Chapter 9: Maternal & Fetal Nutrition

Preconception care is highlighted as vital, particularly the daily intake of folic acid to prevent neural tube defects like spina bifida, and the importance of achieving a healthy body mass index (BMI) to mitigate risks associated with being underweight or obese. Throughout the three trimesters, nutrient requirements evolve; the second and third trimesters demand significant increases in caloric and mineral intake to support accelerated fetal growth, maternal blood volume expansion by 40% to 50%, and mammary development. Weight management is individualized based on pre-pregnancy BMI, with specific recommendations for total weight gain and weekly patterns to avoid complications like intrauterine growth restriction or gestational hypertension. The text details the essential roles of macronutrients, such as proteins for tissue synthesis and docosahexaenoic acid (DHA) for neurological and visual development, alongside critical micronutrients including iron for red blood cell production and calcium for skeletal integrity. Safety concerns regarding mercury in seafood and the potential toxicity of fat-soluble vitamins are addressed to protect the developing nervous system. Additionally, the chapter offers dietary strategies for managing common pregnancy-related discomforts such as nausea, vomiting, constipation, and pyrosis (heartburn). It also examines special considerations for adolescent pregnancies, vegetarian lifestyles, and individuals with a history of bariatric surgery, while underscoring the absolute contraindication of alcohol and the recommendation to limit caffeine intake. Through comprehensive nutritional assessment and interprofessional collaboration involving nurses and dietitians, healthcare providers can support expectant mothers in meeting these complex physiological demands to ensure a healthy start for their children.