Nutrition in pregnancy

1
Nutrition in pregnancy

• B Golden

2
12kg
TF
blood
Maternal stores
Wt gain
Uterus breasts
Foetus, placenta, cord
0
20
10
40 weeks
weeks
Wt gain 62 water, 30 fat, 8 protein, and
10 blood, 25 foetus
3
Factors affecting outcome

• Maternal Wt gain during pregnancy
• - age, pregnancies, alcohol, smoking,
  diseases, prepreg BMI, diet, height, social,
  education, drugs etc etc
• Foetal birth weight
• - multiple pregnancy, congenital abnormalities
  etc

4
Energy cost of pregnancy

• Total 250-300MJ 60 stored, 40 ? metabolic rate
• Over 280 days
• Thus,
• 1 MJ/day (240kcal/day) recommended

5
Protein requirements

• 925 grams accumulated especially in 2nd trimester
• Usually protein intake adequate

6
Fat requirements

• Fat COMPOSITION important
• n-3 fatty acids .
• 3rd trimester, foetal brain development

7
Fat soluble vitamins

• Recommended
• Vitamin D especially. 100 increase
• Vitamin E 25 increase
• Vitamin A No increase, but
• beware deficiency and toxicity
• Vitamin K No increase

8
Water-soluble vitamins

• Vitamin B12 Deficiency affects infants before
  mothers
• Folate Deficiency assocn with megaloblastic
  anaemia, foetal malformations, IUGR,
  prematurity etc
• 400ug/day recommended from before
  conception
• B1, B2, B6, Modest increases recommended.
• niacin, C Infant thiamine deficiency only
  real problem from breastfeeding

9
Minerals

• CALCIUM Phosphorus
• Placental transfer 3rd trimester at mothers
  expense maternal Ca absorption ?
• 50 extra recommended
• IRON
• Approx. 900mg extra required (500mg for maternal,
  350mg foetal placenta, ?250mg blood loss)
• Hence, an extra 3mg/day absorbed
• Fe absorption ? from approx 10 to 20

10
In summary, recommended

• Folate supplement periconceptually
• Iron and folate supplements during later
  pregnancy at least
• Vit D supplement for those at risk at least
• A high quality mixed diet ad libitum
• A healthy lifestyle
• NOT protein or Vit A supplements