Maternal and Child Nutrition Observatory - Dec 7, 2020 - 5 Min read

Ideal biological conditions for a successful pregnancy

Updated: Jan 26

The World Health Organization (WHO) defines pregnancy, or gestation, as the nine months during which the fetus develops in the woman's uterus.

It is a stage that marks the life of a woman going through several physiological and psychological changes. There is a growth of the uterus, increase of the breasts and blood volume, which can cause physiological anemia of pregnancy. Similarly, there is a gradual weight gain, increased heart rate and changes in the respiratory, urinary, digestive and musculoskeletal systems. In addition, the growth of the uterus and hormonal changes are responsible for most of the symptoms present during pregnancy. An immediate control of the pregnant woman is ideal to guarantee a good state of health without generating complications (1).

 

During the nine months of pregnancy, the woman undergoes anatomical, physiological and psychological changes.

 

 

Nutritional intervention is essential to provide a healthy diet, since a higher intake of energy, protein, vitamins and minerals is required to meet the nutritional needs of the mother and the product. Folic acid, iodine and iron should also be supplemented if necessary. Therefore, the WHO recommends counseling on the importance of a healthy diet and physical activity during this stage of life, so that they remain healthy and do not excessively increase their weight (2).

 

Nutritional intervention is essential to meet the requirements of the fetus and the mother.

 

Maturation of organs and systems

During adolescence, in females there are changes in body composition such as increase in height and development of sexual characteristics, such as fertility attainment and breast development (3). There is a maturation of the body due to hormonal changes leading to drastic changes in body composition. Growth and pubertal sex hormones increase, which are responsible for skeletal growth and sexual maturation, blood volume increases and various organs such as the heart, lungs, liver, brain and kidneys increase in size. Due to these changes, it is necessary to provide adequate nutrition in adolescence (4).

 

Adolescence (10-19 years) is a critical period for the maturation of organs and systems.

 

Menarca

Adolescence is a stage of life that goes from 10 to 19 years of age. During this period there are several changes in the female body, such as the appearance of menarche, or first menstruation; its appearance is related to genetic and environmental factors (6), among which are: state of health, diet, age, race, ethnicity (7), presence of obesity, as well as psychological factors. Since there are several factors related to menarche, it is not possible to determine an exact age of onset; therefore, an average of 12.2 years in Mexican-American girls has been chosen (8). Menarche initiates the biological reproductive age of the woman, but she is not necessarily socially and psychologically prepared for gestation.

 

There is no exact age for the onset of menarche, the average is 12.2 years.

 

Ideal chronological age for pregnancy

The ideal age for gestation has been considered to be between 20 and 29 years of age, since better results have been observed during pregnancy in both the mother and the product (9). It has also been statistically considered that the ideal age is from 18 to 35 years of age, because during this period there is greater fertility. In recent decades it has been observed that in developed countries women seek greater personal growth and development and postpone pregnancy for professional, cultural or social reasons. Pregnancies after 40 years of age may present some complications such as maternal mortality, hypertensive disease of pregnancy, gestational diabetes, premature rupture of membranes, miscarriages, among others, if not well controlled (10). Therefore, there is no ideal time for gestation, but several aspects of the woman should be taken into account before conception, such as: being the right age, good living conditions, good health, economic stability, among others (11).

 

The ideal age for pregnancy is 18 to 35 years of age, with best results between 20-29 years of age.

 

Consequences of early pregnancy

Adolescence is a stage that indicates the end of childhood and the beginning of adulthood, where there is a rapid period of growth. There are physiological, sexual, neurological and behavioral changes, where roles and responsibilities are adopted. Currently, pregnancy is frequent at this stage and is considered a public health problem (12). Pregnancy in adolescence, before the completion of physical development, is associated with a higher risk of complications during pregnancy, since the body is not mature enough for conception. Maternal complications include: miscarriage, pregnancy-induced hypertension, or preeclampsia, hemorrhagic syndrome, premature rupture of membranes and urinary tract infection. While in neonates they are: premature delivery, premature death during delivery, intrauterine growth retardation and low birth weight (13).

 

Adolescent girls have not completed their physical development; pregnancy is associated with greater complications during this stage.

 

Fertility in adolescents in low-income countries is three times higher due to contextual factors, among which are: poverty, lack of education, poor employment opportunities, abuse, unplanned pregnancies, lack of autonomy or support. It has also been shown that adolescents can continue to grow during gestation as long as their nutrition is adequate, but, on the other hand, their growth may also be limited (4). Therefore, pregnancy during adolescence entails various consequences that can affect the health of the product and the mother, in addition to limiting adequate growth. In addition to the above, an important factor to consider is that during adolescence there is a greater risk of complications due to late pregnancy control, since 40% of adolescent pregnant women do not start with a control until the second trimester (14).

 

Nutritional intervention from the first trimester is essential for lower risk of complications and proper growth.

 

 

References:

 

  1. National Institute of Health Management. Pregnancy care guide. Ceuta: INGASA; 2011. p. 9, 25-7.
  2. World Health Organization. WHO recommendations on antenatal care for a positive experience of pregnancy. World Health Organization; 2018. p. 14-5.
  3. Abreu AP, Kaiser UB. Pubertal development and regulation. Lancet dbt endocrinol. 2016;4(3):254-64.
  4. Das JK, Salam RA, Thormburg KL, Prentice MA, Campisi S, Lassi ZS, et al. Nutrition in adolescents: physiology, metabolism, and nutritional needs. Ann NY Acad Sci. 2017;1393(1):21-33.
  5. Güemes HM, Gonzáles FM, Hidalgo VM. Puberty and adolescence. Med adolscntes. 2017;5(1):7-22.
  6. Pérez PS, Huamán SY, Pinto IT, Rodríguez AN. Early menarche as a risk factor for preeclampsia, hospital regional docente las mercedes, Chiclayo. Medical Sciences and Global Health. 2019;2(1):40-8.
  7. Biro MF, Pajak MS, Wolff SM, Greenspan CL, Kushi HL, Teitelbaum LS. Age of Menarch in a Longitudinal US Cohort. Pediatr Adolesc Gynecol. 2018;31(1):339-45.
  8. Rubinstein AV, Rahman G, Ocampo DC. Menarche presentation in mothers and daughters: is there a breakthrough? Acta Pediatr Mex. 2017;38(4):219-27.
  9. Cahaco EE, Bergamo MA, Lippi MA, Coelho LG. Perinatal outcomes in women over 40 years of age compared to those of other gestations. Einstein.
  10. Macías VH, Hernández MA, Leboreiro IJ, Zapata BI, Bronstein BA. Advanced maternal age as a perinatal and newborn risk factor. Medigraphic. 2018;16(2): 125-32.
  11. Soriano OK, Carballo ME, Roque SA, Durán ML, Kably AA. Perception of fertility in women of reproductive age according to their age. Gynecol Obstet Méx.
  12. Flores VM, Nava CG, Arenas ML. Adolescent pregnancy in a region in Mexico: a public health problem. Public Health. 2017;19(3):374-8.
  13. Azevedo FW, Diniz BM, Borges VS, Ricarte ML, Evangelista BC. Complications in adolescent pregnancy: systematic review of the literature. Einstein. 2015;13(4):618-26.
  14. Robaina CJ, Hernández GF, Ruiz GL. Correct considerations concerning pregnancy in adolescence. Méd Pinareña.

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