Below standard nutrition

Lack of pre/postnatal check-ups

Infections

Hypertension

Hemorrhage during and after delivery

Pre-pregnant nutritional status

Weight gain during pregnancy

FETAL GROWTH

Very big babyVery big baby Increase cesarean sectionIncrease cesarean section Pre-eclampsiaPre-eclampsia Diabetes during Diabetes during

pregnancypregnancy Late fetal death ( 3 - 4X )Late fetal death ( 3 - 4X ) Early neonatal death Early neonatal death

( 2X )( 2X )

Small babiesPreterm deliveries

1. Respiratory Conditions2. Pneumonias3. Congenital Anomalies4. Diarrheal Diseases5. Birth Injury/ Difficult Labor6. Septicemia7. Measles8. Meningitis9. Other diseases of the Respiratory System10. Avitaminoses & other nutritional

deficiency

Women who have:- Too many pregnancies- Previous low birth weight babies- Short intervals between births

RDA in Pregnancy

% RDA

1998 2002

EnergyProteinCalciumIronFolic Acid

2200 Kcal/ day

60 gm/ day 900 mg / day 41 mg / day 350 ug/ day

72.586.240.925.0(?)

80 > 90

29.533.7

Cigarettes Alcohol Diabetes

Birth defects

low birthweight

low folate, Vit C,

and carotenoids

Stillbirthbirth defectslow birthweight

Lowers plasma levels of Vit. C

Macronutrients Energy Protein Carbohydrates Fats

MicronutrientsDietary Fiber

PROTEIN 15%

FAT 25%

CARBOHYDRATE 60%

Micronutrients

Vitamins Fat-soluble:

A D E K Water-soluble:

B, C, Folate, Niacin

Minerals

Organic food substances found only in living things

Cannot be manufactured nor synthesized by the body

Must be supplied in the diet or in dietary supplements

Regulate metabolism

Convert fat and carbohydrates into energy

Assist in forming tissues and bones

Vital to the overall mental and physical well-being

Act as catalysts for many biological reactions in the body

Constituents of bones, teeth, soft tissues, muscles, blood and nerve cells

Minerals Maternal Fetal

Iron Anemia Easy fatigability Fainting spellsBreathlessness

Anemia

Calcium Osteoporosis Fetal utilization of maternal bone calcium

Poor mineralization of fetal skeleton and teeth

Iodine Abortion Stillbirth , Goiter, Congenital defectsCretinismHypothyroidismImpaired brain devt

Breastfeeding MOMS have a higher daily requirement for almost all nutrients,particularly:

ProteinsIronFolic AcidCalciumIodine

Non Pregnant 1st 6 mos 2nd 6 mos

Energy (kcal)

Protein (gram)

Vitamin:

A (ugRE)

D (ug)

E (mg alphaTE)

K (thiamin)

Thiamin (mg)

Riboflavin (mg)

Niacin (mg)

Pyridoxine (mg)

C (mg)

Folate (ug)

1900

52

450

5

8

65

1.0

1.0

18

70

150

+500

+16

+325

+5

+4

65

+0.4

+0.4

+5

2.1

+35

+100

+500

+12

+275

+5

+3

65

+0.4

+0.4

+5

2.1

+30

+100

Non-Pregnant 1st 6 mos 2nd 6 mos

Minerals:

Calcium (mg)

Phosphorous

(mg)

Iron (mg)

Magnesium (mg)

Zinc (mg)

Iodine (ug)

Selenium (ug)

500

500

26

280

9

100

55

+400

+400

+23

+75

+10

+50

+20

+400

+400

+23

+60

10

+50

+20

The risk of some pregnancy outcomes such as NEURAL TUBE DEFECTS can be reduced by intake of high levels of nutrients BEFORE

conception and during the earliest weeks of pregnancy.

At least 3 months preconception intake of 0.4 mg/ day folic acid until the 12th week of gestation is strongly recommended.

The simplest way to achieve proper nutrient intake for pregnant women is to follow the recommendations in the FOOD GUIDE PYRAMID

In our local setting, it would seem prudent to consider the use of vitamin and mineral supplements, particularly iron and folic acid, for the great majority of women who are not meeting their needs through diets alone.

Education and individual commitment to dietary behavior change of each reproductive age woman and her partner is essential in ensuring a good pregnancy outcome.