Applied Nursing Research 35 (2017) 1317

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Applied Nursing Research

journal homepage: www.elsevier.com/locate/apnr

The dietary composition of women who delivered preterm and

full-term infants
Wioletta Waksmaska a,, Rafa Bobiski a, Izabela Ulman-Wodarz a, Anna Pielesz b, Monika Mikulska a
a
Faculty of Health Sciences, Department of Nursing and Emergency Medicine, University of Bielsko-Biala, ul. Willowa 2, 43-309 Bielsko-Biala, Poland
b
Faculty of Materials, Civil and Environmental, Engineering, University of Bielsko-Biala, ul. Willowa 2, 43-309 Bielsko-Biala, Poland

a r t i c l e i n f o a b s t r a c t

Article history: Objectives: Literature data show that excess and primary deciency in particular nutrients, vitamins and minerals
Received 20 November 2016 may lead to pre-eclampsia, gestational diabetes, hypertension and neural tube defects in the foetus. The aim of
Accepted 1 February 2017 the study was to determine differences in average daily consumption of selected nutrients during pregnancy
Available online xxxx in women who did not supplement their diet and to evaluate the inuence of dietary habits on the occurrence
of pre-term delivery and hypertension in pregnant women.
Keywords:
Sample group and methods: Information on the course of pregnancy and the newborn's health status at birth was
Caesarean section
Deciency
derived from the Charter of Pregnancy and documents recorded by the hospital. Women's eating habits and di-
Hypertension etary composition were analyzed on the basis of a dietary questionnaire. The sample group was divided into four
Minerals groups: women who delivered neonates appropriate for gestational age (AGA), women with gestosis who deliv-
Premature delivery ered AGA neonates by means of caesarean sections, women who delivered pre-term neonates (PTB) and women
with gestosis who delivered PTB by means of caesarean sections.
Results: In the case of women with vaginal delivery at term the average intake of iodine was always higher than in
other groups. Analysis of average daily intake of folates revealed a higher intake in the group of women who gave
birth to full-term neonates with proper neonatal weight in comparison with the groups of women with pre-term
delivery. P 0.05.
Conclusions: Statistically signicant differences in average daily intake of folates, iodine, retinol, magnesium and
iron were observed between the group of women with vaginal delivery at term and the groups of women with
diagnosed hypertension who delivered preterm. Correlation was demonstrated between average daily intake of
iodine and vitamin D and the occurrence of arterial hypertension. Supplementation of the diet of women in the
preconception and prenatal period with minerals and vitamins should be considered.
2017 Elsevier Inc. All rights reserved.

1. Introduction
The diet of a pregnant woman, which conditions proper development
of the foetus, should be the source of wholesome protein, fats and
carbohydrates and take into account recommendations on the right pro-
portions and caloric value which vary depending on the trimester of preg-
nancy. According to recommendations of the Food and Nutrition Board,
daily intake of protein for pregnant women is about 1 g per kilogram of
body weight, which constitutes 1015% of daily energy demand (WHO,
2007a) Consumption of fats should be an average of 2530% of daily en-
ergy demand. During pregnancy, depending on the trimester, fat content
in the diet should be increased by 1115 g daily on average, an adequate
content of fatty acids should also be taken into account (Jarosz, 2012;
Corresponding author at: Faculty of Health Sciences, Department of Nursing and
Emergency Medicine, University of Bielsko-Biala, ul. Willowa 2, 43-300 Bielsko-Biala,
Poland.
E-mail address: wwaksmanska@ath.bielsko.pl (W. Waksmaska).
WHO, 2010). The remaining energy demand, i.e. 4560%, should be pro-
vided by carbohydrates (Jarosz, 2012; WHO, 2007b).
Studies have shown that supplying an insufcient amount of protein
to the body during pregnancy has an adverse effect on foetal develop-
ment and birth body weight of neonates, and low birth weight is associ-
ated with the risk of hypertension, diabetes, obesity or hyperlipidemia
at a later age (Jarosz, 2012; Akbari, Mansourian, & Kelishadi, 2015;
Ostachowska-Gsior, 2008). An excessive intake of carbohydrates dur-
ing pregnancy is associated with the risk of hyperglycemia for the moth-
er and leads to hyperglycemia and hyperinsulinemia in the foetus,
leading to increased protein synthesis in the foetus and deposition of
fat and glycogen in tissues, which result in macrosomia and the occur-
rence of polyhydramnios (Wang, Jiang, Yang, & Zhang, 2015).
An important element of proper nutrition of pregnant women is the
supply of adequate amounts of vitamins and minerals, especially those
scarcely present in food products.
In accordance with recommendations concerning deciency of vita-
min D - daily intake of the vitamin for pregnant women is 2025 g.

