medical notes

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Nutrition and Micronutrientsin PregnancyAdvances in Maternal and Neonatal HealthEvidence of Nutritional InterventionEffectivenessMaternal malnutritionFolateIronIodineVitamin AZincCalciumNutrition and Micronutrients in Pregnancy2Maternal Malnutrition and PregnancyOutcomeSevere nutritional deprivation (Netherlands 194445)Birth weight significantly influenced by starvation Perinatal mortality rate not affected No increase incidence of malformation In healthy women, state of near starvation is needed toaffect pregnancy outcome Severe nutritional deprivation (Netherlands 194446)Periconception: Decreased fertility, increased neural tubedefect1st trimester: Increased stillbirths, preterm births, earlynewborn deaths3rd trimester: Low birth weight, small for gestational age,preterm birthCunningham et al 1997; Susser and Stein 1994.Nutrition and Micronutrients in Pregnancy3Maternal Malnutrition and PregnancyOutcome (continued)Dietary restriction trials in pregnant womenHigh weight for height or high weight gain Inconclusive results to demonstrate or exclude effect onfetal growth or any significant effect on other outcomes Mixed result with nutritional supplementation trialsHigh protein: No evidence of benefit on fetal growthBalanced protein and energy: minimal increase in averagebirth weight (~30 g) and small decrease in

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