Maternal Diet and Pregnancy Outcomes

There is ample evidence showing that maternal obesity increases the risk of
metabolic complications (i.e., gestational diabetes, pregnancy-induced hypertension,
and preeclampsia) and alters fetal growth and risk for disease postnatally.
But little attention has been paid to how to prevent these problems. Maternal diet,
as a key component of the maternal environment, likely contributes to the risk as
well as the prevention of these metabolic complications. Although the studies of
maternal diet and pregnancy complications have been done primarily in nonobese
women, the findings persist after adjusting for body weight or BMI, suggesting
that the results are applicable to obese as well as to nonobese women.
In the past, much of the nutritional therapy for GDM patients focused on energy
restriction because lower calorie intakes controlled glycemia and reduced
macrosomia (53, 67). However, given concern about the effect of maternal ketosis
induced by energy restriction on fetal neurophysiological and cognitive development,
the focus shifted from reducing energy intakes to adjusting carbohydrate
and fat intakes for women with gestational glucose intolerance. Currently, the
American Diabetes Association limits energy intake for overweight compared to
normal-weight women. For example, 36–40 kcal/kg are recommended for women
with body weights <90% of standard, whereas 24 kcal/kg are recommended for
women weighing between 121% and 150% of standard. Only 12–18 kcal/kg are
recommended when ideal body weight exceeds 150% of standard. These energy
recommendations are less than that recommended by the Institute of Medicine for
pregnancy (59), but are higher than the energy levels fed in early studies of GDM
(53, 58). The American Diabetes Association also recommends that carbohydrate
Annu. Rev. Nutr. 2006.26:271-291. Downloaded from
Access provided by Texas A&M University – College Station on 02/06/21. For personal use only.
284 KING
and fat intake each be 40% of total energy, with the remaining 20% from protein
(32). This was updated in 2004 to suggest a range in carbohydrate intake from 45%
to 65% of the total calories to be consistent with the new Dietary Reference Intakes
(82). No specific recommendation was made regarding the type of carbohydrate,
Dietary Carbohydrate
Given that maximal maternal-fetal glucose transfer occurs postprandially (32),
reducing glucose concentrations at this time has a greater impact on limiting accelerated
fetal growth than on lowering fasting glucose levels. Thus, studies have
begun to investigate how to reduce postprandial glycemia and thereby lessen fetal
glucose exposure. Low-glycemic-load diets have been shown in several small
studies of pregnant women to reduce the glycemic response to meals and to improve
insulin sensitivity in mid and late pregnancy, thereby reducing placental
and birth weights and neonatal fat mass (27, 28). Since a low dietary glycemic
load reduces fetal glucose levels, this diet is also associated with approximately a
twofold increased risk of an SGA birth (79). Obviously, if total carbohydrate intake
is limited along with a shift toward low-glycemic foods, the postprandial glycemic
spikes will be reduced and fetal glucose supply may be inadequate to support fetal
growth. Research is needed to determine optimal levels of glycemic load for obese
pregnant women to prevent excessive fetal growth without inducing SGA.
Although GDM women are advised to limit the amount of carbohydrate intake
to 40% of total energy to maintain good glycemic control (32, 47, 58), a shift toward
more complex carbohydrates should permit higher total carbohydrate intakes with
a comparable glycemic response. When low-glycemic sources are the basis of the
diet, up to 60% of the energy can be given as carbohydrate to pregnant diabetic
women without any detrimental effect on glucose tolerance (32). It has also been
shown that diabetic, pregnant women fed diets providing 65% of the energy as
carbohydrate and 60–70 g fiber required less exogenous insulin than did women
consuming 40% carbohydrate diets with 20 g fiber (65). Epidemiological studies
have also shown that 100-kcal increases in carbohydrate to the diet were associated
with a 12% decrease in risk of impaired glucose tolerance and a 9%decrease in the
risk of GDM (77). In other words, substituting carbohydrate for fat significantly
decreased the risk of poor glycemic control. Thus, limiting dietary carbohydrate
among pregnant women to avoid excessive postprandial glucose spikes seems to
be unnecessary if low-glycemic, complex carbohydrates form the basis of the diet.
Dietary Fat
Lowering the level of carbohydrate in a diet implies increased levels of fats. Evidence
is now accumulating that a high fat intake is linked to insulin resistance
and a higher risk of gestational diabetes. The type and the amount of dietary fat
both seem to play a role. For example, the recurrence of GDM is significantly
higher among women consuming diets providing about 40% of the energy as fat
compared with that of women consuming lower-fat (about 33%) diets (63). This
Annu. Rev. Nutr. 2006.26:271-291. Downloaded from
Access provided by Texas A&M University – College Station on 02/06/21. For personal use only.
relationship could reflect a lower intake of fiber and complex carbohydrates since
these dietary factors are usually inversely related to fat intake. Conversely, high
intakes of polyunsaturated fats are associated with better pregnancy outcomes,
and they may even be protective of impaired glucose tolerance (IGT) or GDM
(10, 91). These relationships persist after controlling for body weight or BMI. A
high saturated fat intake also is related to the risk for IGT orGDM(10). All women
consuming more than 30% of their total energy as saturated fat (about three times
recommended intakes) had IGT or GDM; no similar cutoff was evident for high
polyunsaturated fatty acid intakes. Furthermore, a high intake of saturated fat was
the only factor linked to the development of IGT orGDMin young, normal-weight
women lacking other risk factors for this disease, which suggests that modifying
fat intakes prior to and during pregnancy could be an effective way to prevent
gestational glucose intolerance.
