ABSTRACT
Recommendations for Women before Pregnancy ................................................................................................................... 235 Risk Factors for Prenatal Nutrition Risk and Indications for Referral ................................................................................... 237 Weight Gain and Pregnancy .................................................................................................................................................... 239
Pregnancy Weight Goals .................................................................................................................................................... 239 Rate of Weight Gain ........................................................................................................................................................... 240 Weight-Gain Distribution during Pregnancy ...................................................................................................................... 240 Nutrition Snacks ................................................................................................................................................................. 240
Dietary Requirements for Pregnancy and Lactation ............................................................................................................... 240 Dietary Reference Intake (DRI) ......................................................................................................................................... 240 Dietary Assessment of the Pregnant Woman ..................................................................................................................... 243 Behavior-Change Tool........................................................................................................................................................ 243 Nutritional Risk Tool .......................................................................................................................................................... 244
Complications of Pregnancy that may Impact Nutritional Status ........................................................................................... 244 Nausea and Vomiting .......................................................................................................................................................... 244 Hyperemesis Gravidarum ................................................................................................................................................... 244 Constipation ....................................................................................................................................................................... 244 Caffeine during Pregnancy and Lactation .......................................................................................................................... 245 Alcohol ............................................................................................................................................................................... 246
Pregnancy ...................................................................................................................................................................... 246 Lactation ........................................................................................................................................................................ 247
Hypertension ...................................................................................................................................................................... 248 Vitamin and Mineral Requirements, Food Sources, and Supplementation ............................................................................ 248
Prenatal Vitamins ............................................................................................................................................................... 248 Vitamin A ........................................................................................................................................................................... 248 Calcium and Magnesium.................................................................................................................................................... 248 Folate and Iron ................................................................................................................................................................... 248 Zinc .................................................................................................................................................................................... 250 Vitamin B6 ......................................................................................................................................................................... 250 Vitamin C ........................................................................................................................................................................... 250 Vitamin D ........................................................................................................................................................................... 250 Food Sources of Selected Nutrients ................................................................................................................................... 250
Physical Activity during Pregnancy ........................................................................................................................................ 252 Postpartum Weight Loss ......................................................................................................................................................... 253 Nutrition and Lactation ........................................................................................................................................................... 253 Resource Materials .................................................................................................................................................................. 255 References .............................................................................................................................................................................. 256
It seems logical that the nutritional status of a woman prior to pregnancy as well as maternal nutrition should affect fetal development and subsequent pregnancy outcome. However, many confounding variables are common to the investigation of maternal nutrition and fetal development.1 This section briefl y summarizes recommendations for maternal nutrition.2-13 It also includes
comments about lactation, because maternal diet plays a central role in the transfer of nutriments to the infant. Table 13.1 includes special recommendations for women during childbearing years. Suggestions for counseling and treatment during preconception care offi ce visits are given in Table 13.2.
