Einstein (São Paulo) (Mar 2008)
Assessment and specific nutritional recommendations for women during and after pregnancy of twins
Abstract
Objective: To update and adjust nutritional recommendations for twin pregnancy during prenatal and postpartum periods in order to improve care provided to these women and ensure their quality of life, as well as to assess the practices adopted by the Institution and referral hospitals, in view of what was learned in specialized literature. Methods: This literature review was conducted by searching scientific papers in databases (SciELO, Pubmed, Sibi, Medline, Lilacs), published from 1964 through 2006, as well as by surveying some authors directly by e-mail. Results: In studies selected, the age of pregnant women with twins was > 27, and the subjects were divided into three gestational periods ( 28 weeks gestational age). The nutritional program recommends: the intake of 3.000 to 4.000 kcal/day according to the pregnant body mass index (BMI), distributed as: proteins (20%), carbohydrates (40%), and fat (40%); in addition to the supplemental intake of 3 g of calcium, 1.2 g of magnesium, and 45 mg of zinc, with the prescription of two tablets of multivitamin per day after week 20. The daily diet must be divided into three meals and three snacks. The few studies found about these puerperal women recommended the addition of 500 to 600 calories/day per child to ensure the production of the appropriate volume of milk to meet the necessary demand. Discussion: Research demonstrates that this program increases the gestational period and newborns weight, and reduces the risk of prenatal and postpartum complications for mothers and children. The appropriate weight gain during pregnancy benefits the mother and their newborns, facilitating breast-feeding and milk volume production according to the demand. Comparing twin and single pregnant women there are differences related to weekly and total weight gain, recommendations for macro and micronutrients intake, number of portions, and nutritional status classification according to BMI. Conclusions: Nutritional guidance, dietary adjustments, and gestational follow-up improve newborn’s weight gain, extend the gestational period, and reduce the risks of prenatal and postpartum complications for mothers and children, and favors breastfeeding.
