Implication Maternal Csw

7/24/2019 Implication Maternal Csw

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Implications of the Nutrition Transition in theNutritional Status on Pregnant Women

Catur Saptaning Wilujeng


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Nutrition Transition

Increase in the consumption of fats

and simple sugars and decrease in

fruit and vegetable intake. Also,

decrease of physical activity.


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Characteristic

Change in dietary patterns favoring foods richerin fat

An increased consumption of simplecarbohydrates

A reduction in the consumption of fruits and

vegetables

A decrease in physical activity


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Changes in Food Consumption

Increase consumption of processed foodsparticulary fast foods.

Fast food is cheaper than fruits and vegetables.

Improvement in socioeconomic level.

Increase in the purchasing power of the average

family.

Low prices of calorie dense food, eg, Fast foodsand processed snack foods.

Rise in consumptionof low-cost, hight-fat foods,and refined sugar.


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Physical Activity

Car availabilty andaffordbil l i ty was

fairly low. TV ownership was

limited.

S t i l l l i m i t e d o fcomputer.

Exercise usually canbe done on the streetand park.

Fiftyyears

ago


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Effect of The Nutrition Transition on

Pregnancy

Undernutrition

Obesity Complication during pregnancy

Complication during birth


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Undernutrition and Pregnancy

High prevalence of low birth weight and of micronutrient deficiencies

Iodine deficiency disorders

vitamin A deficiency,

iron deficiency anaemia in young children and women of childbearingage

Calcium deficiencies

Zinc deficiencies

Vitamin D deficiencies

Regional Committee for the Eastern Mediterranean ofWHO, 2010


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Obesity and PregnancyThe epidemiology of noncommunicable diseases, suchas cardiovascular disease, diabetes and cancer and therisk factors for these diseases

Closely related to food consumption, dietary patterns,nutrition and lifestyles.

Overweight and obesity are potent risk factors forcardiovascular diseases and type 2 diabetes and aremajor contributors to premature deaths


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Complications of Obesity During Pregnancy

Gestational DiabetesMellitus

HypertensionDisorders

Snoring

Sleep apnea


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Gestational Diabetes Mellitus

That is the higher the BMI, the higher the risk.

Increasingin the cardiovascular risk.

Obesity increase the risk for GDM six times.

Obesity increase the risk for hypertension eighttimes.

Physical activity needs for lowering fasting andpostpandrial glucose concentration.


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Complication During Birth

CesareanDelievery

Anasthesia andPostpartum


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Cesarean Delievery

Incomplete dilation of the cervix, fetaldistress, or failure of induction.

The risk of caesarean delivery also increasesin women with GDM and/or preeclampsia.

To longer gestational periods, whichproduce heavier newborns.


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Anasthesia and Postpartum (1)

The increase in subcutaneous fat may causeanatomical abnormalities, which may make itmore difficult to locate physical reference points.

The epidural administration, are more likely tofail.

General anesthesia may also cause respiratoryproblems due to anatomical differences (forinstance, shorter and fatter necks).


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Anasthesia and Postpartum (2)

Vaginal delieveri!vis-a-vis bleeding, infection, and

urinary problems. In vaginal Valginal delievery !delivery, obese women show a

higher incidence of perianal rupture due to the

elevated weight of the newborn. They tend to stay longer in the hospital after

delivery, further increasing the costs incurred.


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LACTATION


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Lactation

Variety hormonal changes occur alter delievery.

Overwright dan obese women later than donormal- weight women due to a lower prolactinsecretion in response to the infant suckingstimulation.

Though not demonstrated, that this is caused byhigh progesterone levels in obese women.


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Long-term Effects of

Maternal Obesity in theMother and the infant


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Long-term Effects of Maternal Obesity in the

Mother and the infant

Those women with GDM have a higher risk ofdeveloping DM2 later in life.

A higher risk of developing cardiovascular disease(CVD).

Children of women with GDM may present withmacrosomy and have a higher risk of developing DM inadolescence and CVD in adulthood.


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Conclusion

The nutrition transition and changes in lifestyles havecaused a remarkable increase in obesity during pregnancy.

Policy efforts must be directed to the prevention of obesity inyoung girls.

An obese mother has a higher chance of having large-for-gestational-age children, who in turn may become obese inadulthood and will also have newborns with a high risk ofmacrosomy.


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REFERENCE

Rozowski,J & Parodi, C.G. 2008. Implication of the Nutrition

Transition in the Nutritional Status on Pregnant WomanIn: Lammi-

Keefe, C.J; Couch, S.C; & Philipson, E.H, ed.Handbook of Nutrition

and Pregnancy. Humana Press:USA, pp:307-315


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Implication Maternal Csw