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Primers for Nutritional Counseling in Pregnancy: Lessons from Gestational Diabetes

by Teri L. Hernandez, PhD, RN
  • Duration: 1439 Mins
  • Credits: 1 CERP, 1 R-CERP, 0.1 Midwifery CEU
  • Handout: No
Abstract:

Nutrition has a powerful and lasting influence on maternal and fetal outcomes in pregnancy. In gestational diabetes (GDM), nutrition therapy remains the primary approach to treatment and we now understand that lessons from nutrition in GDM may be applied to all pregnancies. Recent data underscore metabolic similarities in patterns of glycemia and lipemia between diet-controlled GDM and maternal obesity without GDM. This highlights an opportunity to more thoughtfully target women with obesity outside of GDM, where macrosomia rates are high, for treatment with nutrition. The importance of good nutrition for all pregnant women was recently highlighted by data demonstrating strong associations between fasting and postprandial triglycerides and neonatal adiposity outside of GDM, further supporting a role for targeting these nutrition sensitive indicators. Currently, evidence does not support one particular nutritional approach to treatment of GDM. The quality of the available evidence is poor due to high heterogeneity. However, a recent meta-analysis across 18 RCTs and 8 diet patterns demonstrated that any modification which improves from intake at GDM diagnosis is effective in reducing fasting and postprandial glucose, and lowering infant birthweight. The goal is balanced, affordable and culturally acceptable nutrition for women with GDM, extending to all pregnancies.

Learning Objectives:

Objective 1: Describe the powerful influence of nutrition in pregnancy on glucose, lipids and infant adiposity;

Objective 2: Discuss the metabolic similarities across pregnancy phenotypes;

Objective 3: Compile recommendations for nutrition in pregnancy and gestational diabetes based on current evidence

Categories: Midwifery
Presentations: 6  |  Hours / CE Credits: 6  |  Viewing Time: 4 Weeks