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Nutrients necessary for fetal growth are mainly needed in the second half of pregnancy when more than 90% of fetal growth occurs. However, changes in nutrient metabolism for this purpose occur from early pregnancy. The health of the pregnant woman is closely related to the health of the fetus, and the health of the expectant mother is closely related to proper nutrition. It is important for pregnant women to eat a variety of foods in moderation to ensure a balanced diet.
One way to determine whether a pregnant woman is getting adequate nutrients is to monitor her weight gain. Weight gain during pregnancy is also related to the birth weight of the newborn, so when the expectant mother is under weight before pregnancy and gains little weight, the risk of the fetus being born with low birth weight increases. The appropriate amount of weight for a pregnant woman with a normal body mass index(BMI) to gain is approximately 12 to 15 kg. However, this amount varies depending on various factors such as the pregnant woman's pre-pregnancy weight and activity level during pregnancy.
Then, what nutrients should pregnant women consume to ensure proper weight gain and a healthy baby? Compared to non-pregnant women, they need an additional 100-300 kcal per day, with the need for additional calories primarily occurring from the second trimester onward. It is recommended to consume an additional 340 kcal per day in the second trimester and 450 kcal per day in the third trimester. Except in special cases, there is no need to take vitamin or mineral supplements.
As iron requirements increase during the second trimester of pregnancy, it is recommended to eat iron-rich foods frequently and consume plenty of vitamin C, which helps iron absorption.
Eat foods rich in iron.
The fetus is actively metabolizing in the mother's womb and grows every day. Among components in the mother’s blood, red blood cells play an important role in transporting the nutrients and oxygen needed for metabolism to the fetus. These red blood cells contain a pigment protein that transports oxygen and contains iron. The increase in plasma volume is disproportionately larger than the increase in red blood cell mass, which can lead to anemia.
Consume with vitamin C, which helps iron absorption.
A balanced diet is essential! Vitamin C helps effectively support iron, which is involved in the fetus' active metabolism.
Drink plenty of water.
If you vomit frequently due to morning sickness, you can easily become dehydrated. Also, when you become pregnant, you sweat a lot and need to replenish moisture. Drinking plenty of water helps produce blood and amniotic fluid and helps expel waste products quickly, which is also beneficial for weight control.
Be careful not to consume excessive amounts of caffeine, such as coffee.
Coffee, black tea, green tea, cocoa, soda, etc. contain caffeine. One to two cups of coffee a day is okay, but consuming too much caffeine can make it difficult to fall asleep at night or increase the risk of miscarriage. Caffeine is also found in tea, soda, cocoa, chocolate, etc. in addition to coffee, so make sure you’re not ingesting too much caffeine throughout your entire diet.
Folic acid supplements
Women planning to become pregnant can prevent birth defects such as neural tube defects by taking folic acid supplements before pregnancy. Folic acid supplements are taken before pregnancy and consistently until 12-14 weeks of pregnancy. If you have had a previous pregnancy with neural tube defects(NTDs), a high-dose folic acid supplement of 4 mg per day is recommended.
Iron supplements
If you are a pregnant woman with anemia, you need to take iron supplements in the first trimester. However, if you are not anemic during early pregnancy, you don’t need to take iron supplements during early pregnancy. Rather, they may worsen morning sickness. From the second trimester of pregnancy, even pregnant women who did not previously have anemia will need to pay attention to iron as their iron needs increase significantly.
Comprehensive nutritional supplement for pregnant women
Most pregnant women do not need to take supplements separately as they get enough from food. However, if you only eat certain foods or are a picky eater, taking supplements containing vitamins and minerals necessary for metabolism can help balance your nutrients.
Hormonal changes in pregnant women make it easier for subcutaneous fat to accumulate in their bodies, and the amount of blood increases, so every pregnant woman gains weight. However, gaining too much weight can increase the likelihood of developing gestational diabetes, pregnancy-related hypertension(preeclampsia), and difficulties in giving birth. If you are of normal weight based on your body mass index(BMI) before pregnancy, it is normal to gain 11.52 to 16 kg compared to before pregnancy. Although you may not be particularly concerned about weight changes yet, it's a good idea to keep these things in mind. Below are recommended weight gain amounts during pregnancy based on your BMI before pregnancy.
| BMI Before Pregnancy(kg/m2) | Recommended Weight Gain During Pregnancy(kg) | |
|---|---|---|
| Low weight | 18.5 or below | 12.5~18 |
| Normal weight | 18.5~22.9 | 11.5-16 |
| Pre-obesity | 23.0~24.9 | 11.5~16 |
| Stage 1 obesity | 25.0~29.9 | 7~11.5 |
| Stage 2 obesity | 30.0 or higher | 5~9 |
There is no need for extra nutrients just yet.
