Nutritional Needs During Pregnancy

During pregnancy, the patient and growing fetus have specific nutritional needs to support sufficient weight gain and development. These include increased calories; a variety of macronutrients such as carbohydrates, fats, and protein; as well as vitamins and minerals, like folic acid, iron, and calcium.

Extra calories are needed during pregnancy to provide the energy to fuel the increased maternal basal metabolic rate; to support the production and maintenance of maternal and fetal tissues, amniotic fluid, and placenta; as well as develop fat stores used for energy during delivery and breastfeeding. By the second trimester, caloric intake should increase by about 340 calories per day, and by about 450 calories per day in the third trimester.

Weight gain during pregnancy is gradual, and patients who are not under- or overweight should gain about 1 pound per week and up to 35 pounds by term delivery. Additional calories should come from nutrient-dense foods, like low fat dairy products, lean meats, legumes, whole grain breads and cereals, and fruits and vegetables; instead of fast food and sweets that have a lower nutritional value.

Now let’s move on to some of the specific macronutrients including carbohydrates, fats, and proteins which are needed in large amounts. Carbohydrates are the primary source of calories used for energy. Good sources of carbohydrates are complex carbohydrates such as starchy vegetables and whole grains. In addition to providing calories, complex carbohydrates contain additional nutrients like vitamins, minerals, and fiber. Fiber is the non-digestible part of carbohydrates that provides bulk to stool to help prevent constipation, which commonly occurs during pregnancy due to hormonal changes that slow the motility of the intestines.

Next, fats provide fat-soluble vitamins along with calories; and they supply fatty acids that help with fetal neurological and visual development. Sources of healthy fats include nuts, seeds, meat, fish, and dairy products.

Proteins are needed for essential processes like building and repairing tissue, making enzymes used in metabolic processes, and making plasma proteins, like albumin, that help maintain fluid balance. Sources of protein include eggs, legumes, grains, tofu, cheese, nuts, meats, and fish.