Planning a Pregnancy

One of the best ways to achieve a healthy pregnancy outcome is to actively plan for pregnancy and enter pregnancy in good nutritional health. A critical time for nutrition is the periconceptional period: the 2 months just before and the 2-3 months after conception. Fetal development occurs rapidly after conception and most organs are formed in the first 8-10 weeks of pregnancy, before many women realize they are pregnant. During this period the tiny embryo is particularly vulnerable to alcohol, environmental toxins, drugs, maternal medications, and nutritional deficiencies. Deficiencies of thiamine, riboflavin, vitamin B12, vitamin A, zinc, and folic acid may increase risk of abnormal fetal development, miscarriage, and birth defects.1

During the child-bearing years, many women chronically diet to lose weight or maintain a

Recommended micronutrient intakes in preparation for pregnancy

Nutrient

Recommended daily

intake (combined in

take from food and

supplement sources)

Vitamins:

Vitamin A (preferably as

800 |ig

beta-carotene)

Vitamin D

10-15 |ig

Vitamin E

15-20mg

Vitamin K

75-150|g

Thiamine (Vitamin B1)

1.5-2.0 mg

Riboflavin (Vitamin B2)

1.6-2.2 mg

Niacin

20 mg

Vitamin B6

2.5-5.0 mg

Pantothenic acid

5-10 mg

Biotin

75-150|g

Folic acid

0.8 mg

Vitamin B12

3-5 ig

Vitamin C

100 mg

Minerals:

Calcium

600-800 mg

Magnesium

300-400 mg

Iron

10-20 mg

Zinc

15 mg

Copper

2 mg

Manganese

2-5 mg

Fluoride

1-3 mg*

Iodine

200 |g

Selenium

100-150|g

Chromium

100-200|g

Molybdenum

100-250|g

* If water or salt supply is not fluoridated

* If water or salt supply is not fluoridated o o o o u

15 10

□ Multivitamin supplement containing 0.8 mg folic acid

□ No Multivitamin supplement

Fig. 4.1: Vitamin supplements during the periconceptional period and birth defects. 4150 women planning a pregnancy received either a multivitamin containing 0.8 mg folic acid or a control for at least 1 month before conception and until the date of the second missed menstrual period or later. Congenital malformations were significantly more frequent in the group not receiving the multivitamin than in the vitamin-supplement group (23/1000 vs. 13/1000). There were six cases of NTDs in the group not receiving the vitamins and none in the vitamin-supplemented group.

(Adapted from: Czeizel AE, et al. N Engl J Med. 1992;327:1832)

slim figure. Most low-calorie diets, whether self-selected or from published dieting programs, are nutritionally inadequate. They often lack the nutrients that young women need most, such as folic acid, iron, calcium, and zinc.2 Chronic dieting that depletes nutrient stores may have adverse effects if a women becomes pregnant.

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