Effects of drinking on the fetus
Alcohol has a significant impact on the development and growth of the fetus through the umbilical cord. In particular, it affected the development of the fetal brain cells the most because it passes the placenta more easily than any other substance. If a pregnant woman drinks a certain amount of alcohol, it can cause the abnormalities of the central nervous system(CNS) such as fetal growth retardation, intellectual disability or behavioral disorders, and malformations such as a small head or flat face. This is called “fetal alcohol syndrome.” Some studies have reported that even a small amount of alcohol consumed by pregnant women can cause a decrease in the newborn's weight and an increase in the risk of miscarriage, so absolute abstinence from alcohol is essential.
However, try not to panic if you had a few drinks in the early stages of pregnancy without knowing you were pregnant. Consuming small amounts of alcohol will not cause serious problems for the fetus. However, if you are concerned, consult your OBGYN.
Effects of smoking on the fetus
Smoking has a negative effect on the fetus. Pregnant women who smoke are twice as likely to have low birth weight babies as non-smoking pregnant women, and their risk of preterm birth, stillbirth, and spontaneous miscarriage increases. Due to the reduced amount of blood flowing through the placenta, the supply of oxygen and nutrients to the fetus is limited, and the risk of premature birth increases. Moreover, as the baby grows, its intellectual development may be delayed. If you want to quit smoking, you can get help by contacting your local public health center.
Caffeine is a stimulant found in coffee, tea, chocolate, and soft drinks(such as soda and energy drinks). Caffeine stimulates the central nervous system and can cause stomach ulcers by promoting gastric acid secretion. Additionally, it can inhibit the absorption of calcium, iron, etc., causing bone disease and anemia. It can also cause water loss due to its diuretic effect.
During pregnancy, the maximum limit of caffeine intake recommended is 200 mg per day. Effects of high doses of caffeine on pregnancy include low birth weight, miscarriage, premature birth, and fetal death, but research results are inconsistent. However, caffeine is found not only in coffee, but also in black tea, green tea, and cocoa, so be sure to check the caffeine content in foods and consume less than the maximum recommended daily intake.
(Source : Korea Health Promotion Institute)
After ovulation, you should not take any medications carelessly. This is because the period up to 10 weeks of pregnancy after fertilization is the period of embryonic organ formation when there is a high risk of miscarriage or fetal malformation if exposed to teratogenic substances. Regardless of whether you are expecting a pregnancy or not, it is recommended that women of childbearing age refrain from taking any medication after ovulation to prevent an unexpected pregnancy.
There is usually no special effect as communication between the fetus and the mother does not occur until the fourth week of pregnancy. If the baby is harmed by medication during the first 4 weeks of pregnancy, it will likely occur in the form of a miscarriage, and the possibility of fetal malformation is extremely low. However, the period from the 4th to the 10th week is when the embryo's organs are formed, so taking medication during this period can cause various malformations in the fetus.
In addition, even in couples in general population, the incidence of malformations is reported to be 3-4 percent of all births. If you suspect any malformations due to your medication, it is recommended to consult an obstetrician/gynecologist and follow your doctor's recommendations.
If you took any medications before you knew you were pregnant, you should consult your obstetrician/gynecologist.
I-sarang provides medication counseling for pregnant women(breastfeeding mothers).
I-sarang Medication and Drug Counseling for Pregnant Women(Breastfeeding Women)
Be especially careful when taking medication up to Week 12 of pregnancy.
The most dangerous time to take medication during your pregnancy is up to Week 12, when the fetus' organs are formed. The 3rd to 8th weeks of pregnancy are when the fetus' heart, central nervous system, eyes, ears, and limbs are morphologically complete. By week 12, its organs are completely developed.
Therefore, if you must take medication during pregnancy, you must consult a specialist and receive a prescription. However, as medication/drug use accounts for only 2-3% of the causes of malformations, you don’t need to feel anxious if you accidentally took medication without knowing you were pregnant. Consult an OBGYN for additional information about this matter. Rest assured that even if a pregnant woman needs to take medication, taking it appropriately after consulting a specialist can help ensure a healthy pregnancy and childbirth.
Cold medicine
A cold is an upper respiratory infection mainly caused by a virus. There is no medicine to cure the virus, and cold medicine only relieves symptoms. Therefore, if you have a cold, it is best to rest first,, drink plenty of warm water, and eat fresh fruit. If your symptoms are severe, you can visit the hospital and receive a prescription for medication at the doctor's discretion.
There are reports that some cold medicines can cause birth defects. However, most of these are results from animal testing, where animals are given hundreds of times the amount a human would normally take in one go. Therefore, cold medicine taken for about a week before pregnancy is generally not likely to cause fetal malformation. However, there are cases where certain medications can cause problems, so it is recommended to consult an OBGYN.
Laxatives
If you don't have severe diarrhea, you'll be fine. Laxatives are sometimes used during pregnancy, so there is no need to worry. However, if you experience diarrhea after taking them, you should be careful because severe. Diarrhea can cause electrolyte imbalances and dehydration. However, don’t worry too much if you took the medicine and nothing happened!
