159
Gastrointestinal
Disorders in Pregnancy
Chapter 15
Glen de Guzman, MD
❍ What are the excess energy requirements during pregnancy (kcal/day)?
Pregnancy increases energy requirements by 340 kcal/day and 452 kcal/day^1 in the second and third trimester,
respectively. Lactation increases energy requirements by 500 kcal/day.
❍ What dietary micronutrients are needed in much greater amounts during pregnancy?
Nutrient Recommended daily intake Add this in pregnancy/lactation
Riboflavin 0.6 mg/1000 kcal 0.3–0.5 mg
Niacin 6.6 mg niacin equivalents/1000 kcal 2–5 niacin equivalents
Pyridoxine 1.6–2.0 mg 1 mg
Folic acid 3g/kg 400 g
Vitamin B12 2 g 0.2–0.6 g
Ascorbic acid 60 mg 10 mg (pregnancy), 35 mg (lactation)
Iron 15 mg 15 mg
Zinc 0.6 mg/1000 kcal 0.3–0.5 mg❍ What are the benefits of multiple-micronutrient supplementation during pregnancy?
Multiple-micronutrient supplementation is associated with a significant decrease in the number of low birth weight
(LBW) and small-for-gestational-age babies, as well as of maternal anemia, when compared with supplementation
with two or less micronutrients. There was, however, no additional benefits obtained when compared with the
WHO-recommended iron-folate supplementation.
❍ What are the most common gastrointestinal (GI) symptoms associated with pregnancy?
Gingivitis 40% to 100%, reflux 30% to 50%, constipation 11%, hemorrhoids 30% to 40%, nausea and vomiting
70% to 85%. The following GI symptoms are also significantly more common among pregnant women: xerostomia,
heartburn, eructation, improved appetite, early satiety, epigastric pain, nocturnal pain, and black stools.