Olson C M
Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853.
Am J Clin Nutr. 1994 Feb;59(2 Suppl):525S-530S; discussion 530S-531S. doi: 10.1093/ajcn/59.2.525S.
This paper describes three key elements for promoting positive nutrition practices among women during pregnancy and lactation: 1) increasing access to prenatal care; 2) redirecting the content of prenatal care to include a greater emphasis on screening and intervention for behavioral risk factors, including poor nutritional practices; and 3) delivering nutritional care based on recent Institute of Medicine guidelines. These guidelines advise the practitioner to determine prepregnancy body mass index (BMI) and to recommend different weight gains during pregnancy according to BMI category, to assess dietary and lifestyle factors to determine the need for nutrient supplements and to base the supplement composition on the nature of the nutritional need identified, to provide routine supplementation of only 30 mg iron beginning in the second trimester of pregnancy, and to base the diagnosis of anemia on different cutoff values by stage of pregnancy and smoking status.
1）增加产前护理的可及性；2）调整产前护理的内容，使其更加强调对行为风险因素（包括不良营养实践）的筛查和干预；3）根据医学研究所的最新指南提供营养护理。这些指南建议从业者确定孕前体重指数（BMI），并根据BMI类别推荐孕期不同的体重增加量，评估饮食和生活方式因素以确定是否需要营养补充剂，并根据所确定的营养需求性质确定补充剂的成分，从怀孕中期开始仅常规补充30毫克铁，并根据怀孕阶段和吸烟状况采用不同的临界值诊断贫血。
