Nutrition Publication

NNIW01 - Maternal Nutrition in Pregnancy - Eating for Two?

Editor(s): J. Dobbing. vol. 01

Related Articles

The Demands of the Fetal and Maternal Tissues for Nutrients, and the Bearing of These on the Needs Of The Mother To "Eat For Two"

Author(s): E.M. Widdowson

The last part of the title of this workshop "Eating for two" requiresdefinition. The pregnant woman does eat for two in that she eatsto maintain herself and to provide for the needs of the growing fetus,but no one would suggest that she should double her accustomedintake of food. The question we are asking ourselves is — does shehave to increase her usual intake of energy or of any specific nutrientsat all in order to meet all the requirements of the fetus and remainherself in a good state of nutrition? This clearly depends partly onher own state of nutrition at the beginning of pregnancy and on heraccustomed diet. It also depends on economies in metabolism thatmay occur within her body as a result of pregnancy. Anyphysiological accretions within her body, for example of protein andfat, must also be taken into account.

Diet During Pregnancy - A Rationale for Prescription

Author(s): D.J. Naismith

The importance of an adequate diet during pregnancy has long beenappreciated by nutritionists, clinicians and in recent times bypoliticians, albeit for diverse reasons. Pregnant women are recognizedas a "vulnerable group" in all intervention projects and in nationalprogrammes, although concern has been more for the health andvitality of the neonate than for the mother herself, but whatconstitutes an adequate diet, the yardstick for effective action,has yet to be defined.

Dietary Behaviour During Pregnancy: The St. Antione Maternity Hospital Study in Paris

Author(s): L. Papoz, E. Eschwege, G. Pequignot, J. Barrat

A study on dietary behaviour during pregnancy was performedbetween January 1976 and September 1979 at the Saint-AntoineMaternity Hospital in Paris. In addition to the routine clinicalexaminations at the 3rd, 6th, 8th and 9th month of pregnancy, thewomen were systematically questioned on their dietary and tobaccohabits. No dietary advice was given by the dieticians at any time.Results show that: (a) mean food consumption increases duringthe first six months and decreases in the third trimester, caloricintake being lower at the end of pregnancy compared to theprepregnancy period, (b) the fatter the women before pregnancy, thelower the caloric intake at the successive examinations, (c) nosignificant relationship is observed between the total weight gain andthe caloric intake at any time (d) birth weight seems to be morerelated to body size before pregnancy than to weight gain.

Nutrition in Slim, Normal and Obese Pregnant Women

Author(s): E. Papiernik, R. Frydman, J. Belaisch

Maternal nutrition is one of the many factors which help to regulatefetal growth, and contribute to the resulting birth weight; but itsrole has not been sufficiently studied and we lack a preciseknowledge of all of the known factors in birth weight regulation.Maternal nutrition is one of the three factors which can bemodified by external intervention during pregnancy, the othersbeing the changing of smoking habits, which is not so easy, andmedical treatment of high blood pressure.

Associations Between Maternal Weight, Height, Weight-For-Height, Weight-Gain and Birth Weight

Author(s): M. Ounsted, A. Scott

Prepregnancy weight, height, weight-for-height index, and net weightgain during pregnancy, were examined in groups of women givingbirth to small-for-dates (SFD), average-for-dates (AFD) and largefor-dates (LFD) babies. Mean maternal weight and height werelowest in the SFD and highest in the LFD group. Mean weight-forheightindices, and their distribution, were similar in the SFD andAFD groups; but in the LFD group they were much higher. Withineach group weight gain during pregnancy covered a wide range;and the mean value for the SFD group was lower than for the othertwo groups.

Pre-Natal Nutrition and Birth Weight: Is there a Causal Association?

Author(s): A. Lechtig, R.E. Klein

This paper reviews the results published during the seventies on therelationship between maternal nutrition and birth weight, with aview to: (1) building articulate knowledge useful to improve currentnutritional programmes; and (2) identifying main gaps and the correspondingresearch needed.To this aim results from eight maternal nutrition interventionstudies were reviewed (Bogota, Guatemala, India, Mexico, Montreal,New York, Taiwan and the Dutch Famine Study). These studiesdiffered in terms of research strategy, target population, sample size,assessment of nutritional supplementation and control of potentialconfounding factors. Notwithstanding the criticism that can beaddressed to each individual study, as a whole, these eight projectsoffer the best information presently available. The following patternemerges from a review of their results.

General Commentary

Author(s): E.M. Widdowson

There seems to me to be clear evidence from the papers of Naeyeand Ounsted that a pregnant woman gains anything up to 18 kgin weight, and on the whole the more she gains the heavier herbaby will be. Most women seemed to gain 4—8 kg in both studies,so let us take 6 kg as a representative figure. This is nearly twicethe weight of the baby and it must consist of something: water,protein or fat or some of each. Let us suppose it is all water, andif it is water without protein it must be extracellular water. Letus take a woman before pregnancy weighing 56 kg who has 15%of fat. Her fat-free weight will therefore be 48 kg. Of this 72%will be water, i.e. 34.5 kg. Of this about one third will beextracellular water, i.e. about 11 kg. If we add to this her gain inweight of 6 kg, her extracellular water is 17 kg which is theproportion of the total we found in our severely undernourished andoedematous German subjects. Though some of the gain may havebeen extracellular fluid it is extremely unlikely that 6 kg could beaccounted for in this way.