Nutritional Counseling for Pregnant Women

임신부의 영양상담

Park, Hyun-Ah
박현아

  • Published : 20020000

Abstract

임신기간은 영양에 민감한 시기로 이 시기의 영양은 임신부와 태아 건강에 영향을 주며, 이 기간동안 좋지 않은 영양습관을 교정하면 중년과 노년의 사망, 이환에까지 영향을 줄 수 있는 중요한 시기이다. 가정의들은 임신기간 동안 임신부가 적절한 체중증가를 이루도록 상담과 중재를 하여야 하며, 영양균형이 잡힌 충분한 식사를 하도록 교육하여야 한다. 적절한 체중증가가 이루어지는 정상임신에서는 철분과 엽산을 제외하고는 보충제의 복용을 권장하지 않는다.

Keywords

References

  1. Gail Morrison, Lisa Hark. Medical nutrition and disease. 2nd ed. Blackwell Science. 1999
  2. Cunningham FG, Norman FG, Kenneth JL, Larry CG III, John CH, Katharine DW. William's Obstetics, 21st ed. McGraw-Hill. 2001
  3. 한윤종, 나혜영, 임재희, 강창성, 박성철, 김영제 등. 임신전 신체질량지수와 임신체중증가에 관한 연구. 대한주산회지 2001;12(4):453-7
  4. 김상만, 이 진, 안병훈, 박샛별, 김광민, 김행수 등. 임신 중 체중변화와 출산 후 체중증가에 대한 전향적 연구. 가정의학회지 2001:22(6);895-903
  5. 유경희, 윤진숙. 우리나라 임산부의 임신시기별 영양섭취상태 및 임신결과에 대한 횡적조사연구. 한국영양학회지 1999;32(8):877-86
  6. Theron G, Thompson M. The usefulness of weight gain in predicting pregnancy complications. J Trop Pediatr 1993;39:269-72 https://doi.org/10.1093/tropej/39.5.269
  7. Dawes M, Green J, Ashurst H. Routine weighing in pregnancy. BMJ 1992;304:487-9 https://doi.org/10.1136/bmj.304.6825.487
  8. Parker JD, Abrams B. Prenatal weight gain advice: an examination of the recent prenatal weight gain recommendations of the Institute of Medicine. Obstet Gynecol 1992;79(5(Pt 1)):664-9
  9. Witter FR, Caulfield LE, Stoltzfus RJ. Influence of maternal anthropometric status and birth weight on the risk of cesarean delivery. Obstet Gynecol 1995; 85(6):947-51 https://doi.org/10.1016/0029-7844(95)00082-3
  10. Cogswell M, Serdula M, Hungerford D, Yip R. Gestational weight gain among average-weight and overweight womenwhat is excessive? Am J Obstet Gynecol 1995;172:705-12 https://doi.org/10.1016/0002-9378(95)90598-7
  11. Carmichael S, Abrams B. A critical review of the relationship between gestational weight gain and pre-term delivery. Obstet Gynecol 1997;89:865-73 https://doi.org/10.1016/S0029-7844(97)00047-1
  12. Johnson J, Longmate J, Fretzen B. Excessive maternal weight and pregnancy outcome. Am J Obstet Gynecol 1992;167:353-72 https://doi.org/10.1016/S0002-9378(11)91414-8
  13. Abrams B, Selvin S. Maternal weight gain pattern and birth weight. Obstet Gynecol 1995;86:163-9 https://doi.org/10.1016/0029-7844(95)00118-B
  14. Hickey C, Cliver S, McNeal S, Hoffman H, Goldenberg R. Prenatal weight gain patterns and birth weight among nonobese black and white women. Obstet Gynecol 1996;88:490-6 https://doi.org/10.1016/0029-7844(96)00262-1
  15. Hickey C, Cliver S, Goldenberg R, Kohatsu J, Hoffman H. Prenatal weight gain, term birth weight, and fetal growth retardation among high-risk multiparous black and white women. Obstet Gynecol 1993;81: 529-35
  16. Institute of Medicine. Nutrition during pregnancy, weight gain and nutrient supplements. Report of the Subcommittee on Nutritional Status and Weight Gain during Pregnancy, Subcommittee on Dietary Intake and Nutrient Supplements during Pregnancy, Committee on Nutritional Status during Pregnancy and Lactation, Food and Nutrition Board. Washington, DC: National Academy Press 1990;1-233
  17. Johnson JW, Yancey MK. A critique of the new recommendations for weight gain in pregnancy. Am J Obstet Gynecol 1995;174:254-8 https://doi.org/10.1016/S0002-9378(96)70403-9
  18. Feig D, Naylor C. Eating for two: are guidelines for weight gain during pregnancy too liberal? Lancet 1998;315:1054-5 https://doi.org/10.1016/S0140-6736(80)91499-3
  19. Cnattingius S, Bergstrom R, Lipworth L, Kramer MS. Prepregnancy weight and the risk of adverse pregnancy outcomes. N Engl J Med 1998;338(3): 147-52 https://doi.org/10.1056/NEJM199801153380302
  20. Deckelbaum R. Prepregnancy body mass index and risk of multiple congenital anomalies. Am J Med Genet 2002;107(3):253-5 https://doi.org/10.1002/ajmg.10164
