Prenatal Nutrition Health Article

Complications

Good nutrition is especially important for certain conditions during pregnancy. Diabetes, a disease of poor blood sugar regulation, is one common problem requiring special attention to diet. Some women develop it only during pregnancy, when it is termed gestational diabetes. It can lead to multiple complications, including abnormally enhanced growth of the fetus, a condition called macrosomia. Such babies need special care at birth until blood sugar levels can be brought under control. Control of gestational diabetes includes careful attention to diet so that maternal blood sugar levels are kept as normal as possible throughout pregnancy. Women should eat frequent small meals; select foods high in fiber and complex carbohydrates; and avoid highly refined foods and simple sugars.

Another common problem is nausea and vomiting in early pregnancy. Because hunger seems to exacerbate the problem, suggestions to alleviate nausea include eating small, frequent meals of easily digestible foods, and having dry crackers near the bed to eat immediately upon awakening. Some women have severe enough symptoms that they are in danger of weight loss, dehydration, and electrolyte disturbances. This condition, termed hyperemesis gravidarum, may require hospitalization or medications to treat it if simple nutritional measures cannot control it.

Phenylketonuria (PKU) is a more unusual condition, but it is one in which the importance of maternal nutrition is paramount. PKU and the related condition, hyperphenylalanemia (HPA), are genetic disorders involving the impairment of the ability to digest phenylalanine, an essential amino acid found in protein. Before the disease was recognized, people with PKU developed severe mental retardation in childhood. Since routine screening and early dietary treatment has been instituted, people with PKU now can develop normally. However, women with these conditions may be advised not to become pregnant because of the high risk of mental retardation and congenital defects in the developing fetus. Women who desire pregnancy should discuss their plans with health personnel in a clinic that specializes in the treatment of these disorders well before becoming pregnant, so that strict dietary measures can be taken before conception and throughout pregnancy.

An abnormal food behavior that sometimes occurs in pregnant women is pica, which involves the consumption of such nonfood items as cornstarch, dirt, hair, cigarette ashes, or coffee grounds. Pica is sometimes associated with iron deficiency; and some think that the consumption of these substances may relieve the nausea and vomiting associated with pregnancy. Although many of these

KEY TERMS

Congenital malformations—Deformities that occur at birth.

Gestational diabetes—A disorder occurring in pregnancy involving insensitivity to insulin, causing poor blood sugar regulation.

Hyperemesis gravidarum—Excessive vomiting during pregnancy.

Macrosomia—An abnormally large body. Macrosomia of the newborn is a common complication of gestational diabetes.

Phenylketonuria (PKU)—A congenital deficiency of an enzyme that aids in the breakdown of an amino acid, leading to the development of severe mental retardation. PKU can be controlled with a strict diet, which is especially critical during pregnancy of a mother with PKU to avoid physical and mental defects in the fetus.

Pica—A desire that sometimes arises in pregnancy to eat such non-food substances as dirt or clay.

Preeclampsia—A syndrome of high blood pressure that develops during pregnancy. The chief danger of preeclampsia is that it will progress to eclampsia, which is a life-threatening condition characterized by seizures.

substances are not inherently harmful, there is a concern that such habits may displace the intake of nutritious foods during pregnancy.

Alcohol consumption during pregnancy can result in fetal alcohol syndrome (FAS), characterized by varying degrees of numerous physical and mental problems, including mental retardation, facial abnormalities, and heart and skeletal defects. Because of the unpredictable effects of even small amounts of alcohol, women are advised to drink no alcohol at any time during pregnancy.

Quitting smoking and avoiding secondhand smoke is especially important during pregnancy. Exposure to tobacco smoke increases the risk of a low birth-weight infant.

The effect of food additives is controversial, but doctors recommend that sugar substitutes, including saccharin and aspartame, be used in moderation if at all. Caffeine consumption during pregnancy is another debatable issue, although too much caffeine may have negative effects.

Especially for teenagers and young women, eating disorders may be of concern. Anorexia, bulimia nervosa (characterized by episodes of binge eating and vomiting), use of laxatives, or excessive exercising pose a serious risk to the mother and the fetus. Poor weight gain during pregnancy may indicate the presence of a eating disorder.