Pregnancy is associated with increased nutritional needs due to the physiologic changes of the woman and the metabolic demands of the embryo (fetus). Proper maternal nutrition during pregnancy is thus imperative for the health of both the woman and the offspring.

Maternal malnutrition during pregnancy has been associated with adverse outcomes, including increased risk of maternal and infant mortality as well as low birth weight newborns (<2,500 grams) — a measure that accounts for preterm birth and intrauterine growth restriction of the fetus.

Nutrient deficiencies have also been linked to congenital anomalies and birth defects. In addition, gestational undernutrition has been implicated in increasing the offspring's susceptibility to chronic disease (i.e., type 2 diabetes, hypertension, coronary artery disease, and stroke) in adulthood.

Maternal undernutrition often refers to malnutrition caused by insufficient caloric (energy) intake from carbohydrates, protein and lipids during pregnancy, but micronutrient deficiencies are also a form of undernutrition. Multiple micronutrient deficiencies com-

monly co-exist in pregnant women, especially in less developed nations.

Some of the important micronutrients are — folic acid, calcium, iron, zinc, iodine, magnesium, biotin and vitamin A, B, C, D, E, K etc. Good nutritional status prior to conception is also important for a healthy pregnancy. For instance, folic acid supplementation one month before and one month after conception dramatically reduces the incidence of devastating birth defects called neural tube defects. Thus, folic acid supplementation (at least 400 mcg/day) is recommended for all women preparing for pregnancy and those at risk of being pregnant.

A well-balanced diet throughout pregnancy is necessary to supply the developing embryo/fetus with micronutrients. In addition to folic acid supplementation, iron supplementation is generally needed to meet the increased demands for this mineral during pregnancy. Folic acid-iron supplementation is universally recommended during pregnancy. However, many health care providers recommend that pregnant women take a daily multivitamin/mineral or a daily prenatal supplement that includes folic acid, iron and several other micronutrients to ensure that all micronutrient needs are met.

The write up is compiled by Dr Shahjada Selim, Consultant Endocrinologist, Health and Hope Hospital, Dhaka.

Email: selimshahjada@gmail.com

Data Source: Linus Pauling Institute