  21. WHO. Energy and protein requirement. Report of a joint FAO/WHO/UNU meeting. Geneva: WHO (WHO technical reports deries #724);1985
  22. Prentice AM, Goldberg GR. Energy adaptations in human pregnancy: limits and long-term consequency. Am J Clin Nutr 2000;71(5 Suppl):1226S-32S
  23. Poppitt SD, Prentice AM, Goldberg GR, Whitehead RG. Energy-sparing strategies to protect human fetal growth. Am J Obstet Gynecol 1994;171(1): 118-25 https://doi.org/10.1016/S0002-9378(94)70087-7
  24. 한국영양학회. 한국인의 영양권장량-7차 개정;2000
  25. Kramer MS. Balanced protein/energy supplementation in pregnancy. Cochrane library, Issue 1, 2002. Oxford: Update Software
  26. Rush D. nutritional and maternal mortality in the developing world. Am J Clin Nutr 2000;72(1 Suppl), 212S-40S
  27. Ceesay SM, Prentice AM, Cole TJ, Foord F, Weaver LT, Poskitt EM, et al. Effects on birth weight and perinatal mortality of maternal dietary supplements in rural Gambia: 5 year randomized controlled trial. BMJ 1997;315(7111):786-90 https://doi.org/10.1136/bmj.315.7111.786
  28. Kramer MS. High protein supplementation in pregnancy. Cochrane library, Issue 1, 2002. Oxford: Update Software
  29. Rush D, Stein Z, Susser M. A randomized controlled trial of prenatal nutritional supplementation in New York City. Pediatrics 1980;65(4):683-97
  30. Whittaker PG, Lind T, Williams JG. Iron absorption during normal human pregnancy: a study using stable isotopes. Br J Nutr 1991;65(3):457-63 https://doi.org/10.1079/BJN19910104
  31. 김은경, 이규희. 임산부의 철분 섭취량과 흡수율 및 관련된 영양지식에 관한 연구. 지역사회영양학회지 1998;3(1):53-61
  32. Yip R. Significance of an abnormally low or high hemoglobin concentration during pregnancy: special consideration of iron nutrition. Am J Clin Nutr 2000;72(1 Suppl):272S-9S
  33. Mohomed K. Iron supplementation in pregnancy. Cochrane library, Issue 1, 2002.Oxford: Update Software
  34. Hemminki E, Rimpelii U. A randomized comparison of routine versus and selective iron supplementation during pregnancy. Am J Clin Nutr 1991;10:3-10
  35. 대한산부인과학회. 산과학. 3판. 서울. 1997
  36. 박태선, 김은경. 한국인의 생활영양. 교문사. 2000
  37. Ensom MH, Liu PY, Stephenson MD. Effect of pregnancy on bone mineral density in healthy women. Obstet Gynecol Surv 2002;57(2):99-111 https://doi.org/10.1097/00006254-200202000-00022
  38. Ann Prentice. Maternal calcium requirements during pregnancy and lactation. Am J Clin Nutr 1994;59 Suppl:477S-83S
  39. Prentice A. Maternal calcium requirements during pregnancy and lactation. Am J Clin Nutr 1994;59 (2 Suppl):477S-82S
  40. 국민건강영양조사. 보건복지부;1999
  41. Atallah AN, Hofmey GJ, Duley L. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane library, Issue 1;2002
  42. Belizan JM, Villar J, Gonzalez L, Campodonico L, Bergel E. Calcium supplementation to prevent hypertensive disorders of pregnancy. N Engl J Med 1991; 325(20):1399-405 https://doi.org/10.1056/NEJM199111143252002
  43. Caulfield LE, Zavaleta N, Shankar AJ, Merialdi M. Potencial contribution of maternal zinc supplementation during pregnancy to maternal and child survival. Am J Clin Nutr 1998;68 Suppl:499S-508S
  44. 박진순, 천종희. 한국성인의 아연 섭취실태 및 아연 보충에 의한 아연 영양상태의 변화. 한국영양학회지 1993;26(9):1110-7
  45. Swanson CA, King JC. Zinc and pregnancy outcome. Am J Clin Nutr 1987;46:763-71
  46. Shah D, Sachdev HP. Effect of gestational zinc deficiency on pregnancy outcomes: summary of observation studies and zinc supplementation trials. Br J Nutr 2001;85 Suppl 2:S101-8 https://doi.org/10.1079/BJN2000301
  47. Rober EB. Micronutrients in pregnancy. Br J Nutr 2001;85Suppl 2:S193-7 https://doi.org/10.1079/BJN2000314
  48. Goldenberg RL, Tamura T, Neggers Y, Copper RL. The effects of zinc supplementation on pregnancy outcomes. JAMA 1995;274:463-8 https://doi.org/10.1001/jama.274.6.463
