Starvation in pregnancy dangerous, could cause placenta dysfunction, others —Gynaecologist 


Angela Onwuzoo

A Consultant Obstetrician and Gynaecologist, Dr. Lateef Akinola, has urged pregnant women to avoid acute starvation, noting that it puts them at risk of severe vomiting, placenta dysfunctions, and respiratory distress.

According to him, acute starvation in pregnancy could also lead to poor pregnancy outcomes.

Dr. Akinola stated further that women experiencing acute starvation in pregnancy might also experience foetal growth restrictions, stillbirths, and increased newborn foetal morbidity/mortality, adding that they are also more prone to maternal preeclampsia and gestational diabetes.

Speaking in an interview with PUNCH Healthwise, Dr. Akinola said the effect of acute starvation in pregnancy was worse in the third trimester.

Akinola who is the Medical Director of Medison Specialist Women’s Hospital, Lagos, said, “Acute starvation in pregnancy can cause severe metabolic dysfunction notably starvation ketoacidosis, and infrequently causes severe metabolic acidosis and placental dysfunctions, which can precipitate insulin resistance, gestational diabetes, and preeclampsia.

“This in turn increases susceptibility to ketosis, particularly in the third trimester that can be complicated by foetal growth restrictions and stillbirths.

“For instance, obesity, diabetes, cardiovascular disease and abnormal reproductive functions in adulthood might be predicated on inadequate nutrition during pregnancy. Acute starvation in pregnancy is usually precipitated by severe hyperemesis gravidarum (severe vomiting during pregnancy.”

According to the United Nations Children’s Fund, more than 400,000 babies are born dead in Nigeria annually. Out of more than 2.5 million babies that are born dead globally each year, more than 400,000 stillborn deaths take place in Nigeria, the agency says.

Nigeria is one of the five countries in the world with the highest number of under-five deaths, says UNICEF.

Dr. Akinola, an IVF specialist, stressed that early diagnosis and management of this condition are necessary to prevent maternal and foetal complications.

 “Symptoms to watch out for include severe vomiting especially late in pregnancy. Respiratory distress and significant acid-base disturbances can occur. Other notable causes to watch out for aside from hyperemesis include diabetic ketoacidosis and alcohol-induced acidosis.

“Management should be promptly instituted, intravenous rehydration, glucose infusion, and nutrient substitution are essential to prevent circulatory hypovolemia.

“This should also be aimed to correct ketoacidosis and metabolic acidosis. Hospital admission is necessary where daily monitoring of vital signs, urinalysis, serum electrolyte, and urea and/or liver functions, adding that diligent foetal monitoring is essential to preventing maternal and foetal morbidity and mortality.

“Sometimes, early delivery in the presence of an experienced neonatologist is essential to prevent foetal complications including stillbirth,” he explained.

According to the National Bureau of Statistics in its Poverty and Inequality report 2019, one in 10 or more than 82.9 million Nigerians live in poverty.

Also, the World Bank says 96 million Nigerians will be living in poverty by 2022.

Poverty, experts say, is a key hindrance to women’s wellbeing, especially during pregnancy resulting in malnutrition, anaemia, low birth babies, or foetal loss.

The maternal expert noted that foetal nutrition in utero keeps going on until a certain stage that could now be detrimental when starvation is prolonged for too long.

“This could result in intrauterine growth restrictions and eventually if not attended to intrauterine foetal death,“ he said.

It is well established that an adequate and balanced diet during pregnancy is essential for the health of mothers and babies, both in the womb and when born,” the gynecologist said.

He noted that it is important to detect this problem during pregnancy so that appropriate care can be given.

“A growth-restricted foetus may need expert care to survive. They come out quite hungry, ” he added.

He pointed out that a pregnant woman is supposed to feed well and have an appropriate diet at all times for optimal development of the foetus.

Highlighting the dangers of poor nutrition in pregnancy, Dr. Akinola said poor nutrition will cause inadequate development of the baby because nutrients are required for cells of the foetus to develop properly. 

“Nutrients such as iron are very important in the development of the cells.

“When a pregnant woman stops taking foods rich in iron, she will be deficient in iron and that deficiency will affect the foetus and the cells will not form properly and this will lead to malformation when the baby is born,” he said.

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