ABSTRACT
This chapter describes the metabolic changes in normal pregnancy, followed by the general guidelines for pregnancy. It explores fetal complications associated with inadequate nutrition or metabolic perturbation, followed by issues and treatment for gestational diabetes mellitus (GDM), with emphasis on specific dietary therapies for GDM. Normal pregnancy nutritional guidelines focus on several dietary elements. Major topics include caloric intake, macronutrient proportion, vitamins and minerals, and alcohol consumption. Uncontrolled hyperglycemia primarily affects fetal growth on both extremes of the normal growth curve. In those diabetic mothers that have advanced vascular disease, fetal growth deceleration may occur due to placental insufficiency, Fetal growth deceleration is defined as those in lower fifth percentile on a growth curve adjusted for gestational age. GDM is a period of glucose intolerance that manifests at the beginning of the third trimester. Metabolic changes in the normal pregnant women also have a degree of insulin resistance that shunts glucose preferentially to the fetus.
