UNIT 1 part 2

• Energy & Folate - most important
• Energy - additional 300 kcal for the 2nd and 3rd trimester of pregnancy.
• Protein - essential as it forms the structural basis for all new cells and tissues in the mother and fetus.
• Protein - additional 27 grams of protein
• Lack of protein, usually accompanied with calorie deficiency, leads to decreased birth weight and greater incidence of pre-eclampsia.
• Carbohydrates - generous amount of carbohydrates (50-60%) is critical to spare protein and to supply energy needs for higher basal energy expenditure and for building tissues
• Folate - RNI: 400 ug DFE (non-pregnant); 600 ug (pregnant).
• Vitamin B12 - Needed for its key role in blood cell production
• Vitamin B12 - RNI: 2.4 ug (non-pregnant); plus 0.2 ug (pregnant)
• Vitamin B6 - increases in requirement because of the greater need for non-essential amino acids for growth and also because the body is making more niacin from tryptophan.
• Vitamin B6 - (RNI 1.3 – 1.6 + 0.5 mg)
• Vitamin A - needed because of its critical role in growth and reproduction
• Vitamin A - RNI = 600 plus 300 ug RE
• Folate - needed to prevent neural tube defects (NTD)
• Calcium – 750-800 mg plus 50mg
• Vitamin D - 5 mcg
• Pre-eclampsia - formerly called toxemia
• Vitamin D - Needed for calcium homeostasis during pregnancy
• Vitamin C - enhances absorption of iron and its deficiency is associated with pre-eclampsia
• Vitamin C - RNI is 60 mg plus 10 mg/day
• Iron - needed to manufacture hemoglobin in maternal and fetal blood cells.
• Iron - RNI- 28 mg +10 mg
• Calcium and phosphorus - promote adequate mineralization of the fetal skeleton and deciduous teeth during pregnancy.
• Zinc - required for DNA and RNA synthesis.
• Zinc - Low zinc levels predicts low birth weight
• Deoxyribonucleic acid (DNA) and Ribonucleic acid (RNA) - most important molecules in cell biology and reading of genetic information that underpins all life
• Iodine - increased basal metabolic rate (BMR)
• Iodine - 150 mcg plus 100 mcg
• Water - An additional 300 ml/day is recommended because of the expanding extracellular fluids, increased BMR, the needs of the fetus, and the amniotic fluid
• Amniotic fluid protects the developing baby by cushioning against blows to the mother's abdomen
• Nausea and Vomiting -  most common discomfort during the early part of pregnancy
• Nausea and Vomiting - “morning sickness” (Paglilihi in our culture)
• Heartburn - common complaint during the latter part of pregnancy
• Constipation - May be due to the relaxation of the smooth muscles; the pressure exerted by the developing fetus on the digestive tract; lack of exercise; and insufficient bulk (fiber) and fluid intakes.
• Edema - usually present in the extremities in the 3rd trimester
• Gestational Diabetes or GDM - glucose intolerance with onset or first recognition during pregnancy.
• Chronic Hypertension - present before pregnancy or diagnosed before 20 weeks of pregnancy
• WHAT IS THE DIFFERENCE BETWEEN PREGNANCY INDUCED HYPERTENSION AND GESTATIONAL HYPERTENSION?

  Proteinuria
• Gestational Hypertension - Exists when elevated blood pressure levels are detected for the first time after midpregnancy, not accompanied by proteinuria.
• Neural Tube Effects - malformation of the brain, spinal cord or both during embryonic development that often results to lifelong disability or death.