MALNUTRITION INDUCED COMPLICATIONS IN PREGNANT WOMEN
Diet and nutrition A healthy and varied diet is important at all times in life, but particularly so during pregnancy. The maternal diet must provide sufficient energy and nutrients to meet the mother’s usual requirements as well as the needs of the growing fetus, and enable the mother to lay down the stores of nutrients required for fetal development as well as for lactation. Diet and nutritional status, before and during pregnancy, plays role in the early processes of fetal development and outcome Nutrition interventions should be assessed over an entire reproductive cycle with its depletion,repletion phases, and pre pregnancy nutrition status Nutritional needs are higher when pregnant and these needs helps protect the long-term health of fetus and mother Maternal nutrition has a role in the regulation of placental-fetal development and productivity of offspring. Protective effects of many nutrients for deficiency diseases had been shown, including thiamine (beriberi), niacin (pellagra), vitamin D (rickets), vitamin A (night blindness), iron (anemia), and iodine (goiter) Mothers who practiced good nutrition such as consuming foods were less likely to have low birth weight babies Requires very diverse nutrients, including essential amino acids, macro mineralscalcium, phosphorus, magnesium, etc.and micronutrients/vitamins and minerals Table 1: Nutrients and their sources Nutrients Sources Riboflavin (B2) Dairy products, eggs, yeast extract, wheat germ, almonds, soya beans, fortified foods including breakfast cereals and soya milk, mushrooms and seaweeds Vitamin B12 Dairy products, eggs, fortified foods including yeast extract, soya milk, textured soya protein and breakfast cereals. Vitamin D Dairy products, eggs, fortified foods including margarine and other fat spreads, breakfast cereals, soya milk and other soya products. Calcium Milk and dairy products, green leafy vegetables, pulses, soybeans and fortified foods, e.g. bread and soya milk, tofu, nuts and dried fruit. Iron Pulses, dark green leafy vegetables, and fortified foods including breads and fortified breakfast cereals, dried fruit, nuts and seeds. Iodine Iodised salt, milk and seaweeds. Table 2: Infections associated with foods Consequences of infection in pregnancy Causes Foods to avoid Listeriosis Can cause miscarriage, stillbirth or severe illness in the newborn. unpasteurized milk and milk products. Salmonella In severe cases may cause miscarriage or premature labour. Raw eggs or foods containing raw or partially cooked eggs, e.g. home-made mayonnaise. Campylobacter May cause premature birth, spontaneous abortion or stillbirth. Raw or undercooked poultry; unpasteurized milk and milk products. Malnutrition Malnutrition means an abnormal physiological condition caused by inadequate, unbalanced, or excessive consumption of macronutrients or micronutrients Half of the world’s malnourished children live in three countries that are Bangladesh, India, and Pakistan In Pakistan researchers concluded that dietary diversity is a good proxy indicator for nutritional status of pregnant women. Malnutrition includes undernutrition and overnutrition as well as micronutrient deficienciesThe excessive consumption of some nutrients may also be harmful to the body and could lead to metabolic disorders or as in case of excessive consumption of fat as carbohydrate lead to obesity Overnutrition is a result of excessive food intake relative to dietary nutrient requirements Fetalundernutrition results in a wide range of consequences and there is growing evidence of causal links to chronic diseases much later in life Undernutrition is the outcome of undernourishment, poorabsorption, and poor biological use (bioavailability) of nutrients consumed as a result of repeated infectious/parasitic diseases, alone or in combination Stunting is also known as linear growth retardation, and it is defined as low height for age, reflecting a past episode or episodes of chronic undernutrition Some causes of malnutrition to child bearing mothers, these involved cultural belief, socio cultural factors are important factors in considering the quantity of food Socio economic factor is one of the causes of consequences in pregnant mothers Malnutrition is often associated with under nutrition due to reduced access to food, unsanitary living conditions, overcrowding, and inadequate child care This is due to some people who are of low income class who find it difficult to meet their ends Overcrowded housing and poor sanitation favor the emergence of frequent infections and infectious disease outbreak such as Ebola. Malnutrition is a worldwide problem especially in the developing countries where starchy tubers and cereals form the staple food This includes problems of food production or supply at the national, regional, or household level, as well as problems of families and communities in accessing sufficient amounts of safe and nutritious food for normal growth and development and an active and healthy life Socio cultural factors are important factors in considering the quantity of food Pica practice and out of home eating, which is associated with the consumption of non-hygienic, and junk foods especially in developing countries was also associated with increased risk of low birth weight. Also fasting during pregnancy could affect dietary intake as well as fetal growth as some of the women might have fasted in the month of Ramadan. Chronic psychological stress may probably also contribute significantly to the problem of preterm delivery and low birth-weight or modify the effect of nutrition interventions Poor dietary practices during pregnancy such as pica, out of home eating, skipping breakfastwere found to be associated with increase odds for low birth weight Other important factors for are her basic dietary intake during this period, the energy and nutrient composition of the supplement, the timing and total duration of supplementation, the replacement level of the supplement, her level of physical activity, and her general health, especially the presence of infectious diseases. Table 3: Risk factors for low birthweight (LBW) and links with low socio-economic status (SES) Risk factor Link with low SES Nutritional status Short stature, low pre-pregnancy BMI, low gestational weight gain more common in low SES women Micronutrient intake Low dietary intake more common in low SES women Smoking Higher prevalence and heavier smoking among low SES women Psychosocial factors More stressful life events, more chronic stressors, more common depression and low levels of social support in low-SES groups Malnutrition among pregnant women Pregnancyis one of the logical
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