General

Pre-pregnancy nutritional status

Pre-pregnancy nutritional status has effects on pregnancy outcomes.

Weight
One of the most obvious indicators of nutritional status is weight. Pre-pregnancy weight affects the amount and rate of recommended weight gain during pregnancy. Pre-pregnancy weight-related risk factors include the following:

Underweight pre-pregnancy increases the risk of:

• low birthweight
• premature delivery

Both of these can raise other risks for the infant, including long-term growth and cognitive deficits, pulmonary disease, diabetes, and heart disease.

Overweight pre-pregnancy increases the risk of:

• gestational diabetes
• pregnancy-induced hypertension
• congenital defects
• abnormal labor (induced labor, need for caesarian section)
• macrosomia, which can lead to lower Apgar scores, and places the infant at an increased risk for childhood obesity
• long-term maternal obesity

Nutritional Status
Pre-pregnancy nutritional status can also affect a pregnancy and birth outcome. Pre- and peri-conceptional folate status has a critical role in the prevention of neural tube defects such as spina bifida and anencephaly. Since the fortification of many grains in the US with folic acid, the incidence of neural tube defects has decreased 28%. (Williams et al, 2015) Healthy People 2020 goals include increasing the proportion of women of childbearing potential with an intake of at least 400 µg of folic acid from fortified foods or dietary supplements from 22.8% (2007-2010 proportion) to 26.2%.

Other issues related to nutritional status prior to or early in pregnancy include recommendations around alcohol, drugs, caffeine, tobacco, and vitamin A. These are covered later in this module.

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