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Review article

Pregnancy and Nutrition 
Asma RS1, Asma-UH2, Ashraful A3

Abstract

Pregnancy is a specially important time in women’s life to focus on proper health care and nutrition.
Nutrition during childhood and adolescence influence a women’s preconceptional nutritional status which
subsequently influence the outcome of pregnancy and health of the baby. Good nutrition is the key to a suc-
cessful pregnancy for both mother and child. The mother’s nutrition from the moment of conception is an
important factor in the development of the infant’s metabolic pathway and future wellbeing. The diet dur-
ing pregnancy should be adequate to provide maintenance of maternal health, the need of growing fetus, the
strength and vitality required during labour and successful lactation. All women need to gain weight during
pregnancy. Weight gain during pregnancy depends on pre-pregnancy weight. A healthy weight gain for most
of the women is between 25-35Lb. During pregnancy a women has different nutritional need for different
trimester to meet extra food needs and extra caloric requirement. Normal weight women need an extra 300
kcal /day during the 2nd and 3rd trimester of pregnancy. The total amount of needed calorie 2000-2500
kcal/day for a normal weight women. Needs for almost all nutrients are greater during pregnancy for own
bodies growth, for baby and successful lactation. The dietetic advice given to the mother should be reason-
able and realistic to the individual women. 

Key words: Pregnancy, nutrition, weight gain.

Introduction
Good nutrition is the key to a successful pregnancy
for both mother and child. It is especially important
during child bearing years. The types and amount of
food taken during pregnancy can affect the growth
and development of the baby. What pregnant women
eat will have a great impact on her unborn child dur-
ing development and in the future. Eating well can
help her have a healthy pregnancy and a healthy
newborn. It can also contribute to the development
of wholesome eating habits for the growing child.

During pregnancy, there is increased calorie require-
ment due to increased growth of maternal tissue,
fetus, placenta and increased BMR. The increased
calorie requirement is to extent of 300 kal over non-
regnant state during 2nd half of pregnancy

1
. 

The diet during pregnancy should be adequate to
provide –Maintenance of maternal health, the need
of growing fetus, the strength and vitality require
during labour, successful lactation

2
.

The mother’s nutrition from the moment of concep-

tion is an important factor in the development of the
infants’ metabolic pathways and future well being.
The pregnant women should be encouraged to eat a
balanced diet and should be made aware of special
needs for iron, folic acid, calcium and zinc

3,4
.

Weight Gain During Pregnancy
All women need to gain weight during their preg-
nancy. Adequate weight gain during pregnancy is
needed to provide the mother and child with good
nutrition. Weight gain during pregnancy depends on
pre-pregnancy weight gain. A healthy weight gain
for most of the women is between 25 to 35Lb. A
gradual weight gain is important during the first 3
month, a weight gain of only 2Lb to 4lB is adequate
since the fetus is very small at this time. Starting
with the 4

th
month of pregnancy, most women need

an extra 300 calorie per day. After that a weight gain
of ½ to 1 Lb/week or 3 to 4Lb/month is suggested. 
Too much or too little weight gain may cause health
problem for both mother and fetus. Fetus is only part
of weight gain. If weight gain is less, the chances of
fetus for good health go down at birth and on later

1. Asma Rumanaz Shahid, Lecturer, Department of Anatomy, Dhaka Medical College, Dhaka. Email:
rumanaz@gmail.com

2. Asma-Ul-Hosna, Assistant Professor, Department of Obstetrics & Gynaecology, BSMMU, Dhaka.
3. Ashraful Alam, Medical Officer, Department of Obstetrics & Gynaecology, BSMMU, Dhaka.
Corresponds to: Dr. Asma Rumanaz Shahid, Lecturer, Department of Anatomy, Dhaka Medical College, Dhaka.
Email: rumanaz@gmail.com

Bangladesh Journal of Medical Science Vol. 11 No. 04 Oct’12

267



life. Under weight women may need to gain more,
whereas obese women should gain only 7-11.5 kg
(15-25Lb). Heavier women and those with excessive
weight gain during pregnancy are likely to have
macroscopic infants. Inadequate weight gain is asso-
ciated with small for gestational age (SGA) infant. A
weight gain of 11.5-16 kg (25-35Lb) during single-
ton pregnancy is recommended. For a twin pregnan-
cy, 35-45 Lb, for a triplet 50Lb weight gain is rec-
ommended.6,8 Most healthy baby, weight gain
between 7-8Lb, some baby little less and some more.
The fetus gain most of the weight and has rapid brain
growth in last weeks of pregnancy 5,6,7.

A women should not try to loose weight during preg-
nancy, because it she do not eat required calories or
variety of foods, the baby will not get the nutrients,
she or he needs to grow1,8,9.

Table-I: Recommended weight gain during preg-
nancy as follows: 6,7,8.

Table-II: Based on a “normal” pre-pregnancy
weight, this chart shows how the weight gained dur-
ing pregnancy is distributed: 6,7,8.