  49. Mohomed K. Zinc supplementation in pregnancy. In pregnancy and childbirth module of the Cochrane database of systemic reviews, Issues I. Oxford. United Kingdom. The Cochrane Collaboration. 1998
  50. O'Brien KO, Zavaleta N, Caulfieid LE, Yang D-X, Abrams SA. Influence of prenatal iron and zinc supplements on supplemental iron absorption, RBC incorporation, and iron status in pregnant Peruvian women. Am J Clin Nutr 1999;69:509-15
  51. Duley L, Henderson-Smart D. Reduced salt intake compared to normal dietary salt, or high intake, in pregnancy. Cochrane library, Issue 1, 2002. Oxford: Update Software
  52. Mohomed K, Gulmezoglu AM. Vitamine D supplementation in pregnancy. Cochrane library, Issue 1, 2002. Oxford: Update Software
  53. Christian P, West KP, Khatry SK, Kimbroughpradhan E, LeClerg SC. Night blindness during pregnancy and subsequent mortality among women in Nepal: effects of vitamin A and beta-carotene supplementation. Am J Epidemiol 2000;152(6): 542-7 https://doi.org/10.1093/aje/152.6.542
  54. West KP Jr, Katz J, Khatry SK, LeClerq SC, Pradhan EK, Shrestha SR, et al. Double blind, cluster randomised trial of low dose supplementation with vitamin A or beta carotene on mortality related to pregnancy in Nepal. The NNIPS-2 Study Group. BMJ 1999; 318(7183):570-5 https://doi.org/10.1136/bmj.318.7183.570
  55. Faisel H, Pittrof R. Vitamin A and causes of maternal mortality: association and biological plausibility. Public Health Nutr 2000;3(3):321-7
  56. Azais-Braesco V, Pascal G. Vitamin A in pregnancy: requirements and safety limits. Am J Clin Nutr 2000;71(5 Suppl):1325S-33S
  57. Rothman KJ, Moore LL, Ringer MR, Nguyen UDT, Mannino S, Milunsky A. Teratogenicity of high vitamin A intake. N Engl J Med 1995;333:1369-73 https://doi.org/10.1056/NEJM199511233332101
  58. Teratology Society position paper: recommendations for vitamin A use during pregnancy. Teratology 1987;35(2):269-75 https://doi.org/10.1002/tera.1420350215
  59. Jewell D, Young G. Interventions for nausea and vomiting in early pregnancy. Cochrane library, Issue 1, 2002. Oxford: Update Software
  60. Sauberlich HE, Kretsch MJ, Skala JH, Johnson HL, Taylor PC. Folate requirement and metabolism in nonpregnant women. Am J Clin Nutr 1987;46: 1016-28
  61. US preventive Services Task Force. Guide to clinical preventive services: report of the US preventive Services Task Force. 2ed ed. Baltimore. Williams & Wilkins. 1996
  62. Onis MD, Villar J, Guelmesoglu M. Nutritional interventions to prevent intrauterine growth retardation: evidence from randomized controlled trials. Eur J Clin Nutr 1998;52 Suppl 1:S83-S93
  63. Villar J, Onis MD, Guelmezoglu AM. Nutritional and Antimicrobial interventions to prevent preterm birth: An overview of randomized controlled trials. Obstetrical and Gynecological Survey 1998;53(9):575-85 https://doi.org/10.1097/00006254-199809000-00025
  64. Kulier R, Onis MD, Guelmezoglu AM, Villar J. Nutritional interventions for the prevention of maternal morbidity. Int J Gynecol Obstet 1998;63: 231-46
  65. MRC Vitamin Study Research Group. Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. MRC Vitamin Study Research Group. Lancet 1991;338(8760):131-7 https://doi.org/10.1016/0140-6736(91)90133-A
  66. Berry RJ, Li Z, Erickson JD, Li S, Moore CA, Wang H, et al. Prevention of neural-tube defects with folic acid in China. China-U.S. Collaborative Project for Neural Tube Defect Prevention. N Engl J Med 1999; 341(20):1485-90 https://doi.org/10.1056/NEJM199911113412001
  67. Botto LD, Moore CA, Khoury MJ, Erickson JD. Neural-tube defects. N Engl J Med 1999;341(20): 1509-19 https://doi.org/10.1056/NEJM199911113412006
  68. Laurence KM, James N, Miller MH, Tennant GB, Campbell H. Double-blind randomised controlled trial of folate treatment before conception to prevent recurrence of neural tube defects. Br Med J (Clin Res Ed) 1981;282(6275):1509-11 https://doi.org/10.1136/bmj.282.6275.1509
