Approximately 18 % of pregnant women are activity restricted (AR) in hospital each year for high-risk pregnancies, with many of these women carrying multiple fetuses. There are no specific Institute of Medicine Dietary Reference Intakes (DRI) recommendations for women with multi-fetal pregnancies (MFP). Current evidence suggests that women with MFP may have additional need for energy, essential fatty acids (EFAs), iron, calcium, vitamins D, C, and folic acid. Given the lack of specific guidelines for women with MFP, it has been suggested that the use of current DRI recommendations for singleton pregnancies is the prudent course of action for managing diet in these women.
PURPOSE: The purpose was to a) compare dietary intake between women with singleton and MFP who were AR in hospital for a high-risk pregnancy, as well as b) determine if the women with MFP were meeting current DRI recommendations for a singleton pregnancy.
METHODS: Dietary intake was analyzed over 7 days in hospitalized AR pregnant women (n=14). All subjects were in the 3rd trimester, and had been AR for at least 3 days. All women in the MFP group (n=5), and 7/9 women in the singleton pregnancy group were taking daily micronutrient supplementation. Mann-Whitney U tests were used to compare groups. Mean intake of energy and nutrients by the MFP group was compared to DRI recommendations for singleton pregnancy using one sample t-tests.
RESULTS: There were no significant differences between the singleton and MFP groups, with the exception of the MFP group having a greater intake of protein (p=0.03). There were also no significant differences between mean MFP group intake and DRI recommendations for energy, linolenic acid, iron, vitamin C and folic acid. The MFP group had a significantly higher (p<0.05) intake of protein, calcium and vitamin D, compared to DRI recommendations, while significantly lower (p<0.05) intake of linoleic acid.
CONCLUSION: AR women with MFP do not have significantly greater intake of energy and nutrients compared to AR women with singleton pregnancies. Women with MFP may benefit from increased intake of high energy foods, and those containing linoleic acid (vegetables, fruits, nuts, grains, and seeds).