Nutrition and Reproductive Health

Nutritional Factors Affecting Reproductive Health

• A diet rich in unsaturated fats, whole grains, fish, and vegetables is linked to improved fertility in both men and women.
• A diet high in saturated fats and refined sugars is linked to poorer fertility.
• Vitamin D deficiency and rickets can cause pelvic abnormalities.
• A history of poor dieting and anorexia nervosa can result in poor nutrient reserves.

Objectives of Nutrition During Pregnancy and Lactation

• Reduce anemia among low-income pregnant women.
• Reduce infant mortality.
• Reduce the incidence of spina bifida and other neural tube defects.
• Reduce Low Birth Weight (LBW).
• Reduce Preterm births.
• Reduce Fetal alcohol syndrome.
• Achieve proper weight gain during pregnancy.

Normal Changes in Maternal Physiology During Pregnancy

Blood Changes

• Blood volume expansion (hemo-dilution).
• Changes in blood lipid levels.

Maternal Organ and Tissue Changes

• Maternal organ and tissue enlargement.

Cardiovascular Changes

• Decreased blood pressure (BP) in the 1st half of pregnancy.
• Return to non-pregnancy levels in the 2nd half of pregnancy.

Immune System Changes

• Suppressed immunity during pregnancy.

Physiological Changes During Pregnancy

• Glomerular Filtration Rate (GFR) increases during pregnancy
• Sodium is conserved, and nutrient spillage into urine occurs, with protein being conserved
• Risk of Urinary Tract Infection (UTI) increases
• Basal Metabolic Rate (BMR) increases in the 2nd half of pregnancy
• Cardiac output and heart rate increase
• Insulin resistance and blood glucose levels increase

Functions of Proteins During Pregnancy

• Growth and development of the fetus
• Development of the placenta
• Enlargement of maternal tissues
• Increased maternal blood volume
• Formation of amniotic fluid
• Protein reserves prepare the mother for labor, delivery, and lactation
• Recommended daily protein intake is 0.6-0.8/kg + 14-25g/day

Functions of Calcium During Pregnancy

• Growth and development of fetal bones and teeth
• Decreases the risk of hypertension, pre-eclampsia, and low birth weights
• Maintains bone strength
• Enables proper muscle contraction
• Essential for blood clotting
• Recommended daily intake is 300 mg/day

Functions of Iron During Pregnancy

• Expansion of maternal tissues, including red blood cell mass
• Maintains additional iron content of placenta
• Builds iron stores in fetal liver
• Compensates for blood loss during delivery
• Recommended daily intake is 30-45 mg/day, or 60 mg/day for women with iron deficiency anemia

Functions of Vitamin C During Pregnancy

• Increases iron absorption
• Essential for fetal growth
• Recommended daily intake is 60 mg/day
• Deficiency increases the risk of preterm delivery

Functions of Vitamin D During Pregnancy

• Essential for fetal bone formation
• Recommended daily intake is 5 μg/day
• Excess amounts can lead to severe infant hypercalcemia and calcification of soft tissue
• Deficiency causes birth defects and small for gestational age infants

Functions of Vitamin A During Pregnancy

• Essential for fetal growth and development
• Protects the fetus from immune system problems, blindness, infections, and death
• Recommended daily intake is 600 μg/day retinol
• Excess doses (> 10,000 IU) can lead to "Retinoic Acid Syndrome"