Nutrition in Pregnancy

1. See Also
   1. First Trimester Education
   2. Second Trimester Education
   3. Third Trimester Education
   4. First Obstetric Visit
   5. Prenatal Visit
2. Physiology: Adequate Weight Gain in Pregnancy
   1. Prevents Intrauterine Growth Retardation (IUGR)
      1. Especially in third trimester
   2. Weight gain distribution over multiple components
      1. Fetus
      2. Placenta, amnion, and Uterus
      3. Edema and Increased blood volume
      4. Breast engorgement
3. Weight Gain in Pregnancy
   1. Normal conception weight (BMI = 19.8 - 26)
      1. Total weight gain: 11.25 - 15.75 kg (25 - 35 lb)
      2. Gain 1st trimester: 1.35-2.25 kg (3-5 lb) per month
      3. Gain 2nd/3rd: 0.45-0.90 kg (1-2 lb) per week
   2. Overweight at conception (BMI 27-29)
      1. Total weight gain: 6.75 - 11.25 kg (15 - 25 lb)
      2. Gain 1st trimester: 0.90-1.80 kg (2-4 lb) per month
      3. Gain 2nd/3rd: 0.45 kg (1 lb) per week
   3. Morbidly overweight at conception (BMI >29)
      1. Total weight gain: 6.8 kg (15 lb)
   4. Low weight at conception (BMI < 15)
      1. Total gain: 15.75 - 18 kg (35 - 40 lb)
4. Indications for Intensive Nutrition Counseling
   1. Weight gain <0.90 kg (2 lb) per month
   2. Weight gain >2.92 kg (6 lb 8 oz) per month
   3. Weight gain < 4.5 kg (10 lb) by mid-pregnancy
5. Postpartum Weight Loss (Gradual!)
   1. Weight loss 0.36 - 0.45 kg (13 oz - 1 lb) per week
6. National Research Council RDA Recommendations
   1. Non-Pregnant Women
      1. Daily caloric intake: 2200 KCals
      2. Daily Protein intake: 55 grams
   2. Pregnant Women: First Trimester
      1. Daily caloric intake 2300 KCals
      2. Equivalent of 100 additional Calories/Day
         1. One and one half slices of bread per day
         2. One Cup of milk or fruit juice
         3. One Banana
   3. Pregnant Women (Second and third trimester)
      1. Daily caloric intake: 2500 KCals
      2. Daily Protein intake: 60 grams
   4. Lactating Women
      1. Daily caloric intake: 2600 KCals
      2. Daily Protein intake: 65 grams
7. References
   1. Cogswell (1999) Obstet Gynecol 94:616-22