WHAT DO YOU NEED TO KNOW ABOUT NUTRITION IN PRE PREGNANCY AND PREGNANCYWomen who are pregnant, or who might become so, should carefully control their intake of nourishments as various building blocks of life become critical to achieve a healthy pregnancy. There is a growing recognition of the importance of the nutritional status of women during the reproductive period. In the first trimester of pregnancy, yolk sac plays a vital role in actively and passively transferring the nutrients to the fetus. In the second trimester, placenta plays a key role in transferring carbohydrates, water, ions, amino acids, vitamins and trace elements, which are essential for the development of a healthy baby.
How to avoid Birth defects?
Birth defects occur in approximately 3 per cent of all live births. Alcoholism, smoking, drug abuse, and nutritional status, can significantly affect pregnancy outcomes. There are specific maternal disorders, including their treatment medications, for example epilepsy, diabetes disorders; thyroid, cardiovascular, respiratory, rheumatic diseases and some hereditary disorders are at high risk for producing babies with birth defects. Obesity and body mass index also play a major role in the outcome of a pregnancy. Women with such problems need to go for pre pregnancy counselling with their obstetrician and medical doctor. Those with hereditary problems or with a family history of genetic disorder need to have genetic counselling done before planning a pregnancy
BUILDING BLOCKS VITAL TO LIFE
FOLIC ACIDFolic acid is of importance in day to day life, especially in women during the pre-pregnancy period and in the first 12-13 weeks of pregnancy. It is essential during periods of rapid cell division, it synthesise nucleic acid essential for blood cell production. If folic acid is deficient, it results in anaemia called megaloblastic anaemia.
Recommended dose of folic acid in pre-conception period
It is proven beyond doubt that, folic acid supplementation prior to planning a pregnancy lowers the incidence of babies born with neural tube defects by 60 per cent. The NICE guidelines from UK recommend a dose of 400 micrograms per day. It should be started 2 months prior to planning a pregnancy and then to continue in the first trimester of pregnancy.
PREGNANCY AND TRACE ELEMENTSCommon trace elements like iron, selenium, and zinc, iodine deficiency are reported in human beings. Iron is important for production of haemoglobin, myoglobin and many enzymes. Iron is important for the development of iron containing tissues in the fetus, for placenta and it delivers oxygen to tissues.
Selenium is an important component in body’s defence against free radical formation. High levels of it can cause toxicity. It supplementation is necessary, only if the levels are proven to be low. Meat is a good source of selenium.
Zinc deficiency is seen in malnourished women, and in women with diabetes and kidney disorders. In coeliac disease, absorption of zinc is affected. Zinc deficiency is associated with infertility, congenital malformations and growth restriction in the fetus.
Iodine is an essential component of thyroid hormones. Its deficiency in pregnancy, if severe can cause irreversible mental and physical retardation in the fetus. Moderate iodine deficiency can cause poor intellectual performance, hearing loss and poor motor skills.
Calcium and Vitamin D intake is important in pregnancy especially for vegetarians and for those who consume less vitamin D. Calcium deficiency is not proven to be associated with poor pregnancy outcomes.
VITAMINSVitamin A, (retinoid) is essential for normal reproduction and for healthy development of the fetus. Vitamin A deficiency, as well as an overdose can cause birth defects. Therefore its consumption before planning a pregnancy or during pregnancy should be carefully controlled. Carotenoids are generally nontoxic. Beta carotene is good for health and is useful for cancer prevention. Periconceptional vitamin supplementation may also protect against cleft palate and cleft lip.
Undoubtedly, women with nutritional deficiencies will benefit from nutritional replacements. Some individuals assume that if they are on nutritional supplements, they need not worry about eating a nutritious, well-balanced diet. It is not true, as nutritional supplements may not provide all the nutrients; hence a healthy diet is important in addition to supplements.
Those who have medical disorders and a history of hereditary disorders need specific counselling before planning a pregnancy with their Obstetrician, medical practitioners and genetic counsellors. Women who are vegetarians, lactose intolerant, or smokers, use drugs of abuse or consume alcohol will need assessment of diet, lifestyle changes and nutrition supplements like Vitamin B12 and amino acids. In conclusion, nutritional supplements should be used on the basis of necessity.