2. • Some complications of pregnancy are related
to women’s nutritional status
• Nutritional interventions for a number of
complications of pregnancy can benefit
maternal and infant health outcomes.
• Nutritional intervention during pregnancy
should be based on scientific evidence that
supports their safety, effectiveness and
affordability
3. Chronic hypertension: that is present before
pregnancy or diagnosed before 20 weeks of
pregnancy. Hypertension is defined as blood
pressure ≥ 140 mm Hg systolic or ≥ 90 mm Hg
diastolic blood pressure.
4. This condition is more likely to occur in
African-Americanand obese women, women
over 35 years old and women who had
previous Bp in the last pregnancy
5. High BP is associated with and increased risk
of fetal death, preterm delivery and fetal
growth retardation.
Nutritional intervention for women with
chronic hypertension during pregnancy is
through monitoring Na intake prior and
during pregnancy and exercise.
6. Gestational hypertension:This condition
exists when elevated blood levels are
detected for the first time after mid-
pregnancy.
It is not accompanied with proteinuria
If BP returns to normal by 12 weeks
postpartum, it is called transit hypertension
If it remains elevated, it is called chronic
7. Preeclampsia-Eclampsia: occurs after 20
week of gestation (or earlier)This represents a
syndrome characterized by:
1- Blood vessel spasm and constriction
2- Increased BP
3- Adverse maternal immune system responses
to placenta
8. 5-Alterations of hormonal and other system
related to blood volume and pressure control
6-Oxidative tissue damage and inflammation
7- Alteration in calcium regulatory hormones
9. • Hypertension
• Increased urinary protein ( albumin )
• Decreased plasma volume expansion
( hemoglobin levels > 13 g/dL)
• Low urine output
• Persistent and severe headache
• Sensitivity of the eyes to bright light
• Blurred vision
11. Mother
1- Early delivery
2- Acute renal dysfunction
3- Increased risk of gestational diabetes,
hypertension and diabetes type 2 later
4- Rupture of plancenta
13. First pregnancy
Obesity, central obesity
Underweight
Mother’s smallness at birth
EthnicityAfricanAmerican,American Indians
History of preeclampsia
Age over 35
14. Multifetal pregnancy
Insulin resistance
Chronic hypertension
Renal disease
High blood levels of homocystein
Nutrient deficiency such vitaminC, E calcium,
Zinc andOmega 3- fatty acids
15. 1000 mg per day of dietary calcium
400 mcg of folate
≥ 5 servings of fruit and vegetables per day
Moderate exercise for 30 minutes for 5
days/week at least
16. Weight gain based on prepregnancy weight
status
Three regular meals and snacks a day
Consumption of low glycemic indexCHO
foods
17. Is considered 2nd leading complication in
pregnancy and has several forms:
Gestational diabetes
Type 2
Type 1
Other specific types
18. Over than 3% of pregnant women develop
gestational diabetes
It is considered a type of NIDDM or type 2
Gestational diabetes in underweight and
normal weight women appears to be related
to insulin resistance in pregnancy combined
with reduction in insulin production
19. • Obesity ( central obesity )
• Weight gain between pregnancies
• Underweight
• Age > 35
• Ethnicity
• Family history
• History of delivery of macrosomic newborn
( > 4500 g)
20.
21. Chronic hypertension
Mother was SGA at birth
History of gestational diabetes in previous
pregnancies
Diabetes in pregnant women’s mother during
pregnancy with them and LGA at birth
22. Mother
1. C-section to prevent shoulder dystocia
2. Increased risk for preeclampsia
3. Increased risk for diabetes type 2,
hypertension and obesity
4. Increased risk for gestational diabetes in
subsequent pregnancies
23. Offspring:
1. Stillbirth
2. Spontaneous abortion
3. Macrosomia ( > 10 lbs or 4500 g)
4. Neonatal hypoglycemia
5. Increased risk of insulin resistance, type 2
diabetes, high BP and obesity
24. Is diagnosed by OralGlucoseToleranceTest
OGTT
100 g glucose and 3 hours test is used
The practice of loading women up with high
CHO diet for 3 days prior to test is no longer
used.
The beverage provided should be consumed
in 5 minutes
25.
26.
27. A diagnosis for gestational diabetes is made
when two or more values for venous serum or
plasma glucose concentrations exceed these
levels:
Overnight fast 95 mg/dL
1 hour after glucose load 190 mg/dL
2 hours after glucose load 155 mg/dL
3 hours after glucose load 140 mg/dl
28. The main goal is to control blood glucose
levels and to get healthy newborn
Other goals are to minimize the risk for other
diseases such as diabetes, heart disease,
hypertension and obesity,
The nutritional management is done through:
29. 1. Assessing dietary and exercise habits
2. Developing an individualizeddiet and
exercise plan
3. Monitoring weight gain
4. Interpreting blood glucose and urinary
ketone results
5. Ensuring follow-up during pregnancy and
postpartum
30. Whole-grain breads and cereals, vegetables,
fruits and high fiber foods
Limited intake of simple sugars
Low GI foods or CHO that less than 50
Monounsaturated fats
31.
32.
33.
34. Three regular meals and snacks daily
Clorie distribution among meals and snacks
Lunch is largest meal
Breakfast and snacks are limited to 10-15% of
total calories
35. 40-50 % from CHO
30-40 from fat
20% from protein
36. Twins increased from 1:56 births in 1988 to
1:34births in 2001
Triplets or higher in creased from 1:2941 to 1:
551 in the same period
Only 1:5 triplets pregnancies are
spontaneously conceived
52. USA has the highest rates of adolescent
pregnancies of all developed countries
In 2002 teen pregnancies were 43 births per
1000 female aged 15-19
Between 1991-2001 it was 26% less
53. Low birthweight
Perinatal death
C-section
Cephalopelvic ( head too large for birth canal)