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1.NutritionDuringPregnancyHormoneschanges Gastrointestinalchanges Delayingastricempty Decreasedgastricacidity Digestivediscomfortsmorningsickness, heartburn Cardiovascularsystem Bloodvolumeincreasesby50% Increaseincardiacoutput Decreaseinalbuminconcentration Renalfunctionchanges weightgain 总体重增加: 11~13kg 胎儿:3.3kg 胎盘、羊水:1.5kg 子宫:1.0kg 血液:1.2kg 乳房:0.4kg 细胞间液:1.5kg 脂肪:2~4kgRecommendWeightGainDuringPregnancyThenutritionalneedsofpregnancyEnergy Atypicalpregnancyhasbeenestimatedtorequireanadditional55000kcalories. Additional200kcal/dayduringthesecondandthirdtrimesters. Protein Proteinneedsarealsoincreasedduringpregnancytoprovidefor RNI:+5g/d1sttrimester +15g/d2ndtrimester +20g/d3rdtrimester Minerals Calcium Pregnantwomenabsorbmoreofthecalciumtheyconsumeandloselesscalciumintheurinethandononpregnantwomen. Thefetusretainsabout30gramsofcalciumoverthecourseofgestation.Mostofthecalciumisdepositedinthelasttrimesterwhenthefetalskeletonisgrowingmostrapidlyandtheteethareforming. RNI800mg1sttrimester 1000mg2ndtrimester 1200mg3rdtrimester foodsource:milkanddairyproductsIron Irondeficiencyanemialowbirthweight pretermdelivery Babiesbornprematurelymaynothavehadtimetoaccumulatesufficientiron,butbabiesbornattermusuallyhaveadequateironevenifthemotherisdeficient. RNI15mg1sttrimester 25mg2ndtrimester 35mg3rdtrimester foodsource:redmeats,leafygreenvegetables, fortifiedcereals ironsupplementZinc Zincdeficiencyduringpregnancyisassociatewithanincreasedriskoffetalmalformationandlowbirthweight. RNI11.5mg/d1sttrimesrer 16.5mg/d2ndtrimester 16.5mg/d3ndtrimester Iodine Iodinedeficiencyduringpregnancyincreasestheriskofstillbirthspontaneousabortionandcanresultinconditionintheoffspringcalledcretinism(呆小病). RNI200μg/dFolicAcidandVitaminB12 FolicacidandvitaminB12areessentialforcelldivision,Adequatefolateintakesiscrucialevenbeforeconceptionbecauserapidcelldivisionoccursinthefirstdaysandweeksofpregnancy.Folateisbelievedtobeessentialforproperformationofneuraltube. DeficienciesoffolateandvitaminB12 canalsores