Stomach medications
Consult with an OBGYN on this matter. There are many different types of stomach medications, but for digestive aids or antacids, there will be no major problems. However, since there is no clear data on the teratogenicity of medications for gastric ulcers or duodenal ulcers, it is recommended that you consult a doctor if you have been taking them for a long time.
Sleeping pills
It's okay if you don't take it habitually. Taking it once a week or for 2-3 days is unlikely to affect the fetus' nervous system. However, if you find out you are pregnant after 6 weeks or have been taking it habitually, consult your doctor.
Tranquilizers
Tranquilizers have been shown to cause teratogenicity in animal testing. It is best to avoid taking medications that affect the nervous system. Therefore, if you have been taking them for a long period of time without knowing you were pregnant, it is recommended to consult a specialist.
Medicines for motion sickness
They are a type of tranquilizer, so caution is advised.
Fatigue recovery medications/drinks
Drinks for fatigue recovery contain small amounts of stimulants such as alcohol. Unless you drink it habitually, the amount if small enough that you don't have to worry.
Vitamin supplements
Vitamin supplements are water-soluble and fat-soluble. If you consume too many water-soluble vitamins, they are excreted, but fat-soluble vitamins remain in the body. The problem with vitamins is excessive intake of fat-soluble vitamins A and D. Therefore, if you take multiple nutritional supplements at the same time without checking the ingredients, excessive intake of vitamin A can cause fetal malformation. Therefore, you need to check your vitamins when taking them.
Medications for allergic rhinitis
Many medications used to treat allergic rhinitis caused by pollen contain antihistamines. There are antihistamines available for pregnant women, so it is recommended to consult a doctor before taking them.
Pain relievers
Among the different pain relievers, Tylenol is safe for pregnant women.
Do not take medication to treat freckles during pregnancy.
Hormonal changes during pregnancy may increase the appearance of dark spots. Freckles or dark spots start to appear around the 12th to 16th week of pregnancy, but don’t worry too much—these will disappear after giving birth.
In general, there are no specific restrictions on exercise unless you are fatigued or the exercise is dangerous to you or the fetus. Rather, appropriate exercise promotes blood circulation, which prevents complications during pregnancy, helps the growth and development of the fetus, and helps you get a good night's sleep. Moreover, appropriate exercise is very important to strengthen your physical strength in preparation for childbirth. There are also studies showing that pregnant women who exercise have a lower C-section rate and a lower incidence of low-birth-weight babies compared to pregnant women who do not exercise. However, you should avoid strenuous exercise.
If you were doing relatively high-intensity exercise such as jogging or aerobics before pregnancy, it is okay to continue doing these after pregnancy. However, it is not recommended for pregnant women who did not exercise much before pregnancy to suddenly start high-intensity exercise after getting pregnant, or to exercise at a higher intensity than before they were pregnant. Pregnant women with complications during pregnancy(gestational hypertension, multifetal pregnancies, intrauterine growth retardation, heart disease, high-risk group for preterm birth, etc.) are advised to first consult with their OBGYN about the intensity of exercise before starting.
If you have any medical or obstetric risk factors, get your health evaluated before exercising. The following are general contraindications to exercise during pregnancy. If any of these apply to you, it is recommended that you consult your doctor:
Severe heart disease, persistent bleeding in the second or third trimester, lung disease with limited lung volume, placenta previa after 26 weeks of pregnancy, incompetent cervix, preterm labor, multifetal pregnancy with risk of preterm birth, rupture of membranes, pregnancy-related hypertension, or preeclampsia
Severe anemia, sedentary lifestyle, arrhythmia without a medical evaluation, chronic bronchitis, uncontrolled type 1 diabetes, morbid obesity, severely underweight(BMI > 12), fetus with intrauterine growth retardation, uncontrolled hypertension, orthopedic problems that limit exercise, uncontrolled epilepsy, uncontrolled hyperthyroidism, and heavy smokers
If you experience symptoms such as vaginal bleeding during exercise, shortness of breath before exercise, dizziness, headaches, or chest pain, you should stop exercising. For additional information, including considerations for aerobic and strength training, check out the following references
Getting enough sleep during pregnancy helps the fetus grow and reduces pregnancy problems. It is recommended that pregnant women sleep 8 to 9 hours a day and strive to get a good night's sleep through regular lifestyle habits. If you don't get enough sleep at night, taking a 15- to 30-minute nap during the day can help. However, taking a nap late in the afternoon or napping for more than an hour can make it difficult to get a good night's sleep.
In the first trimester of pregnancy, when the uterus is not large, you can sleep comfortably without worrying about your position. However, once your belly starts to grow in the second trimester, since it is recommended that you start sleeping on your side. During the third trimester of pregnancy, lying on your left side helps improve blood circulation to the uterus.
(Source: MotherSafe)