c. Nutritional Risk Factors in Pregnancy that Require Observation.
(1)
Risk factors at the onset of pregnancy.
(a) Adolescence. Many adolescents are nutritionally at risk due to a
variety of complex and interrelated emotions and social and economic factors that may
adversely affect dietary intake. Their nutritional needs are greater and pose much
concern from nurses and physicians.
(b) Frequent pregnancies. These pregnancies may have depleted
nutrient stores. This situation can compromise maternal and fetal health and well-being.
(c) Poor reproductive history. Previous poor weight gain,
pregnancy-induced hypertension (PIH), previous stillbirth or small for gestational age
(SGA) baby, premature delivery, and prenatal infection are all common in women who
are or have been poorly nourished in the past. These women may need more than the
usual nutrition guidance.
(d) Economic deprivation. This refers to the pregnant patient who is
not able to afford proper food. There are several programs that help with the purchase
of food or that offer supplements.
(e) Bizarre food patterns. This includes faddish diets. A woman may
enter pregnancy either having or continuing to be on a faddish or otherwise nutritionally
inadequate diet.
(f) Vegetarian diets. This diet may not contain any or enough protein
or vitamins for a developing fetus. Intense nutritional counseling will be required to work
out a diet pattern during the prenatal period.
(g) Smoking, drug addiction, and alcoholism. Physiologic problems
may have been present. Pregnant patients who indulge in this category may have
major physiologic problems. There is the possibility that the patient may not consume
sufficient quantities of nutritious foods and, in addition, can cause major problems to the
fetus.
(h) Chronic systemic disease. There may have been medical
problems, which may have interfered with ingestion, absorption, or utilization of
nutrients. Drugs used to treat these conditions may also affect nutrition by similar
and diet therapy.
(i) Pre-pregnant weight. This may be at risk if the patient is fifteen
percent or more below or twenty percent or more above the standard weight for health.
MD0921
9-5