NUTRITIONAL INFLUENCES DURING PREGNANCY
NUTRITIONAL INFLUENCES DURING PREGNANCY
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DOI：
10.1016/s0025-7125(16)31346-3
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发表时间：
1977-01-01
影响因子：
5.9
通讯作者：
PITKIN, RM
中科院分区：
文献类型：
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作者：
PITKIN, RM
产妇营养是影响妊娠过程和结果的重要因素之一，对营养因素的关注（即营养状况评估、饮食建议和后续评估）是产前护理的重要组成部分。几乎所有的营养素都需要在怀孕期间增加量，但增加的幅度因营养素而异。热量需求每天增加300千卡，相当于增加了15%，应该足以支持在最后两个三个月期间每周平均增加350至400克的体重。怀孕期间总蛋白质摄入量应为1.3克每公斤的成熟妇女和青春期略高。通过饮食不能满足对铁的营养需求，应提供补充剂（以简单亚铁盐的形式，每天30至60毫克）。叶酸的需求量在怀孕期间增加了一倍，虽然这些可以通过饮食来满足，但补充剂可以被认为是一种选择。当（且仅当）食用日常产品时，从食物来源提供妊娠期钙供给是容易的。对其他营养素的普遍增加的需求可以通过适当选择的饮食容易地提供。因此，关于补充剂，铁和叶酸应该经常被建议，而其他维生素矿物质补充剂可能既没有帮助也没有伤害。不能指望维生素矿物质补充剂的处方能够弥补不良的饮食习惯。一般营养素的饮食限制，特别是能量和钠的饮食限制，有可能损害母亲进行怀孕所需生理调节的能力，并干扰胎儿发育。限制任何营养素的水平低于建议的膳食摄入量提供的指导方针是很少的，如果曾经建议。
Maternal nutrition represents one of the important influences on the course and outcome of pregnancy and attention to nutritional factors (ie, assessment of nutritional status, dietary advice, and follow-up evaluation) properly constitute an essential component of prenatal care. Nearly all nutrients are required in increased amounts during gestation but the magnitude of the increase varies from nutrient to nutrient. Caloric needs increase by 300 kcal per day, representing an addition of 15 per cent, and should be sufficient to support a weight gain averaging 350 to 400 gm per week during the last two trimesters. Total protein intake during pregnancy should be 1.3 gm per kg for the mature woman and somewhat higher for the adolescent. Gestational needs for iron cannot be met by diet and supplementation (in the form of simple ferrous salts, 30 to 60 mg daily) should be provided. Folate requirements are doubled during pregnancy and, while these can be met by diet, supplementation may be considered as an option. Provision of the gestational calcium allowance from food sources is readily possible if (and only if) daily products are consumed. The generally increased need for other nutrients can be provided readily by the properly selected diet. Thus, with respect to supplements, iron and perhaps folate should be advised routinely while other vitamin-mineral supplements are probably neither helpful nor harmful. Prescription of vitamin-mineral supplements cannot be expected to compensate for poor dietary habits. Dietary restriction of nutrients in general, and energy and sodium in particular, has the potential for impairing the maternal capacity to make the required physiologic adjustments of pregnancy and interfering with fetal development. Restriction of any nutrient to levels below the guidelines provided by the Recommended Dietary Allowances is rarely if ever advisable.