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CHAPTER ONE

INTRODUCTION

BACKGROUND TO THE STUDY

Expectant and nursing mothers, infants and children constitute the most vulnerable segments of a population from the nutritional standpoint. In any consideration of the problem of malnutrition,' these segments require special consideration, as this unfortunate nutritional situation is prevalent in many under-developed countries today. Pregnancy constitutes states of considerable physiological stress which impose increase nutritional demands (Gopalan, 2000). Pregnancy deserves planning because many practices or conditions of the mother that harm the developing fetus are modifiable, such as the following: Alcohol consumption, Use of certain medications, such as heavy use of aspirin, Use of illegal drugs, such as cocaine or marijuana, Job-related hazards and stresses, Smoking, Inadequate diet, such as too little iron, zinc, and synthetic folic acid, Excess vitamin A intake and mega dose use of other nutrient supplements, Heavy caffeine use, Lack of medical treatment with HIV -positive status or AIDS, Poor control of ongoing diabetes or hypertension (ADA Reports, 2000).

Women need to pay attention to these risks in the months before conception. This precaution is necessary because women often do not suspect they are pregnant during the first few weeks after conception and may not seek medical attention until after the first 2 to 3 months. Still, even without fanfare, the child-to-be grows and develops daily. For that reason, the health and nutrition habits of a woman who is trying to become pregnant - or has the potential to become, pregnant - are particularly important. Although some aspects of fetal and newborn health are beyond control, a woman's conscious decisions about Social, health, and nutritional factors affect her infant's health and future. Much research suggests that an adequate vitamin and mineral intake at least 8 weeks before conception and during pregnancy can help prevent birth defects such as neural lube defects. This problem has been Iinked-in part to a foliate deficiency.

In addition, about 50% of pregnancies are unplanned. For these reasons, parents should be aware of the role nutrition plays in the development of a healthy infant both before and during pregnancy. According to Scholl &Johnson, 2000), the stages of pregnancy include: Prenatal Growth, Development and the Early Growth. For B weeks after conception, a human embryo develops from an ovum into a fit for about another 32 weeks, the fetus continues to develop. When its body finally matures, the infant is born. Until birth, the mother nourishes it via a placenta, an organ that forms in her uterus. The placenta separates the blood supply of the mother from the blood supply of the fetus. Nutrients pass from the mother's blood through the placenta to accommodate the growth and development of the fetus.

In the formation of the human organism, egg and sperm first unite, producing the Zygote. From this point, the reproductive process occurs very rapidly: Within 30 hours-zygote divides in, half to form 2 cells, Within 4 days cell number climbs from 64 to128 cells. At 14 days-the group of cells is called an embryo, Within 35 days-heart is beating, embryo is / of an inch (8 millimeters) long eyes and limb buds are clearly visible, At 8 weeks-the embryo is known as a fetus, At 13 weeks (end of first trimester-most organs are formed, and the fetus can move.

For purposes of discussion, the duration of pregnancy-normally, 37 to 41 we from the mother's last menstrual period-is commonly divided into three periods called trimesters. Growth begins in the first trimester with a rapid increase in cell number. The most serious damage to the fetus from exposure to toxins is likely to occur during the first 8 weeks after conception, two­ thirds of the way through the first trimester. However, damage to vital parts of the body - including the eyes, brain, and genitals ­can also occur during the last months of pregnancy.

This type of growth dominates embryonic and later fetal development. The newly formed cells then begin to grow larger. Further growth and development then involve mostly an increase in cell number with some increase in cell size. By the end of 13 weeks-the first trimester-most organs are formed and the fetus can move. Nutritional deficiencies and other insults transmitted through the mother to the embryo or fetus-for example, injuries caused by medications and other drugs, high intakes of preformed vitamin A" radiation, or trauma-can alter or arrest the current phase of development. The effects may last a lifetime. The most critical time for these problems to happen is during the first trimester. Most miscarriages (more correctly termed spontaneous abortions) occur at this time. Currently, about one-half or more of all pregnancies either fail to attach to the uterine wall or undergo spontaneous abortions, often so early that a woman does not even realize she was pregnant. The early spontaneous abortions usually result from a genetic defect or fetal error in fetal development. Stuart, et al., (2003).

A woman should avoid substances that may harm the developing fetus, especially during the first trimester. This holds true for the time when a woman is trying to become pregnant. As previously mentioned, she is unlikely to be aware of her pregnancy for at least a few weeks. In addition, the fetus develops so rapidly during the first trimester that if an essential nutrient is not available, the fetus may be affected even before evidence of the deficiency appears in the mother. For this reason, the quality of one's nutritional intake is more important than quantity during the first trimester. In other words, women should consume the same amount of food, but the foods should be more nutrient dense. Although some women lose their appetite and feel nauseated during the first trimester, they should be careful to meet nutrient needs.

