Maternal and Fetal Nutrition
What are the 8 factors that affect the outcome of pregnancy?
- Health Status and Health Services
- physical, psychological, emotional, availability, affordable
- Socioeconomic Status
- insurance, income meets needs for care
- Nutrition
- adequate dietary intake, food supply
- Personal
- genetics, culture, language, race
- Environment
- home, community, exposure to teratogens
- Education
- knowledge, skills, language, perinatal education
- Family
- size composition, stability, support
- Self-care
- wanted pregnancy, adherence to programs, active involvement
What can poor maternal nutrition cause in the fetus?
low or large birth weights, neural tube defects, poor fetal circulation, increased maternal mortality in low Fe women, preterm birth rates higher in anemic women, calcium is related to bone and tooth development, zinc is associated with enzyme processes, possibly important with prevention of congenital malformations, vitamin A essential for cell development, E prevents hemolysis
What is heartburn caused by in the pregnant woman?
(pyrosis) caused by reflux of gastric contents into the esophagus, can be reduced by eating smaller more frequent meals and not drinking with meals, avoid spicy foods, no lying down after meals or wearing tight clothing.
For the following list a common food source:
- Protein
- milk, eggs, cheese, beans and peas, whole grains, and nuts
- Iron
- liver, meats, whole grain, enriched bread, green leafy veggies, dried fruit
- Calcium and phosphorus
- milk, cheese, yogurt, fish, green leafy veggies except spinach and chard, beans, tortillas
- Zinc
- liver, shellfish, meats, whole grain, milk
- Fat soluble vitamins A, E, D
- A
- green leafy, yellow veggies and fruits, chili peppers, liver, fortified margarine and butter
- E
- vegetable oil, green leafy, whole grains, liver, nuts and seeds, cheese, fish
- D
- milk and margarine, egg yolk, butter, liver, seafood
- Water soluble vitamins folate, B6, B12, C
- B6
- meat, liver, green leafy, whole grain
- B12
- milk and milk products, egg, meat, liver, fortified soy milk
- C
- citrus, strawberries, melons, broccoli, tomatoes, peppers, raw deep green leafy
Why do woman need folic acid before and while they are pregnant?
Folate prevents neural tube defects such as spina bifida and promotes proper formation of the spinal column. Available from ready to eat cereals and grains, green leafy veggies, oranges, broccoli, asparagus, artichokes, liver
What are signs of adequate nutrition in a pregnant woman?
alert, responsive, energetic, good endurance, well developed muscle structure, good tone, some fat under skin, good attention span, not irritable, normal reflexes, good appetite, normal elimination patterns, no palpable organ masses, normal heart rate and rhythm, normal BP, shiny hair, not easily plucked, smooth skin that is slightly moist, uniform skin color, no enlargement of thyroid, none chapped lips, pink mucous membranes, no gum swelling, clean teeth, bright eyes, no sores, no tender extremities, no swelling, firm nails, no skeletal malformations
Why are adolescents at a higher risk for deficient nutrition while they are pregnant?
In general adolescents have diets that provide inadequate amounts of key nutrients, pelvis growth is delayed, competition for nutrients between the mother and the fetus will occur, they should gain weight to the upper end of their recommended BMI, their own body is still growing
What is a common side effect of iron supplements? What education can you provide for the patient to help with the side effect?
Constipation is a common side effect of iron supplementation. Increase fiber intake (wheat bran, whole-wheat products, popcorn, raw veggies). Normal RDI is 25-30g/day with a 15% increase recommended for pregnant and constipated women. Fluid intake should equal 50 ml/kg/day. Regular exercise and movement also stimulate bowel motility.