Maternal and Child Nutrition Observatory - Dec 7, 2020 - 3 Min. read

Preconception care

Updated: Jan 26

Nutritional intervention in women before pregnancy is essential to improve their health status, because it reduces the risk of developing complications during and after pregnancy (1).

During pregnancy, energy and micronutrient requirements, such as iron, folate, vitamin A, vitamin D, iodine, zinc and calcium, should be met. In general, a varied diet can cover the requirements of most nutrients, but it is difficult to obtain the amount of folate. Therefore, supplementation of 4 milligrams of folic acid per day to women of reproductive age (2) prevents deficiency diseases such as neural tube defects (1).

 

Nutritional intervention before pregnancy is essential to reduce the risk of complications.

 

 

Weight before pregnancy

El peso corporal en la mujer antes del embarazo está relacionado de manera importante con el aumento de peso durante la gestación (3). El índice de masa corporal (IMC) es un parámetro que ayuda a evaluar el estado de nutrición materno (4), el cual se clasifica como bajo peso (<18.5 Kg/m), peso normal (18.5 a 24.9 Kg/m), obesidad (30 a 34.9 Kg/m) y obesidad extrema (> 40 Kg/m) (5). Es ideal mantener un IMC normal antes del embarazo para tener una ganancia de peso gestacional adecuada y prevenir algunas complicaciones que puedan afectar la salud de la madre y producto (3).

 

Normal weight before pregnancy is ideal for an adequate gestation and lower risk of complications.

 

  • Low weight:

Low weight before pregnancy increases the risk of complications during pregnancy, such as: placental abruption, delivery before 37 weeks of gestation, gestational arterial hypertension, better known as preeclampsia (6), micronutrient deficiency such as vitamin A and/or zinc (1) and inadequate weight gain (7) in the pregnant woman. Regarding the product, it can present: low weight and height for gestational age (8) and emaciation (1). These complications occur because the pregnant woman must cover her nutritional needs and provide the necessary nutrients to the growing product (9).

 

  • Overweight and obesity:

Weight above normal pre-pregnancy parameters is a modifiable risk factor that influences the probability of triggering complications in the product during pregnancy (3), such as increased risk of fetal death, infantile cerebral palsy (10), high birth weight, cesarean delivery (3) and risk of autism spectrum disorders (11). It has also been shown that women with high BMI are more likely to have gestational diabetes (GD) and gestational arterial hypertension (6), increased stress, anxiety, depression (11, 12) and may have weight retention after childbirth (13).

 

Underweight, overweight and pregestational obesity are related to complications during pregnancy.

 

References:

 

  1. Stephenson J, Heslehurst N, Hall J, et al. Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health. Lacent. 2018;391(10132):1830-41.
  2. Mexican Official Standard NOM-034-SSA2-2013 [online]. For the prevention and control of birth defects. 24 Jun 2014 [accessed: 18 Jun 2020]. Available at: https://www.dof.gob.mx/.
  3. Pongcharoen T, Gowachirapant S, Wecharak P, Sangket N, Winichagoon P. Pre-pregnancy body mass index and gestational weight gain in Thai pregnant women as risks for low birth weight and macrosomia. Asia Pac J Clin Nutr. 2016;25(4):810-17.
  4. Fernández ML, Soriano DJ, Blesa JJ. Nutrition in the preconceptional period and pregnancy outcomes: literature review proposed intervention of the Dietitian-Nutritionist. Esp Nutr Hum Diet. 2016;20(1):48-60.
  5. Norma Oficial Mexicana NOM-007-SSA2-2016 [online]. For the care of women during pregnancy, childbirth and puerperium, and of the newborn. Official Journal of the Federation. 8 Mar 2016 [accessed: 18 Jun 2020]. Available at: https://www.dof.gob.mx/.
  6. Hung TH, Hsieh TT. Pregestational body mass index, gestational weight gain, and risks for adverse pregnancy outcomes among Taiwanese women: A retrospective cohort study. TW J Obstet Gynecol. 2016;55(4):575-81.
  7. Meléndez GC, Saldaña SC, González HR, Tirán SJ. Relationship between pre-pregnancy low body mass index and risk of preterm delivery. Gynecol Obstet Mex. 2017;85(9):589-94.
  8. Patón CM, Prados RJ, Rodríguez BR, Sánchez GJ. BMI during pregnancy and its relationship with newborn weight. JONNPR. 2018;3(3):215-24.
  9. Orane AL. Nutritional requirements in pregnancy and where to supply them from. Rev Cl EMed UCR. 2016;6(VI):11-23
  10. Econ IF, Wilcox AJ, Moster D, Nohr EA, Terje LR, et al. Association between pregestational maternal body mass index and risk of infantile cerebral palsy. Rev Med La Paz. 2016;22(2):104.
  11. Li MN, Fallin D, Riley A, Landa R, Walker S, et al. The association of maternal obesity and diabetes with autism and other developmental disabilities. Peds. 2016;137(2)
  12. Romero GB, Caparrós GR, Strivens VH, Peralta RM. May pregestational body mass index be related to mother's psychological and physical condition during pregnancy? Nutr Hosp. 2018;35(2):332-339.
  13. Moll U, Olsson H, Landin-Olsson M. Impact of Pregestational Weight and Weight Gain during Pregnancy on Long-Term Risk for Diseases. PLoS One. 2017;12(1).

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