Daily Food Guide And Calorie Requirement
The pregnancy diet ideally should be light, nutri-
tious, easily digestible and rich in protein minerals
and vitamins. Dietetic advice should be given with
due consideration to the socioeconomic condition,
food habit and the test of the individual. 
During pregnancy a women has different nutritional

needs for different trimester. To meet extra food
needs, a women need to add an average 300 Kcal
extra calories per day to her diet after first trimester.
At this extra calories, with extra servings of milk,
low fat cheese, lean meats, poultry, fish, leafy and
dark green vegetables, dried beans and pear, fruits,
whole grain and enriched breads and cereals 

3,4
.

Women with normal BMI should eat as to maintain
the schedule weight gain during pregnancy. Diet-
2000-2500kcal/day for normal weight women and
restriction to 1200-1800 kcal/day for over weight
women is recommended. A healthy eating plan for
pregnancy includes a variety of nutrient rich food.
Eating a variety of foods that provide enough calo-
ries help the mother and the body gain the proper
amount of weight. During the first three month of
pregnancy the pregnant women do not need to
change the number of calories, she get from her food
she eat. Normal weight women need an extra 300
cal/day, during the last 6 month of pregnancy. This
total amount 2000-2500 cal/day. If any one is under
weight or over weight or obese before become preg-
nant or it is a twin pregnancy need of calories may
be different 

10,11,12
.

Table-III: Recommended daily dietary allowances
for non pregnant and pregnant women are given
below 3

Pregnancy and Nutrition 

268

Pre-pregnancy weight  Recommended 

weight 

Average adult weight for height  25-35 Lb 
Under weight  28-40 Lb 
Over weight  15-25 Lb 
Obese  15 Lb  

Affected anatomy  Additional weight 

Fetus  7.0Lb 

Placenta (after birth)  1.5Lb 

Amniotic fluid  2.0Lb 

Uterus  2.0 Lb 

Breasts  1.0 Lb 

Blood  3.0 Lb 

Fluid  3.0 Lb 

Fat  9.0Lb 

Total  28.5Lb 

 Non pregnant women (Age in 
years) 

Pregnant 
Women 

 15-18 19-24 25-50 50+ 
Energy (Kcal) 2100 2100 -2100 -2000 +300 
Protein (g)  48 46 46 46 +30 
Fat- soluble vit.       
Vit. A (IU)  800 800 800 800 800 
Vit. D (IU)  400 400 200 200 400 
Vit. E (IU) 8 8 8 8 10 
Water soluble vit.      
Vit. C (mg) 60 60 60 60 70 
Folate (ng) 180 180 180 180 400 
Niacin (mg) 15 15 15 13 17 
Riboflavin (mg) 1.3 1.3 1.3 1.2 1.6 
Thiamine (mg) 1.1 1.1 1.1 1.0 1.5 
Vit. B6 (mg) 1.5 1.6 1.6 1.6 2.2 
Vit. B12 (mg) 2 2 2 2 2.2 
Minerals       
Calcium (mg) 1300 1000 1000 1200 1000 
Iodine (mg) 150 150 150 150 150 
Iron (mg) 15 15 15 15 30 
Magnesium (mg) 300 280 280 280 300 
Phosphorus  1200 800 800 800 1200 
Zinc (mg) 12 12 12 12 15 



Food Groups
Needs for almost all nutrients (vitamin and minerals)
are greater during pregnancy. Nutrients are impor-
tant for own body’s growth for baby and later for
breast feeding 

11
.

Healthy protein: At least half of the total protein
should be first class containing all essential amino
acid. Good source of protein are chicken, fish, lean
meat, low fat dairy products, eggs, bean and nut.
Fish is the source of DHA. If any one is not able to
eat fish, she should try other source of DHA like,
walnuts, wheat germ, omega 3 enriched eggs or con-
sider taking a supplement with DHA. 
Healthy fat: Majority of the fat should be animal
type contain vit. A and D. Pregnant and breast feed-
ing women needs healthy fat for baby’s develop-
ment. One should avoid transfat as food with hydro-
genated or partially hydrogenated fat like many
packaged and processed foods, friend foods and fast
food. Limits saturated fat like butter, whole milk
dairy products, high fat meat. Healthy fat, are found
in olive oil, fatty fish, canola oil, peanut butter, nuts,
seeds etc. 
Healthy carbohydrates: Fruits and vegetables are
healthy source of carbohydrates. Dark and bright
colour fruits and vegetables are richer source of vita-
mins and minerals. Whole fruit rather than juice is
acceptable. Eat whole grain products like brown
rice, whole wheat bread etc. Limit instant grains and
refined carbohydrate like cookies, soda etc. 
Fluid: One should drink enough water to never feel
thirsty. So urine is light in colour. Choose pasteurize
low fat milk, limit juice and beverage which are high
in calories. 
Vitamins and minerals: If any one is planning for
pregnancy, she should take vitamins and minerals
supplement that includes 400mg of folic acid to pre-
vent birth defect and 200-400 I.U of vit. D. In some
cases a women’s diet may not include enough of a
certain nutrient such as iron, or calcium and addi-
tional supplement may be necessary. Women, who
follow vegetarian diet, usually require vit. B12, D
and zinc. 
During pregnancy she should take prenatal vitamin
and mineral supplement that includes 220 µg of
iodine and does not contain more than 30 mg of iron.
To get calcium, drink 2-3 cup of low fat milk. If any
body cannot to get needed calcium through food to
take calcium supplement. 
The pregnant women may need vit. B12 supplement,
if she is complete vegetarian, calcium supplement

under age 25 years specially if she does not drink
enough milk 

10,11,12
.

