Nutritional needs of pregnant women

1.Energy needs
Energy needs during the first trimester of pregnancy are essentially the same as during
the non-pregnant state. During the second and third trimesters, the average pregnant
woman requires an extra energy intake of approximately 300 kcal/ day to support the
growth of the foetus, placenta and maternal tissues and for the slow steady rise in
basal metabolic rate (BMR) of the pregnant woman. If a woman is active during
pregnancy the energy she expends is added to any extra energy needed for pregnancy
to balance her total energy use. Much of the increase in energy requirement in the
second trimester is due to maternal development resulting from pregnancy. In the last
trimester, the foetus is the primary factor influencing the increased need for energy.
This calls for consumption of sufficient amounts of carbohydrates to spare the
proteins for body building. To avoid possible damage to the foetal activity, a pregnant
woman should not fast for more than 6-8 hours because there is a more rapid fall in
circulating glucose, insulin and gluconeogenesis of amino acids than in non pregnant
women.

-Proteins
There is an increased need for proteins in pregnancy in view of the amount of new
tissues that must be formed. The protein requirements are based on the assumption
that energy available from the diet will be adequate, otherwise proteins will be used to
provide energy and therefore will not be available for its body building functions.
During pregnancy the recommended dietary allowance (RDA) for proteins is
increased by 10 grams/ day for women over age 24 and by about 15 gram/ day for
those under age 24. Problems of premature births, low birth weight, infant mortality
and mental retardation can result from gross inadequate intakes of proteins and
calories.

-Carbohydrates
Carbohydrate needs are about 100g/day. This amount prevents ketosis ( see section
on functions of carbohydrates) which may interrupt fetal development and brain maturation.

2.Vitamin needs
Vitamin needs are generally increased during pregnancy, especially the need for vitamin D and folate.

- Vitamin D
Calcium metabolism increases during pregnancy. To facilitate the absorption and
distribution of calcuim for forming fetal bones, the mothers RDA for vitamin D
doubles to 10mg/day. Pregnant woman should get regular sunlight exposure and
consume sufficient vitamin D fortified milk to make up the difference.

-Folate
Synthesis of DNA requires folate therefore this nutrient is especially crucial during
embryonic development. Both fetal and maternal growth in pregnancy depends on an
ample supply of folate. Red blood cell formation also requires folate. As a result of its
role in DNA synthesis, folate breakdown also increases in pregnancy. Serious
megaloblastic anaemia can result if folate intake is inadequate during pregnancy.

The RDA of folate more than doubles during pregnancy to 400mg/day. Folate
deficiency at conception and after is associated with birth defects especially neural
tube defects, such as spina bifida. Meeting the folate RDA can be achieved by
consuming folate rich fruits and vegetables, fortified breakfast cereals. Meeting folate
needs during pregnancy may be problematic for women who have taken oral
contraceptives for extended periods, as these inhibit folate absorption.

3.Mineral Needs
Mineral needs generally increases during pregnancy. An adequate intake of iron,
calcium, zinc and iodine are particularly important for maternal and fetal health.

- Iron
Extra iron is needed for haemoglobin synthesis during pregnancy. The RDA doubles
to 30mg/day, especially in the 2nd and 3rd trimesters. Pregnant women are encouraged
to consume iron fortified foods. Eating foods rich in Vitamin C along with non-heme
iron containing foods helps to increase iron absorption. Iron supplementation is
routine during pregnancy in Kenya. Severe iron-deficiency anaemia in pregnancy may
lead to preterm delivery, maternal complications or death during delivery and
increased risk for infant mortality. Iron supplements cause nausea, constipation and
depressed appetite in some people, women are advised to take these supplements
between meals with liquids other than milk. Milk should not be consumed with a
supplement as Calcium interferes with iron absorption. Pregnant women should also
wait until the second trimmester to start iron supplementation since pregnancy related
nausea generally lessens by this time.

- Calcium
Efficiency or calcium absorption doubles as pregnancy progresses as compared to
normal condition. Calcium is needed during pregnancy to promote adequate
mineralization of the skeleton, teeth and the health of the mother. Most calcium is
required during the third trimester, when skeleton bones are growing most rapidly and
teeth are forming. The RDA for pregnant women is 1200mg/day. Practical food
sources of calcium are foods such as milk, yogurt and cheese. Deficiency of Calcium
may lead to the mother suffering from osteoporosis and osteomalacia. In infants
Calcium deficiency may lead to reduced birth weight and neonatal hypocalcaemia.

- Zinc
Zinc is an important mineral in supporting growth and development. The RDA for
zinc is 15gm/day for pregnant women, 25% higher than for non-pregnant women. The
extra protein foods in the diet of a pregnant woman should supply most of this zinc.
Inadequate zinc status in pregnancy increases the risk of delivering low birth weight
infants.

- Iodine
The RDA for a pregnant woman is 175mg/day and this covers the extra demands of
the foetus. Deficiency causes cretinism, and other subclinical deficits that place the
child at a developmental disadvantage.

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Titany answered the question on November 8, 2021 at 06:50