Vitamines B12 vit.-IUGR,impaired b-cell function,CV riskA vit.-excessive intake-fetal malformationE vit.-placental transport of hormonesD vit.-cofactor for Ca homeostasis,reduced intrauterine growth of long bones,shorter gestation,lower birth weight and reduced bone mass in childhood,kidney maturationB6,B1-less importance Micronutrients Vitamines(B 12,B 6,A,D)Minerals(Ca)Trace elements(Iron,Iodine,Zinc,Selenium,Copper)Folic acidῲ-3 FFA Macronutrients Recommended energy intake 2500 kcal/day (200-600kcal increasing)No extreme reducing diet in course of pregnancy-Carbohydrates(50-60%)-the main energetic substrate for fetus is glucoseProteins(20-25%)-lean body massFat(20-25%)-energy supply Weight gain in pregnancy Normal weight gain in singleton pregnancy-12kg Normal weight gain in multiple pregnancy- up to 18 kg75%-fetus,placenta,amniotic fluid,uterus,expanded volume of circulating fluid,blood elements,breasts25%- adipose tissue Maternal metabolic changes Gastric motility and gut motilityThe changes in absorption of nutrientsThe changes of kidney functionsThe changes of plasma levels of proteins,minerals,aminoacids,hormonesThe changes of apetiteThe vomiting in pregnancy
Important data Sociodemografic dataPersonal medical history (obstetric history)Dietary habits and weight changesAbusesPhysical routine examination and laboratory screeningPhysical activityUsing of nutritional supplements The influence of mother nutrition Perinatal mortalityPerinatal morbidityIntrauterine growth retardation(IUGR) versus large for gestational age(LGA) babiesFetal programming of later diseases in childhood and in adulthood
Nutrition in pregnancy The undeveloped countries with poor nutritional status of mothersThe developed countries with the owerweight and obesity and micronutrient deficiensesMacronutrients-energetic substrates-carbohydrates,proteins,fatMicronutrients –minerals,trace elements,vitamins,folic acid,ῲ-3 fatty acids (?) Nutrition in pregnancy K.AndelovaThe Institute for the Mother and ChildPrague
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