http://dx.doi.org/10.1016/j.apnr.2017.02.013
0897-1897/ 2017 Elsevier Inc. All rights reserved.
14 W. Waksmaska et al. / Applied Nursing Research 35 (2017) 1317
Literature data show that vitamin D affects expression of genes regulat-
ing angiogenesis. During pregnancy vitamin D is essential to maintain
the foetus. Vitamin D deciency may lead to the occurrence of pre-
eclampsia, gestational diabetes, and in the foetus - to the development
of rickets (Gruber, 2015; Misiorowska & Misiorowski, 2014; Robinson,
Wagner, Hollis, Baatz, & Johnson, 2011; Sadin, Pourghassem Gargari,
Fard, & Tabrizi, 2015).
Calcitriol - an active form of vitamin D, affects calcium-phosphate
metabolism of the organism and inhibits secretion of parathormone
(Misiorowska & Misiorowski, 2014).
Another important vitamin in the diet of pregnant women is vitamin
B9, also called folic acid. The consumption norm concerning folates dur-
ing pregnancy is 600 g.
Folates participate in the synthesis of red cells and joining of alkyl
groups to nucleobases. They are also a cofactor of metabolic changes
of homocysteine (Kapka-Skrzypczak, Niedwiecka, Skrzypczak, &
Wojtya, 2012).
Deciency of folates leads to an increase in homocysteine concentra-
tion, which is a risk factor of development of thrombotic disorders. Dur-
ing the preconception period and early pregnancy, deciency of folates
may lead to neural tube defects in the foetus, and later in pregnancy, it
may increase the risk for premature birth, the occurrence of pre-
eclampsia and hypertension (Kapka-Skrzypczak et al., 2012; Cielik &
Kociej, 2012; Seremak-Mrozikiewicz, 2013).
Another important element of the diet during pregnancy is iodine.
Daily intake of iodine recommended by WHO is 250 g (Hubalewska-
Dydejczyk, Lewiski, Milewicz, et al., 2011). Iodine is essential for the
production of the thyroid hormone - thyroxine, which participates in,
among others, proliferation of neural cells of the developing foetus
(Zygmunt & Lewinski, 2015).
Severe iodine deciency during pregnancy may lead to an increased
risk of miscarriage, preterm delivery, impaired foetal lung development,
deafness, damage to the central nervous system and even to irreversible
brain underdevelopment in the foetus (Zygmunt & Lewinski, 2015).
The risk of hypertension in pregnant women is increased in the case
of magnesium deciency. Magnesium is a cofactor of carbohydrate, fat
and protein metabolism. Magnesium takes part in glycolysis, calcium
homeostasis, vitamin D hydroxylation and synthesis of high-energy
bonds (ATP, GTP). By creating complex formations with phospholipids,
magnesium is also part of the structure of cell membranes (Iskra,
Krasiska, & Tykarski, 2013).
Pregnancy complications concerning both the mother and foetus af-
fect the increase of perinatal mortality, which constitutes an important
public health issue.
To date, research has proved that women's awareness of balanced
nutrition during pregnancy and the inuence of nutrition on the health
of the mother and her future child is insufcient, both in terms of choice
of nutritional ingredients and dietary supplements (Akbari et al., 2015;
Kapka-Skrzypczak et al., 2012; Seremak-Mrozikiewicz, 2013; Zygmunt
& Lewinski, 2015; Hamuka, Wawrzyniak, & Pawowska, 2010; Suliga,
2013; Waszkowiak, Szymandera-Buszka, & Szewczyk, 2010).
2. Aim of the study
The aim of the study was to determine differences in average daily
consumption of selected nutrients during pregnancy in women who
did not supplement their diet, and to evaluate the inuence of dietary
habits on the occurrence of preterm delivery and hypertension in preg-
