POOR NUTRITION DURING PREGNANCY

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During pregnancy, nutrition is an essential concern of public health because pregnancy is a crucial stage at which significant maternal nutrition alongside being a critical aspect that influences the wellbeing of the mother and the unborn child. At the period of prenatal, the development of the fetus depends on the nutrients it gets through the placenta. The intake of the diet has to coincide with the mother’s needs alongside the conception products (Williamson, 2006). A suitable diet of the mother enables the mother avail enough storage of the required nutrients purposely for the fetus development. As per WHO (2014), nutrition is the foods intake putting into consideration the dietary needs of the body. A well-balanced diet, proper nutrition practices as well as planned physical exercise is considered a pillar for good health.
On the other hand, poor diet combined with malnutrition leads to increased disease susceptibility, reduced immunity, and physically impaired, reduction in productivity alongside impaired mental development. For that matter, pregnant women have the responsibility to maintain a well status of nutrition. Maintaining a balanced diet can be done via the lifestyle that considers optimizing the health of maternal and has a reduction in the congenital disabilities risk, the development, and growth of suboptimal fetal, health problems that are chronic in their infants. The significant lifestyle aspects that promotes good health during pregnancy in mothers are having the desired gain of weight, eating of a number of foodstuffs in line with the guidelines of diet of the pregnancy, appropriate physical exercise, and timely and appropriate supplements of minerals alongside vitamins and safe handling of food (Kaiser and Allen, 2008).
Bone diseases are diseases that have impact on the bones of human beings. These diseases have connections to the abnormalities in the system of human skeleton. The consumption of a balanced and adequate diet before the period of conception is essential for successful outcome of pregnancy. Each lady within the bearing age bracket have experiences of an increment in the requirement of more nutrients at the time of pregnancy. Hence all ladies are supposed to be well informed on how to keep up foods with a healthy balanced diet during their periods of pregnancy. A handful of women may be facing hardship of consuming or accessing all the required elements of a balanced diet during pregnancy or in their lives
A good number of articles investigated and found out that inadequate intake of nutrients of both the micronutrients as well as the macronutrients seems to have effects on maternal anemia, the retardation of fetal growth, increased risk of other maternal mortality alongside morbidities and low weight of the fetal during birth. Example of macronutrients are fats, carbohydrates, and proteins while the micronutrients include phosphorus, iron, zinc, thiamine, niacin, magnesium, calcium, vitamin C, riboflavin and vitamin A (Kristensen et al., 2015; Kaiser and Allen, 2008).
In one way or the other, pregnant mothers in unfortunate communities undergo undernutrition. Undernutrition creates serious calamity of having lower weight during birth or even having babies who weigh less than two thousand five hindered grams at the time of their birth. The low weight of children at birth is a significant indication of the whole mother’s health as well as the newborn (Helle et al., 2015). According to Sharma et al. (2016), low birth weight has two causes. These are preterm birth alongside retardation of intrauterine growth. A study done in the rural communities showed that intrauterine growth retardation leads in contributing to babies born with low weight with a percentage of 96.4 while the other percentage of 3.6 are the babies born preterm (Sharma et al.,2016).
The underweight birth rate among the undeveloped communities though have had reduction from a percentage of 40, and they still hold the highest rank in the globe as it ranges from a portion of 20 to 22. After a careful controlling of the impacts of covariates, it was evident that maternal BMI, as well as the height, became the predictors of underweight births in less fortuned communities. Also, 100 pregnant mothers were under study. The mothers were from urban and rural areas. The study found out that there was a direct connection between the weight of the mother and the weight of the born babies. The study indicated that mother who had had a balanced diet gave birth to babies full of health (Sotunde et al., 2018).