Iron and Folate:  
The amount of iron and folate in diet is very impor-
tant. So one should eat food containing these nutri-
ents often. 
Iron; More iron is needed during pregnancy for
the baby. But it is hard to get enough iron from food
alone. There is a negative iron balance during preg-
nancy and the dietetic iron is not enough to meet the
daily requirement specially in the 2nd half of preg-
nancy. Thus the supplement iron therapy is needed
for all pregnant mothers from 16 weeks onwards.
Iron should be taken in between meals or at bed time
on an empty stomach for its better absorption 

1,2
. The

iron in meat, fish and poultry is more readily
absorbed by the body than the iron in plant foods. To
increase iron absorption, eat plant foods with meat
or with foods that contain vit. C 

10,11,12
.

Folate : Folate is a ‘B’ vitamin that helps body to
make RBC and genes. During pregnancy, double
amount of folate is needed. Pregnant women should
eat various food containing folate, to get its required
amount 

1,2,10
.

Table-IV: Food sources of Iron and Folate 
3,4

:
Iron rich food Folate rich food
Lean meat, poultry, fish, organ meat such an liver. 
Dried beans and peas 
Dark green vegetables 
Whole grain and enriched breads and cereals. 
Liver 
Dried beans and peas 
Dark green leafy vegetables 
Whole grain breads and cereals, cereals fortified
with folic acid. 
Fruits (such as oranges and orange juice, grape fruit,
bananas, tomatoes).

Sodium: Salt does not need to be restricted in preg-
nancy for most of the women to avoid excessive salt,
limit intake of highly process food such as canned
soup, salted snacks etc. 

13,14,15,16
.

Food Safety And Preparation
During pregnancy women are at increased risk of
food born illness because of hormonal changes dur-
ing pregnancy weakens the immune systems. So,
one should wash hands before and after food prepa-
ration. Wash fruits and vegetable well. Food should
be cook well. Meat, fish, eggs and poultry should

Asma RS, Asma-UH, Ashraful A

269



properly handled. Egg should be cooked until firm.
Avoid half done food, raw meat, unpasturized milk17. 

Avoidance Of Food
There are certain foods and beverage that are harm-
ful for the fetus, if they are taken during pregnancy.
Fish with high level of methyl mercury Soft cheese
– goat cheese, ready to eat meat- contain bacteria
(listeria) which are harmful for unborn baby.

Raw or undercooked fish, meat or poultry.
Drinking alcohol can be dangerous to unborn child.
More than 50% of the child born alcoholic mother
syndrome, miscarriage, low birth weight. So both
the RDA and the US surgeon general have recom-
mended that pregnant women should avoid drinking
any alcohol during pregnancy18.

Large amount of caffeine containing beverage.
Caffeine is stimulant found in coffee, tea, Coca-Cola
and some drugs. Pregnant women should take con-
trolled food containing tea/coffee.

Women who smoke, put their babies at much higher
risk of premature birth, low birth weight and still
birth compared to non smoker, so pregnant women
should avoid smoking5,19. 

Some drugs are appropriate for use during pregnan-
cy. But there are some drugs, those are contraindicat-
ed during pregnancy. Women should avoid taking
drugs in the first trimester unless it is indicated for
any medical indication8.

Anything that are not food. Some pregnant women
may have crave for something that are not food such
as laundry starch, clay etc20.

Women during her pregnancy period should avoid
taking lots of cookies, candies, cakes, chips, soft
drinks and fats such as butter, margarine, gravy, fried
foods, salad dressings and mayonnaise. These high
calorie foods provide very little nourishment for the
mother and the baby21,22.

Conclusion
Pregnancy is a specially important time in women’s
life to focus on proper health care and nutrition. It is
important to take a life cycle approach to the issue
improving nutrition among child bearing women
and their children rather than focusing solely on
nutrition during pregnancy and postpartum period.
Nutrition during childhood and adolescence influ-
ence a women’s pre-conceptional nutritional status
which subsequently influence the outcome of preg-
nancy and health of the baby. Malnutrition is perpet-
uated across generation via this cycle. For this rea-
sons, programme to improve the nutrition of women
and children must be comprehensive targeting all
stages of life cycle23, 25- 27.

Policy makers and service provider’s can take action
by making maternal and child nutrition and integral
part of the comprehensive programme that serve
women and children. 

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