Nutrition and pregnancy

Nutrition and Pregnancy refers to the Nutrient intake, anbd dietary planning that is undertook befor, 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 wellbeing 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. ^[1]

In a precursory study into the Link between Nutrition and Pregnancy in 1950 showed that women who consumed minimal amounts over the eight week period had a higher mortality or disorder rate into their offspring than women who ate regularly had a much lesser rate, because children born with well-fed mothers had less restriction within the womb. ^[2]

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 ill-nourished, a condition which can also lead to the child becoming more susceptible to later degenerative disease(s). ^[3]

The following sections refer to the pertainance 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 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 benefactors 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 wihout any major factors which could worsen the chances of conceiving, factors such as anorexia or bulimia are thought to be direct links with infertility; the minimum BMI 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 - 26. If this, again, is used in conjuction 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.

For more information on how BMI is calculated, please refer to the BMI 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 reccomendations are that Mothers follow instructions listed on particular Vitamin packaging as to the correct or reccomended 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 follicile.
• Regular Vitamin D supplementation decreases the chances of deficiencies in adolescance. More importantly, it is known to reduce the likelihood of rickets with 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 aftgerwards is the time when it is at it's 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 inheirant 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 defection; women who had 4mg of folic acid in their systems due to supplementing 3 months before childbirth significantly reduced the risk of NTD within the fetus; something which is now completely reccomended by the UK department of health ; reccomending 400 ug per day of Folic acid.

Intake of Retinol, in extreme cases has been linked to birth defects and abnormalities. Although, regular intake of Retinol is not seen as dangerous. However, it is noted that a 100g 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.

As with any health diet, alcohol is reccomended in small amounts, no more than 15 units per week being the reccomendation by the British Medical Society, particularly because excessive amoutns of alcohol have been proven to cause birth defects and malformations of the face, heart, brain, and has even been linked to reduced mental capacity.

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 reccomended, again that women who may be obese, should lose fat before trying to conceive a baby due to the obvious 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.

Reccomended Nutrients during pregnancy

Nutrient	Reccomendation (Extra = Above RDA)	Maxium/Total amount reccomended per day
Energy	Increase by 200kcal per day in last trimester only.	RDA
Proteins	Extra 6g per day	51g per day
Thiamin	Increase in line with energy; Increase by 0.1mg per day	0.9mg per day
Riboflavin	Needed for tissue growth - Extra 0.3mg per day	1.4mg per day
Nicotinic acid	Regular supplementation / diet of substance. No increase required.	RDA
Folate	Maintain plasma levels - extra 100mg ug per day	300ug per day
Vitamin C	Replenish drained maternal stores - extra 120mg per day	50mg per day
Vitamin D	Replenish plasma levels of vitamin 10ug per day.	RDA
Calcium	Needs no increase	RDA
Iron	Needs no increase	RDA
Magnesium, Zinc, and copper	Normal supplementation or consumption.	RDA

References

1. ^ Barasi, E. M., (2003) Human Nutrition - A Health Perspective . London : Arnold Publishing (ISBN 0304810254)
2. ^ Rasmussen, K. M., (1992) The influence of maternal nutrition on lactation . Annual review of Nutrition 12, p103-117
3. ^ UK Department of Health (1991) Dietary reference values for food energy and nutrients for the United Kingdom. - Report oon 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