A recent paper concerning pregnant women in underdeveloped localities showed how providing supplements of prenatal micronutrient with a combination of supplements of fresh food aided in increasing the level of maternal hemoglobin. Even though the weight of the birth was not statically substantial, but there was a decrement in the rate of the mortality of the infants of 16.8 /1000 live births from 44.1/1000 live births. These results were from a standard program that women were treated using folic acid, iron alongside the commonly used food supplements.
Malnutrition that is related to micronutrients is sometimes called *hidden hunger*. Hidden hunger is because the effects are invisible. Insufficient micronutrients consumption at the time of pregnancy exposes women to several pregnancy complications. Williamson, (2006), proved that inadequate intake of iron had a link to the delivery of preterm. Insufficient consumption of calcium had a connection to an increment of blood pressure of the mother at the time of the pregnancy among ladies at hypertension risk (Kaiser and Allen, 2008).
Furthermore, deficiencies of micronutrients pose enormous effects on the wellbeing of the child in the long run. Insufficient nutrition, particularly in the early stages of pregnancy, might have considerable damage of the brain development of the fetal as well as resulting abnormalities in the functioning of endocrine, growth of organs and the child energy metabolism. Women with pregnancy whose levels of foliate were quite low due to their intake diet had exposure to lacked foodstuffs that contained vitamin B-complex. The lack of vitamin B-complex resulted in an increment of the defect risk in the neural tubes of babies that had been born (Kristensen et al., 2015). Vitamin E alongside D prenatal deficiency has an association with escalated conditions of difficulties in respiratory systems. The complications included asthma as well as wheezing in the newborn baby (Helle et al., 2015). According to Sharma et al. (2016), prenatal vitamins intake reduces the risk at which children can have exposure to autism.
Moreover, deficiencies of macronutrients specifically folic acid and iron have impacts such as nutritional anemia in women and children alongside defects in the neural tube that the newborn suffer has remained a calamity in the public health in developing countries. Reduced consumption of spicy food, as well as a diet rich in folic acid and many infections, have been seen as causing high anemic rates in kids not more than two years of age and pregnant women. The pre, as well as postnatal folic acid and iron supplements, is quite low because of low rates of compliance alongside coverage of services offered to antenatal; only fifteen percent of the pregnant women residing in the rural areas have a consumption of 100 tablets at minimum at the time they are pregnant. The coverage of many supplements of micronutrients that are formulated to tackle the deficiencies of iron alongside other micronutrients is low.
The generality of the sickness of childhood like infections of acute respiration merges to be the leading cause of children and infant mortality and morbidity (Sotunde et al., 2018). A proposal is forward to explain how insufficient consumption of nutrients at the time of pregnancy have induction of the fetus to the development of the adaptation of limited nutrient supply. The development of the adaptation of nutrient resulted in permanent variation of its function, structure, metabolism, and physiology. That change is *fetal programming. *It stimulates many diseases in the future of a person if he or she has exposure to the intake of the diet alongside the lifestyle that is diverse from the shortage of knowledge in indecent uteroplacental. Indecent uteroplacental causes the theory emergence called *fetal origins of adult disease, *cardiovascular diseases and endocrine in the life of the adults (Kaiser and Allen, 2008).
Iodine is considered a vital micronutrient in the body of humans. Its significance can is in the development of a healthy brain. When the intake of iodine is inadequate disorders associated with iodine emerge. These disorders affect every stage of human life, more so in pregnancy, iodine deficiency disorders (IDD) at the scene of pregnancy impairs the fetus’ neurodevelopment. In the maternal side, stillbirth can result, not forgetting miscarriage, mental retardation, abnormalities of inherent, losing hearing ability, dwarfism, among other problems. According to Kristensen et al., (2015) the transient, moderate gestation iodine deficiency results in adverse effects that include IQ reduction, poor education results alongside uncoordinated language skills. Therefore maintenance of sufficient intake of iodine is significant for a woman during pregnancy.
