yulius hermanto
Nutrition in Pregnancy
Introduction
Pregnancy is a unique process of women's life, pregnancy also becomes a transition for a woman to be a mother. Thus pregnancy besides physical changes, also gives an emotional, psychological changes to a woman. During pregnancy, women are worried about their offspring inside their womb.
Those feelings usually occurs and should accepted gratefully.
Normally, pregnancy should be between 37-42 weeks in durations or about 9 months, during that period the fetus keep growing inside woman's womb. During that period many factors contribute to successful pregnancy, such as genetics, mother's conditions, nutritional factors, etc.
In this article, i gonna write about the nutritional support in pregnancy, one of the major concern of pregnant women. Pregnancy is associated with physiologic changes that result in increased plasma volume and red blood cells and decreased concentrations of circulating nutrient-binding proteins and micronutrients. In many developing countries, these physiologic changes can be aggravated by undernutrition, leading to micronutrient deficiency states, such as anemia, that can have disastrous consequences for both mothers and newborn infants.
Nutrition is important in pregnancy, because not only mother but also the offsprings need the nutrients. Eventhough the offspring is protected by unique mechanisms, thus makes it minimally effected by nutritional depletion but some nutritional deficiencies could resulted in congenital anomalies.
Nutrition and Pregnancy
Pregnancy increases the demand both energy and nutrients, but the requirements maybe different from each woman, and trimester. For well-nourished women, only a small amount of additional energy is required because the body adapts to the increased energy requirements and becomes more energy efficient through reduced physical activity and a lowered metabolic rate. Recent evidence suggests, however, that infants who are small or disproportionate at birth have increased health risks later in life. The hypothesis is that such infants have had to adapt to a limited supply of nutrients and that in so doing their physiology and metabolism are permanently changed, although the rationale for this hypothesis has been challenged.
Deficiencies can exist because of losses or malabsorption associated with disease or inadequate intakes, lack of knowledge about adequate prenatal nutrition, or dietary taboos associated with pregnancy, with potential adverse consequences for both mothers and newborn infants. Anemia in pregnancy and pregnancy-induced hypertension are common and thought to contribute significantly to maternal mortality and morbidity in developing countries.
Vitamins and Minerals
As a component of prenatal care, micronutrient supplementation might reduce maternal morbidity and mortality directly by treating a pregnancy-related illness or indirectly by lowering the risk of complications at delivery.
Nevertheless, the effectiveness of supplementation programs notably of iron and folate has tended to focus on infant outcomes, perinatal mortality, preterm delivery, and low birth weight. When infant outcomes are discussed, however, a distinction needs to be made between the teratogenic effects of deficiency at periconception and deficiency in later pregnancy. The former includes folate deficiency resulting in fetal neural tube defects and iodine deficiency that causes cretinism, whereas the latter includes intrauterine growth retardation and other pregnancy-related and delivery complications.
This distinction is important because many pregnancies in developing countries are unplanned; the use of prenatal care services, in which iron or iron and folate supplements are generally provided or prescribed, is less than optimal, and the cost-effectiveness of the programs promoted needs to be considered. Even in developed countries, prenatal care providers have reservations about the widespread and indiscriminate use of prophylactic minerals and vitamins because of unproven benefits in well-nourished populations, risks of teratogenicity, and side effects. These concerns need to be considered in the context of developing countries.
The Deficiency
Pregnant women in developing countries are associated with malnutrition, thus the demand of nutrients supplementation is quite high. WHO create the programs in antenatal care with the supplementation of folate, iron and iodine
to reduce pregnancy related mortality and morbidity.
Iron deficiency resulting mainly from poor dietary iron bioavailability causes anemia and has been associated with maternal mortality. Iron deficiency is known to affect immune status by reducing the delayed-type hypersensitivity reaction, graft rejection, and cytotoxic activity of phagocytes. Thus, iron may be important for maintaining maternal health and reducing the risk of infection.