nant women.
3. Research and method
In accordance with Polish perinatology protocols, mothers and chil-
dren were admitted onto the Maternity Ward in Hospital in Tychy in III
2016, for 3 days after the delivery.
To obtain a homogeneous group of women, the following inclusion
criteria were applied:
1. Polish nationality (excluding naturalized Polish citizens); single
pregnancy; pregnancy IIII (consider parity);
2. Stable socioeconomic status. Socioeconomic status was determined
based on factors such as income, marital status, education, place of
residence. Women eligible for the study were married, had good
housing conditions, had secondary or higher education level; lived
in a highly industrialized urban region, both the women and their
husbands had a steady job;
3. Following a typical diet for the Polish population. The diet of the
women was determined on the basis of Album of Photographs of
Food products and Dishes (Szponar, Wolnicka, & Rychlik, 2010)
(the women accepted into the study were neither vegetarians nor
followed any other special diets). Their diet was not modied in
any way;
4. Granting consent to participate in the study.
The following exclusion criteria were applied:
1. Chronic diseases occurring in the women before pregnancy, such as
chronic hypertension, pre-gestational diabetes; infections during
pregnancy (any kind of infection in the perinatal period, such as
fever, respiratory infections, urinary infections, etc.); miscarriages
and/or premature birth resulting in the death of the child or develop-
mental anomalies in the foetus;
2. AIDS and sexually transmitted diseases;
3. Adherence to a vegetarian diet, Mediterranean diet, or any other spe-
cial diet;
4. Lack of the mother's consent to take part in the research program or
withdrawal of consent during the study.
Women who participated in the research program were classied
into four groups according to the following criteria:
-Group A - Group of women who delivered neonates appropriate for
gestational age. (AGA), healthy mothers, routine, uneventful pregnancy
(neonatal weight 10th90th percentile) (n = 11),
-Group B - Group of women who delivered neonates appropriate for
gestational age by means of caesarean sections due to gestational high
blood-pressure (neonatal weight 10th90th percentile) (n = 10),
-Group C - Group of women who delivered preterm neonates (PTB),
healthy mothers, routine, uneventful pregnancy (n = 7),
-Group D - Group of women who delivered preterm neonates (PTB),
by mean of caesarean sections due to gestational high blood-pressure
(n = 8) (Table 1).
Women eligible for the study underwent three ultrasound examina-
tions (between the 12th and 14th weeks of gestation, between the 20th
and 22nd weeks and between the 32nd and 33rd week). All the foetuses
had normal karyotypes and no malformation at birth.
The mothers did not receive any dietary supplementation during
pregnancy. The mothers in PTB did not receive corticosteroids. Those
children whose weight exceeded the 90th percentile (Large for gesta-
tional age - LGA) were not included in the study.
The information on the course of pregnancy of the women came
from the Charter of Pregnancy, i.e. the document recorded by the gyne-
cologist who took care of the pregnant woman. All the information
Table 1
Analysis of the studied groups, g - gram.
Studied Size of Mean age of Birth order Average birth
group group participants dened in % weight (g)
I II III
Group A 11 32 9% 91% 3470.45
Group B 10 31 60% 40% 3433
Group C 7 32 43% 57% 2137.14
Group D 8 27 100% 2052
 W. Waksmaska et al. / Applied Nursing Research 35 (2017) 1317 15

