Skip to main content

Currently Skimming:

1 Summary
Pages 1-24

The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.


From page 1...
... To address these deficiencies, the Food and Nutrition Board (FNB) established the Committee on Nutritional Status During Pregnancy and Lactation late in 1987 to conduct a detailed assessment of the published data.
From page 2...
... PART I: NUTRITIONAL STATUS AND WEIGHT GAIN The overall goals of the Subcommittee on Nutritional Status and Weight Gain During Pregnancy were to analyze the scientific evidence pertaining to weight gain during pregnancy and to formulate recommendations for healthy gestational weight gain. The subcommittee was asked to address the following questions: .
From page 3...
... The subcommittee began its work by tracing trends in selected aspects of prenatal care, maternal nutritional status, and the course and outcomes of pregnancy (e.g., fetal growth, birth weight, postpartum weight retention)
From page 4...
... Potential causal relationships were examined by applying standard epidemiologic terms and concepts to characterize the relationships between maternal factors, nutritional intervention, gestational weight gain, and maternal and child health. Factors that investigators have linked with gestational weight gain include maternal prepregnancy weight for height, prepregnancy weight, maternal height, ethnic background, age and parity, cigarette smoking, socioeconomic status, and energy intake.
From page 5...
... Several factors that may also have contributed to fetal growth or gestational weight gain during the period include increased prepregnancy weight, increased height, decreased smoking during pregnancy, increased participation in the WIC program, and earlier prenatal care. Conclusions on Weight Gain During Pregnancy Assessment of Weight and Weight Gain Prepregnancy weight-for-height and serial weight measurements are the only anthropometric measurements with documented clinical value for assessment of gestational weight gain.
From page 6...
... Deviations from the expected pattern of weight gain may be entirely unrelated to nutrient intake and energy balance but, rather, may be related to such factors as those listed above. Gestational weight gain is normally attributable to increases in both lean and fat tissue of the mother and the fetus as well as to water retention.
From page 7...
... Furthermore, energy intake may erroneously appear to be relatively unimportant for gestational weight gain if women expend less energy by decreasing their physical activity. Overall, however, there is no question that restriction of energy intake can limit weight gain or that excessive energy intake leads to extra fat storage.
From page 8...
... However, prepregnancy weight for height is a determinant of fetal growth above and beyond the effect of gestational weight gain: women who are thinner before pregnancy tend to have babies that are smaller than those of their heavier counterparts with the same gestational weight gain. Since higher birth weights generally present lower risks for the infants, desirable weight gains for thin women are higher than those for normal-weight women, whereas desirable weight gains for overweight and obese women are lower.
From page 9...
... In twin pregnancies, increased maternal weight gain also appears to be associated with increased birth weight. Clinical Recommendations The following recommendations are based largely on observational studies of weight gains in large groups of women and an attempt to balance the benefits of increased fetal growth with the risks of complicated labor and delivery and of postpartum maternal weight retention.
From page 10...
... · Measure height and weight at the first prenatal visit carefully by procedures that have been rigorously standardized at the site of prenatal care. The initial weight measurement can be compared with prepregnancy weight and provides the baseline for monitoring weight change over the course of pregnancy.
From page 11...
... The subcommittee emphasizes use of a range rather than a single target weight, because a wide range of gestational weight gains is compatible with desirable pregnancy outcomes, because there is no method available for establishing the ideal gestational weight gain for an individual woman, and because a range rather than a single number may help alleviate excessive concern about weight gain during pregnancy. All women should be encouraged to gain enough weight to achieve at least the lower limit of weight specified for their weight-for-height category in Table 1-1.
From page 12...
... The subcommittee set a 6.8-kg (15-lb) lower limit on gestational weight gain by extremely obese women (BMI >29.0)
From page 13...
... The subcommittee encourages investigators to give careful consideration to methodologic problems related to estimates of gestational weight gain, prepregnancy weight for height, and gestational duration (discussed in Chapter 4) when designing studies and interpreting results.
From page 14...
... For example, include prepregnancy weight and height on birth certificates and standardize assessment and reporting instruments used in government programs such as WIC. · Test recommended ranges of gestational weight gain against out comes.
From page 15...
... Specific recommendations for nutrition counseling and other services to help improve maternal and family food intakes are beyond the scope of this report. Among the many sources of information on these topics are the National Center for Education in Maternal and Child Health in Washington, D.C., Cooperative Extension's Expanded Food and Nutrition Education Program (operated at the county level)
From page 16...
... for pregnant women, especially if there is no evidence that a sizable segment of the pregnant population has intake falling substantially below the RDN On the other hand, average nutrient intakes lower than the RDA were viewed as inadequate evidence to support routine supplementation of pregnant women with that nutrient. Because the RDAs for most minerals and vitamins include a wide margin of safety, the needs of many pregnant women can be met with intakes below the RDN Moreover, estimates of nutrient intake based on dietary intake data are imprecise and tend to underestimate total food and nutrient intake.
From page 17...
... After an in-depth review of dietary intake data for women in the United States and evidence from clinical, metabolic, and epidemiologic studies, the subcommittee concluded that iron is the only known nutrient for which requirements cannot be met reasonably by diet alone. 1b meet the increased need for iron during the second and third trimesters of pregnancy, the average woman needs to absorb approximately 3 mg of iron per day in addition to the amount of iron usually absorbed from food.
From page 18...
... Low-dose iron supplements offer distinct advantages over higher-dose ones: less potential for undesirable nutrient-nutrient interactions, more efficient absorption, and less risk of causing gastrointestinal distress. Pregnant women can meet the physiologic requirements for folate from diet by following dietary guidelines such as those provided in the publications listed at the end of this chapter (American Red Cross, 1984; Corruccini, 1977; DHHS/USDA~arch of Dimes Birth Defects Foundation, 1982; Dimperio, 1988; USDA, 1979, 1989~.
From page 19...
... Clinical Recommendations Dietary Assessment Routine assessment of dietary practices is recommended for all pregnant women in the United States to allow evaluation of the need for improved diet or vitamin or mineral supplements.
From page 20...
... Women who ingest fruit, juices, whole-grain or fortified cereals, and green vegetables infrequently are likely to have low folate intake. Multivitamin Mineral Supplements For pregnant women who do not ordinarily consume an adequate diet and for those in high-risk categories, such as women carrying more than one fetus, heavy cigarette smokers, and alcohol and drug abusers, the subcommittee recommends a daily multivitamin-mineral preparation containing the following nutrients beginning in the second trimester: Iron 30 mg Vitamin Be 2 mg Zinc 15 mg Folate 300 fig Copper 2 mg Vitamin C 50 mg Calcium 250 mg Vitamin D 5 ,ug To promote absorption of these nutrients, the supplement should be taken between meals or at bedtime.
From page 21...
... to improve the data base regarding health and usual nutrient intake in relation to age, income, and ethnic background. Nutritional Assessment · Special purpose longitudinal studies should be conducted from before pregnancy to parturition to relate food and nutrient intake of individual women to maternal and fetal nutritional status and pregnancy outcome.
From page 22...
... March of Dimes Birth Defects Foundation, White Plains, N.Y.
From page 23...
... Report of the Committee on Maternal Nutrition, Food and Nutrition Board. National Academy of Sciences, Washington, D.C.


This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More information on Chapter Skim is available.