD within the [[fetus]]. This is now advocated by the UK department of health, recommending 400&nbsp;µg per day of folic acid. Intake of [[retinol]], in extreme cases, has been linked to birth defects and abnormalities. However, regular intake of retinol is not seen as dangerous. It is noted that a 100&nbsp;g serving of liver may contain a large amount of retinol, so it is best that it is not eaten daily during pregnancy, something which is also the same with alcohol intake in binge drinking. Excessive amounts of alcohol have been proven to cause [[Fetal alcohol syndrome]]. The [[World Health Organization]] recommends that alcohol should be avoided entirely during pregnancy, given the relatively unknown effects of even small amounts of alcohol during pregnancy.{{ref|WHO}} ===Beneficial factors against pre-pregnancy nutrition=== During pregnancy, the most important factor could be seen as the amount of fat content within the woman when in the early stages of pregnancy. It is recommended, again that women who may be obese, should lose fat before trying to conceive a baby due to the infertility related to obesity. Again, research has shown that women who have had optimal fat stores, and who were well-supplemented, had a much lessened experience in childbirth in regards to the energy and effort required during metabolic changes within the body, which was noted by monitoring [[leptin]] levels during pregnancy. ===Recommended nutrients during pregnancy=== {| align=center border=1 | '''Nutrient''' | '''Recommendation''' (Extra = Above RDA) | '''Maximum/Total amount recommended per day''' |---- | [[Food energy|Energy]] | Increase by 200&nbsp;kcal (840&nbsp;kJ) per day in last trimester only. | [[RDA]] |---- | [[Protein]]s | Extra 6&nbsp;g per day | 51&nbsp;g per day |---- | [[Thiamin]] | Increase in line with energy; increase by 0.1&nbsp;mg per day | 0.9&nbsp;mg per day |---- | [[Riboflavin]] | Needed for tissue growth; extra 0.3&nbsp;mg per day | 1.4&nbsp;mg per day |---- | [[Niacin]] | Regular supplementation/diet of substance. No increase required. | RDA |---- | [[Folate]] | Maintain plasma levels; extra 100&nbsp;µg per day | 300&nbsp;µg per day |---- | [[Vitamin C]] | Replenish drained maternal stores; extra 120&nbsp;mg per day | 50 mg per day |---- | [[Vitamin D]] | Replenish plasma levels of vitamin 10&nbsp;µg per day. | RDA |---- | [[Calcium]] | Needs no increase | RDA |---- | [[Iron]] | Extra 3 mg per day needed | RDA |---- | [[Magnesium]], [[zinc]], and [[copper]] | Normal supplementation or consumption. | RDA |---- | [[Iodine]] | Extra 100&nbsp;µg per day. | 250&nbsp;µg per day<ref name="pmid17956157">{{cite journal |author=Zimmermann MB |title=The adverse effects of mild-to-moderate iodine deficiency during pregnancy and childhood: a review |journal=Thyroid |volume=17 |issue=9 |pages=829–35 |year=2007 |pmid=17956157 |doi=10.1089/thy.2007.0108}}</ref><ref name="pmid17701774">{{cite journal |author=Pérez-López FR |title=Iodine and thyroid hormones during pregnancy and postpartum |journal=Gynecol. Endocrinol. |volume=23 |issue=7 |pages=414–28 |year=2007 |pmid=17701774 |doi=10.1080/09513590701464092}}</ref><ref name="pmid17684390">{{cite journal |author=Glinoer D |title=Clinical and biological consequences of iodine deficiency during pregnancy |journal=Endocr Dev |volume=10 |issue= |pages=62–85 |year=2007 |pmid=17684390 |doi=10.1159/0000106820 |doi_brokendate=2008-06-23}}</ref><ref name="pmid15107513">{{cite journal |author=Sethi V, Kapil U |title=Iodine deficiency and development of brain |journal=Indian J Pediatr |volume=71 |issue=4 |pages=325–9 |year=2004 |pmid=15107513 |doi=}}</ref> |} ==Nutrition after pregnancy== Proper nutrition is important after delivery to help the mother recover, and to provide enough food energy and nutrients for a woman to [[Breastfeeding|breastfeed]] her child. Women having serum ferritin <= 70&nbsp;µg/L may need [[iron]] supplements to prevent [[iron deficiency anaemia]] during pregnancy and postpartum.<ref name="pmid16733739">{{cite journal |author=Milman N, Byg KE, Bergholt T, Eriksen L, Hvas AM |title=Body iron and individual iron prophylaxis in pregnancy--should the iron dose be adjusted according to serum ferritin? |journal=Ann. Hematol. |volume=85 |issue=9 |pages=567–73 |year=2006 |pmid=16733739 |doi=10.1007/s00277-006-0141-1}}</ref><ref name="pmid15715531">{{cite journal |author=Milman N, Bergholt T, Eriksen L, ''et al'' |title=Iron prophylaxis during pregnancy -- how much iron is needed? A randomized dose- response study of 20-80 mg ferrous iron daily in pregnant women |journal=Acta Obstet Gynecol Scand |volume=84 |issue=3 |pages=238–47 |year=2005 |pmid=15715531 |doi=10.1111/j.0001-6349.2005.00610.x}}</ref> ==References== {{citation style|date=June 2008}} {{reflist}} #{{note|mary_e_barasi}} Barasi, E. M., (2003) ''Human Nutrition - A Health Perspective'' . London : Arnold Publishing (ISBN 0340810254) #{{note|rasmussen_k}} Rasmussen, K. M., (1992) ''The influence of maternal nutrition on lactation'' . Annual review of Nutrition 12, p103-117 #{{note|DOH}} UK Department of Health (1991) ''Dietary reference values for food energy and nutrients for the United Kingdom.'' - Report on Health and social Subjects No 41. report of the Panel on Dietary Reference Values of the Committee on Medical Aspects of Food Policy London:HMSO #{{note|HEA}}Health Education Authority (1996) ''Folic acid - what all women should know (leaflet)'' London:HEA #{{note|WHO}}[http://www.euro.who.int/document/e88335.pdf World Health Organisation ''Framework for alcohol policy in the WHO European Region''] ==External links== *[http://www.americanpregnancy.org/pregnancyhealth/fishmercury.htm American Pregnancy Association: Mercury Levels in Fish] *[http://www.nal.usda.gov/fnic/pubs/bibs/topics/pregnancy/pregcon.pdf Nutrition During Pregnancy Resource List for Consumers, USDA NAL Food and Nutrition Information Center (PDF|92KB)] [[Category:Nutrition]] [[Category:Pregnancy]]