Nutrition and pregnancy refers to the nutrient intake and dietary planning that is undertaken before, during, and after pregnancy. Nutrition of the fetus begins at conception. For this reason, the nutrition of the mother is important from before conception (probably several months before) as well as throughout pregnancy and breastfeeding. An ever-increasing number of studies have shown that the nutrition of the mother will have an effect on the child, up to and including the risk for cancer, cardiovascular disease, hypertension, and diabetes throughout life. An inadequate or excessive amount of some nutrients may cause malformations or medical problems in the fetus, and neurological disorders and handicaps are a risk that is run by mothers who are malnourished. An estimated 24% of babies worldwide are born with lower than optimal weights at birth due to lack of proper nutrition. Personal habits such as consumption of alcohol or large amounts of caffeine can negatively and irreversibly affect the development of the baby, which happens in the early stages of pregnancy. Caffeine consumption during pregnancy is associated with an increased risk of pregnancy loss. The available research favors the notion that the benefits of fish consumption during pregnancy outweigh the risks; however, the type of fish is important. Folic acid, which is the synthetic form of the vitamin folate, is critical both in pre- and peri-conception.
Nutrition before pregnancy As with most diets, there are chances of over-supplementing. However, as general advice, both state and medical recommendations are that mothers follow instructions listed on particular vitamin packaging as to the correct or recommended daily allowance (RDA). Daily prenatal use of iron substantially improves birth weight, potentially reducing the risk of low birth weight.
Folic acid supplementation is recommended before conception, to prevent the development of spina bifida and other neural tube defects. It should be taken as at least 0.4 mg/day throughout the first trimester of pregnancy, 0.6 mg/day throughout the pregnancy, and 0.5 mg/day while breastfeeding in addition to eating foods rich in folic acid such as green leafy vegetables. Iodine levels are frequently too low in pregnant women, and iodine is necessary for normal thyroid function and mental development of the fetus, even cretinism. Pregnant women should take prenatal vitamins containing iodine. Vitamin D levels vary with exposure to sunlight. While it was assumed that supplementation was necessary only in areas of high latitudes, recent studies of Vitamin D levels throughout the United States and many other countries have shown a large number of women with low levels. For this reason, there is a growing movement to recommend supplementation with 1000 IU of Vitamin D daily throughout pregnancy. A large number of pregnant women have been found to have low levels of vitamin B12, but supplementation has not yet been shown to improve pregnancy outcome or the health of the newborn. Long-chain polyunsaturated fatty acids, specifically docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), are beneficial for fetal development. Several studies have shown a lower risk of preterm delivery and low birth weight in mothers with higher intakes. Iron is needed for the healthy growth of the fetus and placenta, especially during the second and third trimesters. It is recommended that the first and third trimesters retain concentrations greater than 11 grams/deciliter and that the second trimester has levels above 10.5 grams per deciliter. It is also essential before pregnancy for the production of hemoglobin. There is no evidence that a hemoglobin level of 7 grams/100 ml or higher is detrimental to pregnancy, but it must be acknowledged that maternal hemorrhage is a major source of maternal mortality worldwide, and a reserve capacity to carry oxygen is desirable. Iron supplementation reduces the risk of maternal anaemia and iron deficiency in pregnancy but the positive effect on other maternal and infant outcomes is less clear.
Nutrition during pregnancy The United States and the European Union have established vitamin and mineral recommendations during pregnancy and lactation. The amounts in the table below are the higher of the two. The citations separately list recommendations for pregnancy and lactation. Recommendations (RDAs = Recommended Dietary Allowances and PRIs = Population Reference Intakes) are set higher than what has been determined to be average requirements so as to address women who have above-average needs. For some nutrients, there is not enough information to set a recommendation, so the term Adequate Intake (AI) is used based on what appears to be sufficient.
*Adequate Intake †Not established. The EU has not identified an AI for sodium or chloride, and does not consider chromium to be an essential mineral nutrient.
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