Nutrition During Pregnancy Part I: Weight Gain, Part II: Nutrient Supplements (1990) / Chapter Skim
Currently Skimming:
3 Historical Trends in Clinical Practice, Maternal Nutritional Status, and the Course and Outcome of Pregnancy
3 Historical Trends in Clinical Practice, Maternal Nutritional Status, and the Course and Outcome of Pregnancy
Pages 37-62
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 37... ...
Changes in clinical practice and socioeconomic status undoubtedly have influenced the nutrition and health of women entering and during their pregnancies, as well as both maternal and fetal outcomes. The following review of historical trends provides a foundation for evaluating current standards of practice and relationships between those standards and gestational weight gain and pregnancy outcome.
|
From page 38... ...
reported that maternal weight gain could be used as an indicator of maternal nutritional status and that, in turn, maternal nutritional status influenced fetal growth. Mean birth weight increased with increasing gestational weight gain from approximately 3,100 g with a 7-kg (15-lb)
|
From page 39... ...
The 1974 RDAs were listed. The 1978 ACOG Task Force on Nutritional Status criteria were reviewed, and the 1980 RDAs were presented.
|
From page 40... ...
. They also emphasized that prepregnancy weight as well as gestational weight gain influenced pregnancy outcome.
|
From page 41... ...
b Recommendations for women in the other two activity groups are calculated by adding 20% to the recommendation for nonpregnant women. TRENDS IN MATERNAL NUTRITIONAL STATUS AND CHARACTERISTICS ASSOCIATED WITH OUTCOME Not only have standards for clinical practice changed in the past 50 years, but there also have been substantial changes in the health status and the health habits of women who are entering pregnancy.
|
From page 42... ...
Using data from these three national surveys, Flegal et al.
|
From page 43... ...
These changes in maternal body size may influence pregnancy outcomes: infant birth weight has been correlated with maternal height, weight, and weight-for-height ratios (Kramer, 1987~. Age of Menarche The onset of menstruation is believed to be related to body size (Frisch, 1980~; i.e., a particular ratio of fat to lean mass and total body weight is necessary for puberty.
|
From page 44... ...
t::::1 < 18yr ~ 18-19 yr 2~29 yr > 29 yr FIGURE ~1 Distnbution of live births according to maternal age, by race. Based on unpublished data from the National Vital Statistics System, computed by the Division of Analysis from data compiled by the Division of Vital Statistics, National Center for Health Statistics.
|
From page 45... ...
Based on unpublished data from the National Vital Statistics System, computed lay the Division of Analysis from data compiled by the Division of Vital Statistics, National Center for Health Statistics.
|
From page 46... ...
In general, black and Asian mothers give birth to smaller infants than do white mothers (Kramer, 1987~. Thus, a substantial shift in the ethnic origin of mothers having babies could influence national data on infant birth weights.
|
From page 47... ...
Kleinman and Kopstein (1987) analyzed data from two national samples of live births to married mothers, the 1967 and the 1980 National Natality Surveys, and showed that the proportion of white married mothers age 20 and over who smoked decreased from 40 to 25%; the proportion of pregnant black smokers decreased from 33 to 23% (Figure 3-3~.
|
From page 48... ...
If we assume that the lifestyles of women who became pregnant in 1985 were similar to those of the women in the survey, we can also assume that the prevalence of substance use would be the same, i.e., alcohol, 64%; marijuana, 17%; and cocaine, >6%. There are no specific data on alcohol, marijuana, and cocaine use among pregnant women in the United States.
|
From page 49... ...
The primary objective of the Supplemental Food Program was distribution of surplus commodity foods to low-income people in general; there was no special attempt to supply foods to pregnant women. In contrast, the WIC program provides nutrition education, counseling, and referrals, in addition to food or vouchers, for a carefully tailored, nutritious food pack
|
From page 50... ...
The effects of the WIC program on maternal weight gain and birth weight are briefly reviewed in Chapter 7. TRENDS IN PREGNANCY OUTCOME The changes in maternal health habits and characteristics noted above could have both a positive and negative impact on infant mortality and birth
|
From page 51... ...
Given these divergent changes in maternal health characteristics and habits, it is not possible to predict trends in infant mortality rates or birth weights based on these data alone. Infant Mortality Infant mortality is used frequently as an indicator of infant health.
|
From page 52... ...
_ 3.105 1 1 1 3.409 3.421 Black 3.137 3.144 1 970 1980 1 985 Year FIGURE 3-7 1tends in mean birth weight of live-born singleton infants in the United States from 1960 through 1985, by race. Based on unpublished data from the National Vital Statistics System, computed by the Division of Analysis from data compiled by the Division of Vital Statistics, National Center for Health Statistics.
|
From page 53... ...
0 9 5.74% Black < 1,500 9 - _ 4.88% 4.73% 1.99% 2 08% 2.28% I White 1 ~ 1,500 9 0.77% 0.74% 0.75% 1 1 1 1 19&0 1970 1980 1985 Year FIGURE 38 [lends in low and very low birth weight of live-born singleton infants in the United States from 1960 through 1985, by race. Based on unpublished data from the National Vital Statistics System, computed by the Division of Analysis from data compiled by the Division of Vital Statistics, National Center for Health Statistics.
|
From page 54... ...
~ 0 .~) G 9 m ~ al ~ J 0 Oh j 7 o TO O' 5 NUTRITIONAL STATUS AND WEIGHT GAIN White Black Asian Mexican Puerto Ricar Cuban _ _~ ~ 1970 1975 1980 Year 1985 1990 FIGURE 3-9 [lends in low birth weight of live-born singleton infants in the United States from 1970 through 1987, by race and ethnic background.
|
From page 55... ...
Decreased cigarette smoking, improved diets, and improved utilization of early prenatal care during the 1970s may have contributed to improved intrauterine growth and, therefore, a reduced rate of full-term LBW infants. At the other end of the birth-weight scale, changes in the incidence of high birth weights for white and black women have been observed (Figure 3-10~.
|
From page 56... ...
A comparison of mean reported weight gains from studies with large sample sizes completed during the past 45 years provides some information on weight gain trends. Data from 11 studies of maternal weight gain and birth weight completed between 1946 and 1983 are summarized in Able 3-5.
|
From page 57... ...
. The change in average birth weight increased 100 to 150 g.
|
From page 58... ...
This upward shift in gestational weight gain occurred simultaneously with lower infant mortality rates, increased average birth weights, a decreased incidence of LBW infants but an increased incidence of VLBW infants among blacks and little change in the incidence of VLBW white infants. Most impressive is the increase in high birth weight (>4,000 g)
|
From page 59... ...
1978. How does maternal smoking affect birth weight and maternal weight gain?
|
From page 60... ...
Report of the Committee on Dietary Allowances, Committee on Interpretation of the Recommended Dietary Allowances, Food and Nutrition Board. National Academy of Sciences, Washington, D.C 128 pp.
|
From page 61... ...
1968. Relationship of weight gain during pregnancy to birth weight and infant growth and development in the first year of life: a report from the Collaborative Study of Cerebral Palsy.
|
From page 62... ...
62 NUTRITIONAL STATUS AND WEIGHT GAIN Ventura, SJ.
|
Key Terms
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.