The problems raised related to prophylactic iron supplementation. Which populations need those supplementation, recent recommendations for iron supplementation during pregnancy for developing countries. In other countries, iron supplementation is recommended only for anemic women with proven iron deficiency anemia, as in Great Britain, or for women with low prepregnancy iron stores, as in Canada. Iron overload leads to impairment of body function, this conditions commonly found in thalassemia patients that having frequent transfusions.
Thus iron supplementation should be give only for the women that need it, such as anemic women.
Folate deficiency is due to inadequate dietary intakes, cooking habits that exacerbate losses, food taboos, inadequate food storage, and intense erythroid hyperplasia in the bone marrow (eg, sickle cell anemia, chronic hemolytic anemia, or homozygous ß-thalassemia); deficiency is associated with megaloblastic anemia, low birth weight, and potential fetal anomaly.
The findings of folic acid roles in pregnancy to reduce the number of births with neural tube defects, is significant, from the literatures folic acid supplementation could reduce up to 75% neural tube defects. Thus, folic acid administration is recommended as standard prenatal care. Except for women taking anticonvulsant drugs, who may have coexisting vitamin B-12 deficiency, there is no evidence that folate supplementation in pregnancy is unsafe.
Inadequate iodine intakes during pregnancy result in fetal loss, stillbirths, cretinism, and mental retardation of the newborn infant In regions of moderate to severe iodine deficiency, pregnant women need iodized salt before or iodized oil before or during pregnancy. This regimen reduces reproductive loss, morbidity, and adverse fetal outcomes.
There are others vitamin and minerals that the demands increase during the pregnancy, such calcium, phosphorus, zinc, vitamin A, vitamin C, etc. Eventhough the demand is increase but the incidence of deficiency isn't quite high, so daily consumption of dietary products can meet the demands.
At the end, nutritional support is important for fetal development besides others factors such as mother's conditions, genetic, placenta, etc.
Pregnant women with anatomical and physiological changes, increase the demands of certain nutrients. Thus proper supplementation during pregnancy is needed. Well-nourished women basically, need less supplementation or maybe don't need at all compare to undernourished women.
"Being pregnant not only means that you're being bless, but also you have chosen to receive the responsibility"
Pregnancy is a unique process of women's life, pregnancy also becomes a transition for a woman to be a mother. Thus pregnancy besides physical changes, also gives an emotional, psychological changes to a woman. During pregnancy, women are worried about their offspring inside their womb.
Those feelings usually occurs and should accepted gratefully.
Normally, pregnancy should be between 37-42 weeks in durations or about 9 months, during that period the fetus keep growing inside woman's womb. During that period many factors contribute to successful pregnancy, such as genetics, mother's conditions, nutritional factors, etc.
In this article, i gonna write about the nutritional support in pregnancy, one of the major concern of pregnant women. Pregnancy is associated with physiologic changes that result in increased plasma volume and red blood cells and decreased concentrations of circulating nutrient-binding proteins and micronutrients. In many developing countries, these physiologic changes can be aggravated by undernutrition, leading to micronutrient deficiency states, such as anemia, that can have disastrous consequences for both mothers and newborn infants.
Nutrition is important in pregnancy, because not only mother but also the offsprings need the nutrients. Eventhough the offspring is protected by unique mechanisms, thus makes it minimally effected by nutritional depletion but some nutritional deficiencies could resulted in congenital anomalies.
Nutrition and Pregnancy
Pregnancy increases the demand both energy and nutrients, but the requirements maybe different from each woman, and trimester. For well-nourished women, only a small amount of additional energy is required because the body adapts to the increased energy requirements and becomes more energy efficient through reduced physical activity and a lowered metabolic rate. Recent evidence suggests, however, that infants who are small or disproportionate at birth have increased health risks later in life. The hypothesis is that such infants have had to adapt to a limited supply of nutrients and that in so doing their physiology and metabolism are permanently changed, although the rationale for this hypothesis has been challenged.
Deficiencies can exist because of losses or malabsorption associated with disease or inadequate intakes, lack of knowledge about adequate prenatal nutrition, or dietary taboos associated with pregnancy, with potential adverse consequences for both mothers and newborn infants. Anemia in pregnancy and pregnancy-induced hypertension are common and thought to contribute significantly to maternal mortality and morbidity in developing countries.