concerning the birth and postpartum period, the newborn's health sta-
tus at birth and the results of their physical examination was taken from
the documents recorded by the hospital.
The study was approved by the Bioethics Review Board of Bielsko-
Biala (No: 2016/02/11/4) which is in accordance with the Declaration
of Helsinki.
4. Procedures
The women's eating habits and dietary composition were ana-
lyzed based on a monthly dietary questionnaire designed by the
National Food and Nutrition Institute in Warsaw, Poland. The
women specied their diet during the last month of their pregnancy.
Portion sizes were veried using The Album of Photographs of Food
Products and Dishes (Szponar et al., 2010). Before the research
began every participant was clearly instructed and offered training
on how to ll in the questionnaire as well as how to record the vol-
ume or the mass of foods using standard household measures such
as a spoonful, a glass, etc. The mothers were not given any hints or
tips on how to diet. Based on the album, the women lled in the
questionnaire specifying the quantity and quality of the food con-
sumed. The questionnaire allowed the researchers to determine the
daily consumption of each particular dietary component (proteins,
carbohydrates, fats, fatty acids, vitamins) as well as the mother's
calorie consumption over a one-month period.
The questionnaire included a list of products grouped according to
the following 22 food groups: milk and dairy products, eggs, meat, sau-
sages, offal, sh, seafood, animal and vegetable fats, vegetables, fruit and
fruit-products, potatoes and potato-based products, seeds, legumes, ce-
reals and cereal-products, pre-cooked ready meals, salty snacks, nuts
and grains, sugar and sweets, soft drinks, alcohol, soup concentrates,
sauces and spices. The study participants had to record how frequently
they consumed each product, with the options being: daily, several
times a week, once a week, 23 times a month or never. The question-
naire was lled in by each mother in the hospital, three days after child-
birth. The DIETA FAO program, which includes data on 1067 typical
Polish dishes or food products, was used to estimate the quantity of
the aforementioned components. Dietary consumption was validated
via the Food Intake Frequency Questionnaire, a 7-day nutritional sur-
vey. The method employed was to write down all the products and
dishes that were consumed each day, for a period of 7 days. Food por-
tion sizes were given in household measures, and in the case of some
products, where possible, also in grams. The sizes of portions and food
products quantities were veried via direct consultation with each
member of the study, using the Album of Photographs of Food Products
and Dishes (Szponar et al., 2010).
5. Statistics
The Kruskal-Wallis ANOVA test was used to determine differences in
food intake by the three groups. The Kruskal-Wallis nonparametric
analysis of variance was used due to high absolute values of the skew-
ness and kurtosis of a large number of the variables. A detailed post
hoc analysis was also conducted.
The statistical signicance was determined at P b 0.05.
Gestational age was calculated according to the Naegele's rule. The
mean age of subjects ranged between 27 and 32 years. In the group of
women who delivered at term it was second pregnancy for them in
91%. For women who gave birth before the due date it was the rst preg-
nancy in 43%, and in 57% - the third pregnancy. Women diagnosed with
hypertension who at the same time had a caesarean section performed
before the due date it was their rst pregnancy in 100% (Table 1).
6. Results
The highest average daily intake of fatty acids has been recorded in
the group of women with full-term delivery by means of caesarean sec-
tion (group B). Rather considerable differences concerning average
daily intake of calcium, magnesium, iron and vitamin D have been re-
corded between women who delivered vaginally at term (group A)
and other studied groups. In the case of women with vaginal delivery
at term (group A) the average intake of iodine was always higher (and
statistically signicant) than in other groups. Analysis of average daily
intake of folates revealed a higher intake in the group of women who
gave birth to full-term neonates with proper neonatal weight (group
A) in comparison with the groups of women with preterm delivery
(groups C and D). Lower than recommended norms of folates and iodine
consumption were reported in all analyzed groups (Table 2).
The highest average daily cholesterol consumption was reported in
the group of women with preterm vaginal delivery (group C). When
compared to women diagnosed with hypertension and who gave
birth to pre-term neonates by means of caesarean section (group D),
women who gave birth to full-term neonates (group A) consumed
daily more retinol, folates, iodine, magnesium and iron on average.
The differences were statistically signicant. No statistically signicant
differences concerning average daily consumption of nutrients were re-
corded in the group of women who gave full-term birth by caesarean
section due to arterial hypertension (group B) when compared to
women with preterm vaginal delivery (group C).
No statistically signicant differences between average values of
daily intake of proteins, fats, carbohydrates and mineral substances
were found in groups of women who gave preterm birth regardless of
the type of delivery (Table 2).

