1. Action and forces influence nutrition through life cycle (nutrition intervention) Maternity and Infancy Dr. Dina Qahwaji

2. Importance of nutrition during maternal and infancy  Poor nutrition during pregnancy ↓ decreased the health of mom & child and so may affect the child’s later life.  Illness, birth defect  Long term alteration in tissue function  Retarded mental or physical development  Learning ability and behaviour Dr. Dina Qahwaji

3. Trends in Maternal and Infants Health  The health nation is often judged by the health status of its mother and infants.  Best indicator of nation’s health (according to epidemiologist) is the infant mortality rate (IMR)  Infants deaths under one year of age, expressed as the number of such deaths per 1,000 live births.  Differences in ethnic group and class level Dr. Dina Qahwaji

4. Trends in Maternal and infants Health  Other measures of increase risk of morbidity and death are incidence of birth defect, preterm delivery and low birth weight.  Leading cause of death Dr. Dina Qahwaji

5. Infant Mortality and Life Expectancy for Selected Countries, 2009 CountryInfant mortality rate Angola180.21 Afghanistan151.95 Iraq43.82 Egypt 27.26 Malaysia15.87 Jordan14.97 Saudi Arabia11.57 Kuwait8.96 United States 6.26 United Kingdom4.85 Singapore 2.31 Infant deaths per 1,000 live births

6. Under-5 mortality: Estimated trend and MDG goal Saudi Arabia, 1980-2004 Source: i) WHO mortality database ii) World Health Statistics 2006

7.  Maternal mortality rate  Women death assigned to causes related to pregnancy, expresses as the number of such death per 100,000 live birth  Decreased ↓ significantly in the last 5 decades from a high of 83.3 per 100,000 live births in the 1950s to a low of 7.2 for white women in 2001  Healthy people 2000 and 2010 objective for maternal mortality of no more than 3.3 maternal death per 100,000 live birth Dr. Dina Qahwaji

8. Maternal mortality rate in Saudi Arabia  The UAE and Kuwait from the Arab Gulf Cooperation Council (GCC) have been able to reduce maternal mortality to a level low by international standards,  While Oman, Saudi Arabia and Qatar have moderate low levels between 10 and 20 per 100,000 live births. However, these levels remain higher than those for countries with same healthy economies. Dr. Dina Qahwaji

9. Goals for maternal and infant health  Improve the nutrition and health status of mother and infants  Health care professional must focus on changing the behaviour that effect pregnancy outcomes  Protective (daily folate supplement)  Risky (smoking / alcohol use) Dr. Dina Qahwaji

10. Goals for maternal and infant health  Objective addressing risk factors include the area of preterm birth, infant sleep position and developmental disabilities  Other action such as early screening, timely prenatal care can significantly improve infants health and changes for survival. Dr. Dina Qahwaji

11. Healthy people 2010 progress review  Decline in infant mortality rates (Hispanics, whites and American Indians)  Decrease in incidence of spina bifida from 6 (1996) to 4.8 (2000) per 10,000  Increase in breastfeeding in all ethnic groups  Decline in smoked women during pregnancy Dr. Dina Qahwaji

12. Healthy Mothers 1.Maternal Weight Gain  Women pregnant with a healthful weight gain 25-35 pounds  Women pregnant with twins gain 35-45 pounds  Women pregnant with triplets gain 45-55 pounds  Underweight women gain 28-40 pounds  Overweight women gain 15-25 pounds Dr. Dina Qahwaji

13. Healthy Mothers  Low weight gain is associated with increased risk of LBW infant; these infants have high mortality rates  Excessive weight gain increases the risk of complications during delivery, and postpartum obesity Dr. Dina Qahwaji

14. Healthy Mothers 2.Adolescent Pregnancy  Pregnant adolescents are nutritionally at risk and require intervention early and throughout pregnancy  Medical and nutritional risk high when the teenager is 15 years or younger  When the mothers under 15 year more babies who die within the first year than do any other age group Dr. Dina Qahwaji

15. Healthy Mothers 3.Nutrition Assessment in Pregnancy  Preconception care  Early prenatal visits  Following prenatal visits Dr. Dina Qahwaji

16. Healthy Babies  The growth of infants directly reflects their nutritional well-being and is the major indicator of their nutritional status  Birth-weight doubles during the first 4-6 m and triples by the end of the year  Infants need smaller total amount of nutrients than adults  After 6 m, energy needs ↑ less rapidly as the baby’s growth rate begins to slow down Dr. Dina Qahwaji

17. Healthy Babies  Anthropometric measures in infancy  Length  Weight  Head circumference Dr. Dina Qahwaji

18. Mother & infant A stable base of essential program and services is required to :  Meet maternal and infants health care needs  Improve knowledge and information among high risk group  A way to educate the population other than the academic way  Helps to reduces disease and improve health status  Helps to achieve the objective of healthy people 2010 Dr. Dina Qahwaji