Vitamins and Minerals
As a component of prenatal care, micronutrient supplementation might reduce maternal morbidity and mortality directly by treating a pregnancy-related illness or indirectly by lowering the risk of complications at delivery.
Nevertheless, the effectiveness of supplementation programs notably of iron and folate has tended to focus on infant outcomes, perinatal mortality, preterm delivery, and low birth weight. When infant outcomes are discussed, however, a distinction needs to be made between the teratogenic effects of deficiency at periconception and deficiency in later pregnancy. The former includes folate deficiency resulting in fetal neural tube defects and iodine deficiency that causes cretinism, whereas the latter includes intrauterine growth retardation and other pregnancy-related and delivery complications.
This distinction is important because many pregnancies in developing countries are unplanned; the use of prenatal care services, in which iron or iron and folate supplements are generally provided or prescribed, is less than optimal, and the cost-effectiveness of the programs promoted needs to be considered. Even in developed countries, prenatal care providers have reservations about the widespread and indiscriminate use of prophylactic minerals and vitamins because of unproven benefits in well-nourished populations, risks of teratogenicity, and side effects. These concerns need to be considered in the context of developing countries.
The Deficiency
Pregnant women in developing countries are associated with malnutrition, thus the demand of nutrients supplementation is quite high. WHO create the programs in antenatal care with the supplementation of folate, iron and iodine
to reduce pregnancy related mortality and morbidity.
Iron deficiency resulting mainly from poor dietary iron bioavailability causes anemia and has been associated with maternal mortality. Iron deficiency is known to affect immune status by reducing the delayed-type hypersensitivity reaction, graft rejection, and cytotoxic activity of phagocytes. Thus, iron may be important for maintaining maternal health and reducing the risk of infection.
The problems raised related to prophylactic iron supplementation. Which populations need those supplementation, recent recommendations for iron supplementation during pregnancy for developing countries. In other countries, iron supplementation is recommended only for anemic women with proven iron deficiency anemia, as in Great Britain, or for women with low prepregnancy iron stores, as in Canada. Iron overload leads to impairment of body function, this conditions commonly found in thalassemia patients that having frequent transfusions.
Thus iron supplementation should be give only for the women that need it, such as anemic women.
Folate deficiency is due to inadequate dietary intakes, cooking habits that exacerbate losses, food taboos, inadequate food storage, and intense erythroid hyperplasia in the bone marrow (eg, sickle cell anemia, chronic hemolytic anemia, or homozygous ß-thalassemia); deficiency is associated with megaloblastic anemia, low birth weight, and potential fetal anomaly.
The findings of folic acid roles in pregnancy to reduce the number of births with neural tube defects, is significant, from the literatures folic acid supplementation could reduce up to 75% neural tube defects. Thus, folic acid administration is recommended as standard prenatal care. Except for women taking anticonvulsant drugs, who may have coexisting vitamin B-12 deficiency, there is no evidence that folate supplementation in pregnancy is unsafe.
Inadequate iodine intakes during pregnancy result in fetal loss, stillbirths, cretinism, and mental retardation of the newborn infant In regions of moderate to severe iodine deficiency, pregnant women need iodized salt before or iodized oil before or during pregnancy. This regimen reduces reproductive loss, morbidity, and adverse fetal outcomes.
There are others vitamin and minerals that the demands increase during the pregnancy, such calcium, phosphorus, zinc, vitamin A, vitamin C, etc. Eventhough the demand is increase but the incidence of deficiency isn't quite high, so daily consumption of dietary products can meet the demands.
At the end, nutritional support is important for fetal development besides others factors such as mother's conditions, genetic, placenta, etc.
Pregnant women with anatomical and physiological changes, increase the demands of certain nutrients. Thus proper supplementation during pregnancy is needed. Well-nourished women basically, need less supplementation or maybe don't need at all compare to undernourished women.
"Being pregnant not only means that you're being bless, but also you have chosen to receive the responsibility"
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