Table 2
Presentation of average daily intake of selected nutrients in analyzed groups.

Studied variable and unit Group A Group B Group C Group D Statistical signicance Daily norm of average consumption for pregnant woman

Average caloric value of daily calorie intake 2262 2320 2150 2005 No 25003000 kcal
Protein (g) 101.8 98.41 93.09 87.36 No 0.98 g/kg of bodyweight
Fats (g) 88.49 99.66 85.55 76.18 No 70115 g
Carbohydrates (g) 286.28 277.46 271.69 260.23 No 175 g
Saturated fatty acids (g) 38.07 40.09 34.45 29.98 No Lowest possible
Monounsaturated fatty acids (g) 33.49 38.55 31.59 29.89 No Not determined
Polyunsaturated fatty acids (g) 10.31 13.96 12.72 10.46 No Not determined
Calcium (mg) 903.02 783.50 793.31 738.54 No 8001100 mg
Vitamin D (g) 5.13 3.46 4.17 2.95 No 2025 g
Folates (g) 317.15 261.02 236.67 219.53 Yes: A and C; A and D 600 g
Iodine g 221.79 128.06 152.27 111.65 Yes: A and B; A and C; 250 g
A and D
Retinol (g) 431.87 474.36 433.09 264.59 Yes: A and D; B and D 530 g
Magnesium (mg) 373.73 327.19 332.95 300.26 Yes: A and D 300335 mg
Iron (mg) 13.03 12.97 12.22 10.41 Yes: A and D 23 mg
Cholesterol (mg) 424.73 480.60 488.44 244.44 Yes: B and D Not determined
16 W. Waksmaska et al. / Applied Nursing Research 35 (2017) 1317
7. Discussion
Provision of medical services for women during the preconception
and prenatal period should include health education on proper nutri-
tion. Knowledge about the inuence of poor nutrition on the occurrence
of diseases has signicantly increased (Suliga, 2015). Proper nutrition of
the future mother is an essential factor in infant mortality reduction
(Akbari et al., 2015). A properly balanced diet provides the body with
all essential nutrients adjusted to the physiological status of the organ-
ism and, at the same time, reduces the risk of disease complications at a
later age. Deciency of protein, the basic component of every human
cell, may lead to immunity impairment, muscle atrophy and protein-en-
ergy malnutrition. Deciency of protein, calcium and vitamin D in the
future mother's diet results in the reduction of foetal bone mass and in-
creases the frequency of bone fractures during childhood (Mitchell,
Cooper, Dawson-Hughes, Gordon, & Rizzoli, 2015). The study conducted
by Ostachowska-Gsior revealed that an average consumption of pro-
tein per day by pregnant women amounted to 7486 g, depending on
the pregnancy trimester (Ostachowska-Gsior, 2008). The analysis of
the author's material pointed to a higher average daily protein intake.
The highest daily intake of protein - 101.8 g (and, at the same time, of
calcium and vitamin D) was observed among women who delivered
vaginally at term, whereas the lowest daily intake of protein - 87.6 g
was noted among women with diagnosed hypertension who gave pre-
term birth by caesarean section. Longer duration of pregnancy in the
case of women with full-term delivery is more benecial for foetus in
terms of protein intake. The authors' research results did not reveal
any statistically signicant differences in daily consumption of proteins,
carbohydrates and fats. An important element of pregnant woman's diet
are polyunsaturated fatty acids which guarantee proper development of
the foetal nervous system. Polyunsaturated fatty acid deciency may
lead to stunted growth of the foetus and smaller head circumference
(WHO, 2010; Bobiski & Mikulska, 2012). The authors' own research
showed that the highest daily intake of polyunsaturated fatty acids
was noted among women with diagnosed hypertension who gave
birth by caesarean section (13.96 g), whereas the lowest intake of poly-
unsaturated fatty acids was observed among women with vaginal deliv-
ery at term (10.31 g). Differences in daily intake of polyunsaturated
fatty acids in the analyzed groups were not statistically signicant.
Another important element of pregnant woman's diet is vitamin D
which takes part in the process of bone mineralization. Analysis of the
studied material revealed that women who delivered vaginally at
term consumed the largest amount of vitamin D - the average daily
intake being 5.13 g, which constituted 1/41/5 of the recommended
dose. Studies conducted in Canada, aiming at determining vitamin
intake before pregnancy in two groups of women - pregnant and non-
pregnant, showed that pregnant women consumed more vitamin D
(5.8 g) in the preconception period compared to non-pregnant
women (5.2 g). These values were nonetheless considerably lower
than the recommended values. Research on calcium intake brought
similar results. Pregnant women declared their calcium intake during
the preconception period to be 1146 mg and non-pregnant women -
988 mg. However, the authors of the study point to the fact that
pregnant women had to reconstruct their diet from 8 to 9 months
back which fact could have affected the accuracy of the data (Ramage
et al., 2015).
The authors' own research did not concentrate on the consumption
of nutrients in the preconception period, however, vitamin D intake
during pregnancy was lower compared to the Canadian study and, at
the same time, lower than the recommended values. The lowest values
