Nutrition During Pregnancy Part I: Weight Gain, Part II: Nutrient Supplements (1990) / Chapter Skim
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2 Introduction
2 Introduction
Pages 27-36
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From page 27... ...
Shortly thereafter, the FNB's Committee on Maternal Nutrition completed a more comprehensive report entitled Maternal Nutrition During the Course of Pregnancy (NRC, 1970a) , which reviewed problems, practices, and research bearing on the relation between nutrition and the course and outcome of pregnancy and provided recommendations for weight gain and intake of certain nutrients.
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From page 28... ...
, and although the effects of gestational weight gain on fetal growth are better documented than those on length of gestation (see Chapter 8) , a shift in the distribution of birth weight for gestational age would nonetheless lead to some reduction in perinatal deaths (Prentice et al., 1988; Sappenfield et al., 1987~.
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From page 29... ...
In addition to the specific request to consider special recommendations for women with different prepregnancy nutritional statuses, the subcommittee was also asked to consider differential recommendations according to age and ethnic background, in particular the needs of pregnant adolescents; women over age 35; and women of black, Hispanic, and Southeast Asian origin. The section that follows concerns the relationships among maternal factors, nutritional intervention, gestational weight gain, and maternal and child health in healthy women in a developed country (especially the United States)
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From page 30... ...
The term mediating variable is sometimes used to indicate a factor that, like gestational weight gain, lies on the causal path between a preceding determinant (energy intake) and a subsequent consequence (fetal growth)
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From page 31... ...
As discussed in greater detail in subsequent chapters, many of the studies in this area have not distinguished changes in fat stores or lean body mass from weight increases as a result of increases in the size of the fetus, placenta, and amniotic fluid, on the one hand, or from increases in the size of the maternal breast and uterus and in plasma volume and extravascular body water, on the other. Ideally, in examining the maternal and child health consequences of different gestational weight gains, distinctions in components of weight gain should be considered.
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From page 32... ...
Mother Lean body mass Fat Plasma volume Extravascular body water Breasts Uterus Products of Conception Fetus Placenta Amniotic fluid -11 1 ~. SHORT-TERM HEALTH OUTCOMES F Mother Mortality Complications of pregnancy, labor, and delivery Postpartum nutritional status Lactation performance Fetus, Child Fetal growth (birth weight, length, head circumference)
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From page 33... ...
1~ Fetus, Child Mortality Fetal growth (birth weight, length, head circumference) Gestational duration Spontaneous abortion Congenital anomalies LONGER-TERM HEALTH OUTCOMES Mother Obesity Child Somatic growth Neurocognitive development denotes possible modification of effect indicates possible causal influences, I indicated by arrow on which it abuts FIGURE 2-3 Determinants, consequences, and effect modifiers discussed in this report.
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From page 34... ...
Both may be worthy of consideration, but such short-term outcomes as early postpartum maternal nutritional status and birth weight are potentially less serious than longer-term maternal nutritional status and child morbidity, growth, and performance. Despite the importance the subcommittee attaches to these longer-term outcomes, however, the majority of the epidemiologic evidence concerning the erects of gestational weight gain bears on birth weight and fetal growth.
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From page 35... ...
Energy requirements during pregnancy and the relationship between energy intake and gestational weight gain are considered in Chapter 7. In Chapter 8, the subcommittee reviews the evidence concerning the maternal and child health consequences of variations in gestational weight gain, including fetal/infant mortality, fetal growth, gestational duration, spontaneous abortion, congenital anomalies, maternal mortality, complications of pregnancy, lactation performance, and maternal obesity.
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From page 36... ...
1985. The contribution of low birth weight to infant mortality and childhood morbidity.
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