The need for iodine increases at the time of pregnancy; the necessity of iodine due to changes in the physiology in the metabolism of iodine. The cause of the changes also includes increased clearance of renal, the fetus requirement of iodine and synthesizing of the thyroid hormone for the mother to have the maintenance of euthyroidism. As per the recommendation of world health organization during the iodine nutritional condition assessment, women bearing unborn babies had a more significant requirement of iodine than any other individual (Helle et al., 2015). A pregnant mother will require 250 μg/24 hours while the other persons will need 150 μg/day. 250 μg/24 hours to 150 μg/day in approximation to an increase by percentage of 50 in the production of the thyroid hormone at the time of pregnancy (WHO, 2014). Thus pregnant women seem to be at higher risk due to insufficient iodine.
Most of the foodstuff has a low content of iodine. WHO in conjunction with UNICEF, recommends that there should be iodization of the universal salt so that to ensure every human being on earth has adequate iodine intake. Nevertheless, some of the nation’s iodization of the salt is not feasible in all its areas. Statistically, settings in place where this process of universal iodization of salt has not faced implementation fully, women with pregnancy may have the chance of not receiving sufficient quantity of the iodized salt.
Three hundred calories in approximation are in need so that a healthy pregnancy is maintained. The calories are from a well-balanced diet that includes the fruits, proteins, vegetables, whole grains, among others with keeping the following it their minimum sweets alongside fats. A balanced diet and healthy foods at the time of the pregnancy aid in minimizing some crazy symptoms of pregnancy like constipation as well as nausea. According to Williamson, (2006) the following significant elements of wellbeing lifestyle at the time of pregnancy show recommendation; balanced diet eating, regular exercise, appropriate weight gaining, a well timely mineral, and vitamin supplements intake. Besides, folic acid is also crucial in terms of the nutrition of a pregnant mother. Folic acid is in fortified cereals of the breakfast, beans, some green vegetable, nuts, and most barriers, among others. In the absence of folic acid, intellectual ability decreases and paralysis emerges. Intake of the fluid is also significant part of nutrition as far as pregnancy is concerned. Pregnant women can have enough fluid by having water daily. Lastly, iodine is a crucial nutrient in the body, especially for the expectant mother. Deficiency in iodine results in maternal hypothyroidism. Maternal hypothyroidism leads to deficit in growing, psychomotor and cognitive among the infant, neonates, and children. Even though the primary source of the nutrition required during pregnancy should be in the diet, a regular prenatal vitamin is essential. It helps in filling small gaps.

References
WHO/UNICEF Joint Water Supply, & Sanitation Monitoring Programme. (2014). *Progress on drinking water and sanitation: 2014 Update*. World Health Organization.
Williamson, C. S. (2006). Nutrition in pregnancy. *Nutrition Bulletin*, *31*(1), 28-59.
Kaiser, L., & Allen, L. H. (2008). Position of the American Dietetic Association: nutrition and lifestyle for a healthy pregnancy outcome. *J Am Diet Assoc*, *108*(3), 553-561.
Kristensen, N. B., Madsen, M. L., Hansen, T. H., Allin, K. H., Hoppe, C., Fagt, S., … & Pedersen, O. (2015). Intake of macro-and micronutrients in Danish vegans. *Nutrition Journal*, *14*(1), 115.
Helle, N., Barkmann, C., Bartz-Seel, J., Diehl, T., Ehrhardt, S., Hendel, A., … & Bindt, C. (2015). Very low birth-weight as a risk factor for postpartum depression four to six weeks postbirth in mothers and fathers: Cross-sectional results from a controlled multicentre cohort study. *Journal of affective disorders*, *180*, 154-161.
Sharma, D., Shastri, S., & Sharma, P. (2016). Intrauterine growth restriction: antenatal and postnatal aspects. *Clinical Medicine Insights: Pediatrics*, *10*, CMPed-S40070.
Sotunde, O. F., Laliberte, A., & Weiler, H. A. (2018). Maternal risk factors and newborn infant vitamin D status: a scoping literature review. *Nutrition research*.

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