  69. Locksmith GJ, Duff P. Preventing neural tube defects: the importance of periconceptional folic acid supplements. Obstet Gynecol 1998;91(6):1027-34 https://doi.org/10.1016/S0029-7844(98)00060-X
  70. 김연수, 김기남, 장남수. 가임여성의 엽산섭취실태. 한국영양학회지 1999;32:585-91
  71. 염현수, 진현옥, 이정아. 가임기 여성의 엽산섭취량 및 엽산 영양상태. 한국영양학회지 2000;33:296-303
  72. Kolander CA, Ballard DJ, Chandler CK. Contemporary women's health. 1st ed. McGraw-Hill. 1999
  73. May PA, Gossage JP. Estimating the prevalence of fetal alcohol syndrome. A summary. Alcohol Res Health 2001;25(3):159-67
  74. Russell M. Clinical implications of recent research on the fetal alcohol syndrome. Bull NY Acad Sci 1991; 67:207-22
  75. Virji SK. The relationship between alcohol consumption during pregnancy and infant birthweight: an epidemiologic study. Acta Obstet Gynecol Scand 1991;303-8
  76. Forrest F, Florey CDV, Taylor D. Reported social alcohol consumption during pregnancy and infants' development at 18 months. BMJ 1991;303: 22-6 https://doi.org/10.1136/bmj.303.6793.22
  77. National Institute on Alcohol Abuse and Alcoholism. Alcohol and health: eighth special report to the U.S. Congress from the Secretary of Health and Human Services. Rockville, MD: U.S. Department of Health and Human Services, National Institutes of Health, 1993 (NIH Publication no. 94-3699)
  78. Rosett HL, Weiner L, Edelin KC. Treatment experience with pregnant problem drinkers. JAMA 1983; 249:2029-33 https://doi.org/10.1001/jama.249.15.2029
  79. Halmesmaki E. Alcohol counselling of 85 pregnant problem drinkers: effect on drinking and fetal outcome. Br J Obstet Gynaecol 1988;95:243-7 https://doi.org/10.1111/j.1471-0528.1988.tb06864.x
  80. Report of the U.S. Preventive Services Task Force. Guide to Clinical Preventive Services. 2nd Edition. 1996. available from: URL: http://www.ahrq.gov/clinic/cpsix.htm
  81. Conover WB, Key TC, Resnik R. Maternal cardiovascular response to caffeine infusion in the pregnant ewe. Am J Obstet Gynecol 1983;145:534 https://doi.org/10.1016/0002-9378(83)91191-2
  82. Fernandes O, Sabharwal M, Smiley T, Pastuszak A, Koren G, Einarson T. Moderate to heavy caffeine consumption during pregnancy and relationship to spontaneous abortion and abnormal fetal growth: a meta-analysis. Reprod Toxicol 1998;12(4):435-44 https://doi.org/10.1016/S0890-6238(98)00024-0
  83. Santos IS, Victora CG, Huttly S, Morris S. Caffeine intake and pregnancy outcomes: a meta-analytic review. Cad Saude Publica 1998;14(3):523-30 https://doi.org/10.1590/S0102-311X1998000300009
  84. 김수영. 커피와 건강. 대한가정의학회지 2000;21 (5):569-85
  85. Caffeine content of common beverage. available from: URL: http://www.mayohalth.org
  86. Kendrik JS, Merritt RK. Women and smoking: An update for the 1990s. Am J Obstet Gynecol 1996; 175:528-35 https://doi.org/10.1053/ob.1996.v175.a74919
  87. Women and smoking; a Report of the Surgeon General available from: URL: http://www.cdc.gov/tobacco/sgr_forwomen.htm
  88. DiFranza JR, Lew RA. Effect of maternal cigarette smoking on pregnancy complications and sudden infant death syndrome. J Fam Pract 1995;40(4): 385-94
  89. Scoll TO, Hediger ML, Bendich A, Schall JI. Use of multivitamin/mineral supplement: Influence on the outcome of pregnancy. Am J Epidemiol 1997;146: 134-41 https://doi.org/10.1093/oxfordjournals.aje.a009244
  90. Godfrey KM, Barker DJ. Fetal nutrition and adult disease. Am J Clin Nutr 2000;71(5 Suppl):1344S-52S
  91. Moore SE, Cole TJ, Poskitt EM, Sonko BJ, Whitehead RG, McGregor IA, et al. Season of birth predicts mortality in rural Gambia. Nature 1997; 388(6641):434 https://doi.org/10.1038/41245
  92. Kramer MS. Nutritional advice in pregnancy. Cochrane library, Issue 1, 2002. Oxford: Update Software