Department of Family Health Care Nursing, University of California San Francisco School of Nursing, San Francisco, CA 94143-0606, USA.
J Midwifery Womens Health. 2010 Nov-Dec;55(6):502-11. doi: 10.1016/j.jmwh.2010.02.017.
Diet and patterns of eating during pregnancy can affect perinatal outcomes through direct physiologic effects or by stressing the fetus in ways that permanently affect phenotype. Supplements are not a magic nutritional remedy, and evidence of profound benefit for most supplements remains inconclusive. However, research supports calcium supplements to decrease preeclampsia. Following a low glycemic, Mediterranean-type diet appears to improve ovulatory infertility, decrease preterm birth, and decrease the risk of gestational diabetes. Although women in the United States have adequate levels of most nutrients, subpopulations are low in vitamin D, folate, and iodine. Vitamin D has increasingly been shown to be important not only for bone health, but also for glucose regulation, immune function, and good uterine contractility in labor. To ensure adequate vitamin and micronutrient intake, especially of folate before conception, all reproductive age women should take a multivitamin daily. In pregnancy, health care providers need to assess women's diets, give them weight gain recommendations based on their body mass index measurement, and advise them to eat a Mediterranean diet rich in omega-3 fatty acids (ingested as low-mercury risk fatty fish or supplements), ingest adequate calcium, and achieve adequate vitamin D levels through sun exposure or supplements. Health care providers should continue to spend time on nutrition assessment and counseling.
孕期的饮食和进食模式可通过直接的生理效应，或通过胎儿应激而永久影响表型，从而影响围产期结局。补品不是神奇的营养补救措施，大多数补品的深远益处证据仍不明确。但是，研究支持钙补充剂可降低先兆子痫的风险。遵循低血糖、地中海式饮食似乎可改善排卵性不孕，降低早产率，并降低妊娠期糖尿病的风险。尽管美国的大多数女性的营养水平都充足，但某些亚人群的维生素 D、叶酸和碘含量较低。维生素 D 越来越多地被证明不仅对骨骼健康重要，而且对葡萄糖调节、免疫功能和分娩时子宫良好的收缩力也重要。为确保充足的维生素和微量营养素摄入，特别是在受孕前摄入足够的叶酸，所有育龄妇女都应每天服用多种维生素。在怀孕期间，医务人员需要评估女性的饮食，根据其体重指数测量结果给予增重建议，并建议她们食用富含欧米伽-3 脂肪酸（以低汞风险的油性鱼类或补充剂形式摄入）的地中海饮食，摄入足够的钙，并通过晒太阳或补充剂获得足够的维生素 D 水平。医务人员应继续花时间进行营养评估和咨询。
