LB2882MaternalNutriti+ - Mead Johnson Nutrition

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Preterm birth Preterm birth—live birth before thirty-seven completed weeks of gestation—is a daunting obstetrical problem. An estimated 15 million babies are born preterm worldwide every year. 146 Preterm babies are at greater risk of death and disability, including cerebral palsy, sensory impairments, intellectual disabilities, and vision and hearing loss. 147 Most preterm births occur between 32 and 36 weeks of gestation. Babies born before 34 weeks of pregnancy generally experience more health consequences that affect their ability to properly grow and develop, such as respiratory distress syndrome (RDS), necrotizing enterocolitis (NEC), and anemia, than do those born further along in gestation. 148 The cause of preterm birth is unidentifi able in many cases but it is more common in women with a past history of preterm birth, multiparity, abnormalities of the cervix or uterus, and autoimmune diseases. 148 Maternal diabetes, hypertension, pre-eclampsia, gestational alcohol consumption, maternal stress and anxiety, smoking cigarettes during pregnancy, 148 pre-pregnancy underweight, and gaining an inadequate amount of weight during pregnancy 149 are also associated with preterm birth risk. Some nutrient defi ciencies, such as folate and vitamin A defi ciencies, have been linked to preterm birth. 65,82,89 Several studies have investigated the relationship between maternal n-3 LCPUFA intake and duration of gestation and some suggest that consuming n-3 LCPUFA slightly increases duration of gestation (within the normal range). 72 In 2010, Makrides and colleagues reported the results of the large randomized DOMINO (DHA to Optimize Mother Infant Outcomes) trial with 2399 women. In this study, the group of women who received 800 mg DHA per day during pregnancy had signifi cantly fewer very preterm births (
Women are encouraged to enter pregnancy at a desirable body weight and with good control of chronic medical conditions, such as diabetes, to help optimize pregnancy outcomes. Once pregnancy is achieved, appropriate weight gain should be encouraged. In the United States, the IOM has issued detailed recommendations on pregnancy weight gain that are based on a woman’s pre-pregnancy BMI. Women with pre-pregnancy BMIs indicating overweight or obesity are encouraged to gain less weight than women with low or normal BMIs. Physical activity is encouraged for all women except those with specific obstetric and/or medical conditions. Recommended intakes for energy, protein and carbohydrate increase during pregnancy and lactation. Recommended intakes for total fat as a percentage of total energy do not change, but the importance of consuming the fatty acid DHA should be emphasized since it supports a healthy pregnancy and visual and cognitive development of the infant. The IOM and WHO also recommend higher intakes for several vitamins and minerals during pregnancy and lactation. It is important for pregnant and lactating women to consume adequate levels of all essential vitamins and minerals. Folic acid intakes during the first few weeks of pregnancy and iodine intakes during pregnancy and early infancy are particularly important since deficiencies of these nutrients can have irreversible negative consequences for an infant. Diet, nutrient, and lifestyle modifications may also prove helpful if pregnancyassociated conditions arise. The goal in highlighting these recommendations is to increase familiarity with nutrients and nutrition-related issues that play important roles in supporting healthy pregnancies and lactation. Eating a safe, balanced diet with appropriate levels of energy, macronutrients and micronutrients, getting regular physical activity, and avoiding noxious substances are increasingly recognized at strategies for achieving good pregnancy and lactation outcomes. 29
Page 1 and 2: MATERNAL NUTRITION bY Elizabeth M.
Page 3 and 4: TAbLE OF CONTENTS EXECUTIVE SUMMARY
Page 5 and 6: EXECUTIVE SUMMARY A mother’s nutr
Page 7 and 8: INTRODUCTION A mother’s nutrition
Page 9 and 10: Preconception Care In 2005, the WHO
Page 11 and 12: Nutrient Needs during Pregnancy and
Page 13 and 14: During lactation, the U.S. Dietary
Page 15 and 16: The United States has not establish
Page 17 and 18: Folate and Folic Acid Folate is a g
Page 19 and 20: Vitamin D Vitamin D’s principal r
Page 21 and 22: Iron Iron is vital to the productio
Page 23 and 24: Table 10. WHO Recommended Nutrient
Page 25 and 26: Guidelines for Physical Activity du
Page 27 and 28: FOOD SAFETY ISSUES Fish and Seafood
Page 29: the recommendations, summarized bel
Page 33 and 34: 53. Viswanathan M, Siega-Riz AM, Mo
Page 36: XXXXXX NEW 12/12 ©2012 Mead Johnso

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