By the beginning of the second trimester, a fetus weighs about Arms, hands, fingers, legs, feet, and toes are fully formed. The fetus has ears and begins to form tooth sockets in its jawbone. Organs continue to grow and mature, and, with a stetho­scope, physicians can detect the fetus's heartbeat. Most bones are distinctly evident through the body. Eventually, the fetus begins to look more like an infant. It may suck its thumb and kick strongly enough to be felt by the mother. The fetus can still be affected by exposure to toxins, but not to the degree seen in the first trimester. During the second trimester, the mother's breast weight increases by approximately 300/0 due to the deposition of 2 to 4 pounds of fat for lactation. Consequently, under nutrition in the second trimester has a greater effect on the mother than on the fetus. For example, if the mother does not meet the nutritional requirements during this time, her ability to successfully breastfeed her infant may be affected, as fat stored during pregnancy helps serve as an energy reserve for lactation (Robert and Kail, 2006).

Also by the beginning of the third trimester, a fetus weighs about 2 to 3 pounds. The third trimester is a crucial time for fetal growth. The fetus will double in length and will multiply its weight, by five times. Art infant that isborn after about 26 weeks of gestation has a good chance of survival if it is cared for in a nursery for high-risk newborns However, the infant will not contain the vitamin (mainly vitamin E), mineral (mainly iron and calcium), and fat stores normally accumulated during the last month of gestation. This and other medical problems, such as a poor ability to suck and swallow complicate nutritional care for preterm infants. Note also that infants will use the stores of the mother to obtain needed iron. If the mother is not meeting her iron needs, she can be severely depleted after delivery (Gordon, 2002). At 9 months, the fetus weighs about 7 to 9 pounds (3 to 4 kilograms) and is about 20 inches (50 centimeters) long. A soft spot in the forehead indicates where the skull bones (fontanels) are growing together. The bones finally close by the time the baby is about 12 to 18 months of age (Scholl and Johnson, 2000).

1.1   STATEMENT OF THE PROBLEM

The events of pregnancy with birth provide the foundation on which all child development is built, this events of prenatal development that transform sperm and e.g. into a living, breathing human being which is a biological and social reality in the existent of man. The effect of maternal malnutrition on the course of pregnancy, the condition of the infant at birth, and state of lactation of the mother, the food a pregnant woman eat are the main source of the nutrition's for the baby because a lot of pregnant woman don't know what to eat? What manner of intake a pregnant woman should avoid? Is it important for pregnant woman to understand what kind of food is best for them and their baby? Why are some babies healthier than others?

1.2   RESEARCH QUESTIONS

1.   What are the implications of nutrition on the course of pregnancy?

2.   How can nutrition contribute to the health of the infant?

3.   How does the state of maternal nutrition affect the condition of the infant at birth and the neonatal period? 

4.   What are the optimal maternal nutritional requirements in pregnancy which would ensure proper health of the mother, normal course of her pregnancy and satisfactory condition of her infant at birth?

1.3   OBJECTIVES OF THE STUDY

The aim of this study is to know the implication of nutrition on maternal child health among pregnant women in Alimosho Local Government area as a case study. In achieving this, the following will be looked into;

1.  To find out the role of nutrition in pregnancy.

2.  Which diet and lifestyle habit contribute to a successful pregnancy outcome.

3.  To understand the changes, that occurs m the body during pregnancy and the nutrient needed.

4.  The view of respondents as regards the need for nutrition in pregnancy.

5.  To plan an adequate balanced diet for the pregnant women.

1.4   SIGNIFICANCE OF STUDY

This research work will focus on the effects' of nutrition in pregnancy among pregnant women in Alimosho Local Government area, the findings will lead to the understanding of the factors that promote successful pregnancy outcome and the extent to which these factors contribute to the welfare of the infants, it will also trace the events of prenatal development that transform sperm and egg into a living breathing human begin. Base on this, the medical institution will derive very useful benefit from the findings of this study and available recommendations will be made. Secondly, this study will show an insight to the limiting factors which act as nutritional deficiency to infants' development and health. The study also highlights the importances of nutrition in pregnancy and how it leads to successful delivery. Finally, this research work will help to generally contribute to existing literature work on nutrition in pregnancy.

1.5   SCOPE AND DELIMITATION OF STUDY

This study is restricted to pregnant women in Alimosho Local Government Area of Lagos State. However, the major limitations of this study are time and financial constraint in carrying out the research.

1.6   DEFINITION OF TERMS

Nutrition: The process by which living things receive the food necessary for them to grow and be healthy.

Pregnancy: The state of being pregnant of a woman or female animal having a baby or young animal developing inside her or its body.

Implication: A possible effect or result of an action or a decision.

Health: The condition of a person's body or mind.

Maternal: having feelings that are typical of a caring mother towards a child.

Child: A young human being who is not yet an adult, an unborn child or three years old.

Hospital: A large building where people who are ill, sick and injured are given medical treatment and care.