of vitamin D intake (3.46 and 2.95 g) were reported in two groups of
women with diagnosed hypertension. It is common knowledge that hy-
pertension is one of the symptoms of pre-eclampsia, the risk of which
increases in the case of vitamin D deciency. Thus, the results of the au-
thors' own research conrm the inuence of vitamin D deciency on the
occurrence of pre-eclampsia.
The risk of hypertension is also increased in the event of deciency of
magnesium which takes part in the regulation of cell membranes func-
tioning. Magnesium deciency causes an increase of calcium ions inux
to vascular myocytes leading to disorders of membrane potential repo-
larization (Kopaski & Maslyak, 2014). The authors' own research
showed a statistically signicant difference in daily magnesium intake
between women with vaginal delivery at term and women with diag-
nosed hypertension who gave preterm birth by caesarean section.
The research proved that the risk of pre-eclampsia, hypertension
or preterm birth increases also in the case of folates deciency
(Kapka-Skrzypczak et al., 2012; Cielik & Kociej, 2012;
Seremak-Mrozikiewicz, 2013; Laskowska-Klita, Chechowska,
Ambroszkiewicz, & Gajewska, 2012). Folates inuence proper func-
tioning of cells, and thus the proper development and functioning of
the whole organism, particularly the hematopoietic and nervous systems
(Laskowska-Klita et al., 2012). At the same time, proper use of folates in
the organism depends on the consumption of other nutrients such as vi-
tamin C, iron and zinc (Kapka-Skrzypczak et al., 2012; Cielik & Kociej,
2012). Folates intake was identied as lower than the recommended
values in each tested group, even with regard to the recommended
dose of 400 g for an adult. In two groups of women who gave preterm
birth, regardless of the type of delivery, the values were the lowest and
amounted to 219.53 and 236.67 g respectively. A statistically signicant
difference was demonstrated in daily folates intake between the above
mentioned groups and women who gave vaginal birth to healthy
children at term, which conrms the inuence of folates deciency on
preterm birth (Cielik & Kociej, 2012; Seremak-Mrozikiewicz, 2013;
Laskowska-Klita et al., 2012).
The increased incidence of premature births is also noted in the case
of iodine deciency (Kapka-Skrzypczak et al., 2012; Cielik & Kociej,
2012; Seremak-Mrozikiewicz, 2013). It is conrmed by the authors'
own research which showed statistically signicant differences in
daily iodine intake between women who delivered healthy children at
term vaginally and the other tested groups, including the groups of
women who delivered preterm.
The most recent WHO recommendations referring to the reduction
of salt consumption resulted in the necessity to increase iodine concen-
tration in milk which is, as a food product, an important element of
pregnant women's diet (Waszkowiak et al., 2010). However, achieving
an adequate level of iodine through diet does not seem possible. Despite
supplementation recommendations, only 35% of women supplement its
deciency (Gietka-Czernel, Dbska, Kretowicz, et al., 2010). In the ana-
lyzed material none of the women applied dietary supplements, neither
vitamins nor minerals. Suliga's study demonstrated that 3145.8% of
women (depending on their education) did not take vitamin supple-
ments during pregnancy (Suliga, 2013), whereas Hamuka and the co-
authors showed that N98% of questioned women took vitamins and
minerals (Hamuka et al., 2010). However, the researchers did not
analyze the inuence of mineral and vitamin supplements on the total
content of nutrients in diet. They did not analyze the effects of the sup-
plements on the occurrence of such complications as hypertension or
preterm birth either.
Preterm birth, which results in giving birth to a premature infant, in-
creases the risk of serious health consequences for the child and, at the
same time, for public health. Previous studies testify to the lack of
knowledge on rational nutrition. Education should be particularly relat-
ed to supplementation of pregnant women's diet, bearing in mind that
both deciency and excess of vitamins and minerals have a negative ef-
fect on health (Kapka-Skrzypczak et al., 2012; Hamuka et al., 2010;
Suliga, 2013).
8. Conclusions
1. Statistically signicant differences in average daily intake of folates,
iodine, retinol, magnesium and iron were observed between the
 W. Waksmaska et al. / Applied Nursing Research 35 (2017) 1317
group of women with vaginal delivery at term and the groups of
women with diagnosed hypertension who delivered preterm.
2. Correlation was demonstrated between average daily intake of io-
dine and vitamin D and the occurrence of arterial hypertension.
3. The content of iodine and folates in the diet of women with preterm
delivery was statistically lower compared to women who gave full-
term birth.
4. Supplementation of the diet of women in the preconception and pre-
natal period with minerals and vitamins should be considered.
Acknowledgments
Our grateful thanks to the women who participated in the survey.
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