The nutritional status of the pregnant woman

The incorporation of women to increasingly complex tasks in the labor, social and political spheres, without abandoning their physiological function of motherhood and the sociocultural function of caring for their children, requires an adequate physical and biological development, which must be supported by a lifestyle that allows them to fulfill such dissimilar roles without affecting their health or the growth and development of their children.

Nutrition before and during pregnancy plays an important role, not only for the mother, but also for the formation and development of the child. Nutritional deficiencies can cause the following disorders:

• Infertility.

• Spontaneous miscarriage.

• Premature delivery.

• Congenital malformations.

• Low birth weight.

While maternal obesity can cause:

• Arterial hypertension.

• Gestational diabetes.

• Cesarean section and use of forceps, due to the size of the newborns.

Adaptations in the mother's metabolism during pregnancy, which influence the needs and utilization of nutrients.

Gastrointestinal adaptations: as a consequence of maternal and fetal demands, intestinal absorption capacities are increased, favoring an increase in appetite and some stomach disorders, such as burning sensations in the stomach, vomiting and nausea.

Cardiovascular adaptations:

• Heart rate is increased up to 90 beats per minute.

• Blood pressure decreases slightly.

• Cardiac output increases, pumping more blood.

Renal adaptations:

• Glomerular filtration rate increases.

• Ion and water retention increases.

Adaptation of blood volume and composition:

• Increase in blood volume.

• Reduction of hemoglobin, albumin and water-soluble vitamins.

• Increase in fat-soluble vitamins.

• Increase in the number of red blood cells.

Initial nutritional status

It is recommended to plan pregnancy, preferably after the age of 20, and before the age of 35; they should also wait at least two years after their last birth to conceive the next child.

To face pregnancy, the ideal would be that the mother-to-be, go to the doctor several months before, in order to prepare for this stage. He/she will guide you to a balanced diet, adequate to your needs; in addition, if necessary, he/she will order you to take some nutritional supplements.

If pregnancy has come as a surprise, as is almost always the case, you are still in time, go to your doctor and follow his recommendations to the letter, so that you can maintain your health and give your child the best nutrition, which will allow him to grow and develop properly.

Aspects to take into account for the initial nutritional evaluation

Age of the pregnant woman: from the point of view of nutritional needs, it is recommended that pregnancies occur after the woman reaches adulthood (20 years of age). Pregnancies in adolescence are considered high risk, since during these ages, high levels of nutrients are required to ensure the development and physiological maturation of young women, so that pregnancy would increase the chances of malnutrition, favoring the emergence of serious health disorders in mother and child.

These risks are sometimes increased because the young women hide their condition out of fear, delaying prenatal care and continuing with an inadequate diet for their condition. To avoid these dangers, we must warn girls, boys and adolescents about the consequences of teenage pregnancy and the ways to avoid it, as well as the correct way to deal with it, in case it could not be avoided.

Blood volume and composition: it is very important to diagnose and correct anemia in the mother as early as possible. Maternal anemia is a major risk factor associated with preterm delivery, low birth weight and increased risk of maternal mortality.

It should be taken into account that during gestation, the blood volume expands, causing the levels of hemoglobin, water-soluble vitamins and albumin to decrease; at the same time, the levels of fat-soluble vitamins increase. All these changes should be considered in the nutritional recommendations, based on the analysis of blood volume and composition.

Weight of the pregnant woman: the woman should become pregnant with an adequate body weight. For this purpose, the body mass index (BMI) should be in a range between 19 and 25 kilograms per square meter, and with sufficient nutrient reserves.

Healthy, well-nourished women should gain between 10 and 14 kilograms of weight during pregnancy to increase the chances of giving birth to a baby weighing 3.3 kilograms and reduce the risk of maternal and fetal complications.

It is logical that a woman who starts pregnancy thin may gain more weight than a woman who starts pregnancy overweight or obese.

Maternal weight gain should also be in correspondence with the mother's height; in very short mothers, a weight gain of more than 12 kilograms could increase the risk of cephalopelvic disproportion.

Gastrointestinal disorders: as a consequence of the physiological state, some pregnant women suffer from vomiting, nausea and burning sensations in the stomach, which prevent them from eating properly. To combat these disorders, it is necessary to adapt the frequencies, volumes and types of food, depending on the degree of tolerance of the pregnant woman, in order to ensure the supply of the necessary nutrients.