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Nutrition During Pregnancy (Part II) By Mumtaz Khalid Ismail
More Links Neural Tube Defect Morning Sickness Constipation Gestational Diabetes Mellitus Pregnancy Induced Hypertension Alcohol And Smoking Recommended Dietary Allowances For A Pregnant Woman Great importance has been considered for the diet of pregnant women not only for the general well being for the mother and the baby and also for the prevention of complications for the mother as well as the baby.
Neural Tube Defect
Deficiency of folic acids and zinc has been implicated as the preventable cause of congenital anomaly of nerve tissue like menigomyelocele (protrusion of brain tissue and its covering to out side). Taking folic acid supplementation six weeks prior to becoming pregnant can prevent this. The centre for disease control of the US recommend that women of child bearing age who are capable of becoming pregnant should consume 0.4 mg of folic acid per day to prevent neural tube defects.
Folic acid rich foods are liver, kidney, green leafy vegetables and pulses and zinc rich foods are oysters, crabs and other seafood, wheat, bajra, pulses, pumpkin and nuts.
Morning Sickness
- Morning sickness of early pregnancy can be corrected by small and frequent meals.
- Taking lemon or orange juice in the morning and before meals helps to relieve nausea of early pregnancy.
- Very rich sweets and fried foods should be avoided.
- Avoid excessive consumption of pickles or chutney, which is rich in salt.
Constipation
Constipation is the other problem seen among the pregnant woman. This can be rectified by including lot of fibrous foods in the diet such as whole grains, raw vegetables, and fruits and by drinking plenty of water.
Gestational Diabetes MellitusGestational diabetes mellitus increases the risk of pregnancy for the mother as well as the foetus. Insulin requirement goes up in pregnancy due to reduced insulin sensitivity and relative deficiency of insulin. Reduced insulin sensitivity in terms due to the ovarian and placental hormones and relative deficiency of insulin is due to in adequate compensatory insulin production by pancreas gland.
The risk of toxaemia, intrauterine death, hydraminos (more fluid), macrosomia (large baby), microsomia (small baby), pre maturity, neonatal hypoglycaemia (less sugar) impaired lung maturity and congenital heart disease and other congenital anomalies are increased in gestational diabetes. By controlling blood sugar the incidence of these complications can be reduced. The problem in controlling diet is that it will interfere with requirement of the increased nutrient requirements during pregnancy and the risk of developing hypoglycaemia. Hypoglycaemia is equally or more dangerous for mother and the foetus. Because of these limitations diet is not strictly controlled in gestational diabetes. The main principle is to have discipline in eating habit and reduce intake of simple carbohydrate. Total calories content can not be reduced below a certain limit with out compromising on nutrition.
Pregnancy Induced Hypertension
It is common among woman who is elderly primi (first pregnancy), maternal age in both extremities, on inadequate diets with little or no prenatal care. High blood pressure induced by pregnancy is called as pregnancy induced hypertension. This can not be prevented. But the complication of it both on mother and baby can be prevented to certain limit. It does harm to the baby because the blood supply going to the placenta is reduced as a result the baby does not receive adequate nutrition and oxygen, and may fail to grow properly and may not be able to with stand the stress of labour. In mother, if not controlled properly may cause eclampsia, which is a very serious condition for the mother and the baby.
Recommended Dietary Allowances for a Pregnant Woman *
Index Normal adult woman Pregnant woman Sedentary worker 1800 kcal +300 kcal Moderate worker 2100 kcal +300 kcal Protein gm /day 1gm/kg body weight +15 gm Fat gm / day 15 gm 25 gm Calcium mg / day 400 mg 1000 mg Iron mg /day 30 mg 38 mg Folic acid mg/day 100 mg 400 mg * Source Indian Council of Medical Research 1989
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Alcohol consumption at the time of pregnancy is harmful. Risk of delivering a low birth weight baby is twice the normal to mother who consumes 100ml alcohol per week. Foetal breathing activity may be depressed with a small quantity of alcohol. Spontaneous abortion may be caused by maternal alcohol consumption. Foetal alcohol syndrome consists of physical and mental retardation and altered facial appearance. Maternal smoking and alcohol consumption increase the risk of intrauterine growth retardation