Maternal energy requirements during pregnancy of rural Philippine women

Body weight, body fatmass, basal metabolic rate, energy intake, and activity pattern, were measured longitudinally from 13 wks of gestation until 12 wks postpartum in fifty-one healthy rural Philippine women. Initial body weight, body fatmass and height were 44.5 kg, 25%, and 151 cm, respectively. The gain in body weight and maternal fat stores over the final two trimesters of pregnancy were 8.4 kg and 1.3 kg, respectively. The cumulative increment in basal metabolism over this period was calculated to be 88.7 MJ (21,200 kcal). Mean birthweight and placental weight were 2885 g and 509 g, respectively. The energy equivalent of the gain in fat stores, including costs of synthesizing, can be estimated to be 59.8 MJ (14,300 kcal). When the energy equivalent of the gain in tissue other than fat stores is assumed to be 40.6 MJ (9,700 kcal), total energy cost of pregnancy over the final two trimesters of pregnancy arrives at 189 MJ (45,200 kcal) or 1130 kJ (270 kcal) per day. Energy intake did not change throughout pregnancy (average intake 7.3 MJ (1750 kcal) per day), so energy costs of pregnancy were not met, not even partly, by an increase in energy intake. Differences in activity pattern explain only part of the observed gap between costs of pregnancy and energy intake (375-415 kJ per day) (90-100 kcal per day). our results suggest that normal pregnancy is much less demanding of extra energy than actual pregnancy costs suggest. However, only if the above mentioned discrepancy (for our women at least 700 kJ/day) is explained, recommendations on energy intake throughout pregnancy can be modified in a responsible way.