Maternal Nutrition

• calcium: involved in mineralization of fetal bones and teeth, energy cell production, and acid-base buffering
• sources of calcium: milk, cheese, yoghurt, tofu, broccoli, spinach, sardines
• effects of caffeine on calcium: increases urinary secretion of calcium
• sources of phosphorus: dairy, lean meat, fish
• Influences on the outcome of pregnancy include: health, motivation, income, family, education, and nutrition
• Fetal growth occurs in three overlapping stages:

  1. Growth by increase in cell number

  2. Growth by increase in cell number and cell size

  3. Growth by increase in cell size
• Nutritional problems can occur during cell division and when cells are increasing in size
• Assessment of Nutritional Status:

  • Maternal weight gain is crucial
  • The amount of optimal gain depends on body mass index (BMI) or weight for height
  • BMI is calculated as weight (kg) / height (meters)^2
• Maternal weight gain patterns:

  • First trimester: 2-4 lb.
  • Second trimester: average of 1 lb. (0.5 kg) per week
  • Third trimester: average of 1 lb. (0.5 kg) per week
• Nutritional Requirements:

  • Calories: increase of 340 kcal during the 2nd trimester and 450 kcal during the 3rd trimester
• Proteins are essential during pregnancy for fetal development, blood volume expansion, and growth of maternal tissues. The recommended daily allowance (RDA) during pregnancy is 60 g (46 g for non-pregnant women)
• Iron requirements increase during pregnancy due to fetal growth, placenta development, and maternal blood volume expansion. Iron deficiency anemia can lead to a decrease in the oxygen-carrying capacity of blood
• Vitamins:

  • Vitamin A: essential for epithelial cell growth, carbohydrate and fat metabolism, and vision in dim light. RDA is 770 mcg during pregnancy
• Vitamin D: important for calcium and phosphorus absorption and utilization. Adequate intake is crucial for maternal and fetal health
• Vitamin E: acts as an antioxidant, involved in enzymatic reactions, and essential for red blood cell synthesis. RDA is 15 mg
• Vitamin C: aids in connective tissue formation and collagen synthesis. RDA during pregnancy is 85 mg
• B Vitamins:

  • Thiamine, Riboflavin, Niacin, Folic Acid, Vitamin B6, Vitamin B12 are essential for various cellular functions and metabolism
• Fluid intake of 1500-2000 ml per day is recommended during pregnancy
• Factors influencing nutrition during pregnancy include age, nutritional knowledge, nausea, vomiting, hyperemesis gravidarum, and cultural, ethnic, and religious factors
• Lactation nutritional needs include a balanced diet with adequate intake of proteins, fats, vitamins, and minerals
• sources of iodine: iodized salt, shellfish, seafood
• iodine deficiency can lead to: increased risk of miscarriage, stillbirth, congenital hypothyroidism, and neuro problems
• zinc is involved in protein metabolism and synthesis of DNA and RNA
• sources of zinc: meat, poultry, whole grains, legumes
• risks of iron deficiency: increase maternal mortality, increase in postpartum infections, and increased risk for preterm delivery
• normal hematocrit in non-pregnant woman: 37-47
• sources of iron: meats, legumes, green leafy vegetables, dried fruit, molasses
• vitamin C enhances the absorption of iron
• vitamin D deficiency: can result in neonatal hypocalcemia, fetal hypoplasia of tooth enamel, and maternal osteomalacia
• folic acid promotes adequate fetal growth and prevents macrocytic, megaloblastic anemia of pregnancy
• folic acid deficiency can cause neural tube defects in the fetus
• hyperemesis gravidarum is excess vomiting during pregnancy
• pica is eating non-food items during pregnancy
• what fish should you not eat during pregnancy? shark, swordfish, king mackerel