Diet Recommendations
As mentioned above, the current recommendations by the American Diabetes Association
specify amounts of carbohydrate and fat intake for preventing or treating
gestational glucose intolerance. Maintaining carbohydrate and fat intakes within
the acceptable macronutrient distribution ranges recommended by the Institute of
Medicine (46a) would allow more flexibility in dietary planning without appreciably
altering risk of IGT. At the same time, it seems prudent to also consider
types of carbohydrate and fat when managing the diets of pregnant women at risk
for IGT. Emerging evidence suggests an emphasis on high-complex, high-fiber,
low-glycemic sources of carbohydrate while increasing the intake of polyunsaturated
fat acids and limiting saturated fat intake. The 2005 Dietary Guidelines for
Americans provide guidance consistent with this dietary pattern for nonpregnant
women. The following adaptations from the 2005 Dietary Guidelines may serve
as the basis of a sound dietary pattern for pregnant women (80).
Keep total fat intake between 20% and 35% of the calories and total carbohydrate
intake between 45% and 65% of the calories.
Choose fiber-rich fruits, vegetables, and whole grains often. In general, consume
at least 2 cups of fruit, 21/2 cups of vegetables, and 3 ounces of wholegrain
products daily.
Choose most fats from good sources of polyunsaturated fatty acids, such as
fish, nuts, and vegetable oils, and limit the intake of saturated fatty acids to
less than 10% of the calories each day.
There is substantial evidence that maternal obesity alters the course of pregnancy.
In early pregnancy, placental and embryonic development is affected. In late pregnancy,
maternal metabolic complications and alterations in fetal size and body
Annu. Rev. Nutr. 2006.26:271-291. Downloaded from
Access provided by Texas A&M University – College Station on 02/06/21. For personal use only.
286 KING
fat occur. The in utero environment of obese women appears to force the fetus
to metabolic adjustments that influence immediate and long-term development.
These adjustments may not be consistent with good health in the postnatal environment.
Ways to prevent or reduce metabolic aberrations in obese pregnant
women have not been identified. Maternal diet seems to play a substantial role, but
the effects of preconceptional and gestational diet need further study. In preparation
for pregnancy, obese women are often advised to lose weight. However, exposure
to undernutrition during the periconceptional period may also be inconsistent with
good pregnancy outcomes. It is prudent, therefore, to proceed with caution when
advising obese women about diet prior to and during gestation.
I would like to acknowledge Amy Lightner for her help in reviewing and summarizing
the literature for this article and Janet Wu for her assistance with drawing
the figures.
The Annual Review of Nutrition is online at
1. Bajoria R, Sooranna SR,Ward B, Chatterjee
R. 2002. Prospective function of placental
leptin at maternal-fetal interface.
Placenta 23:103–15
2. Barker D. 1995. Fetal origins of coronary
heart disease. Br. Med. J. 311:171–74
3. Barker D, Bull A, Osmond D, Simmonds
S. 1990. Fetal and placental size and risk
of hypertension in adult life. Br. Med. J.
4. Barker DJ. 2001. A new model for the origins
of chronic disease. Med. Health Care
Philos. 4:31–35
5. Barker DJ. 2003. Coronary heart disease:
a disorder of growth. Horm. Res.
59(Suppl. 1):35–41
6. Barker DJ. 2004. The developmental origins
of chronic adult disease. Acta Paediatr.
Suppl. 93:26–33
7. Barker DJ. 2004. The developmental origins
of well-being. Philos. Trans. R. Soc.
Lond. B Biol. Sci. 359:1359–66
8. Bethune M, Bell R. 2003. Evaluation of
the measurement of the fetal fat layer, interventricular
septum and abdominal circumference
percentile in the prediction
of macrosomia in pregnancies affected by
gestational diabetes. Ultrasound Obstet.
Gynecol. 22:586–90
9. Bo S, Menato G, Gallo ML, Bardelli C,
Lezo A, et al. 2004. Mild gestational hyperglycemia,
the metabolic syndrome and
adverse neonatal outcomes. Acta Obstet.
Gynecol. Scand. 83:335–40
10. Bo S, Menato G, Lezo A, Signorile A,
Bardelli C, et al. 2001. Dietary fat and
gestational hyperglycaemia. Diabetologia
11. Boney C, Verma A, Tucker R, Vohr B.
2005. Metabolic syndrome in childhood:
association with birth weight, maternal
obesity, and gestational diabetes mellitus.
Pediatrics 115:e290–96
12. Bronstein MN, Mak RP, King JC. 1996.
Unexpected relationship between fat mass
and basal metabolic rate in pregnant
women. Br. J. Nutr. 75:659–68
13. Burton G, Hempstock J, Jauniaux E.
2001. Nutrition of the human fetus during
the first trimester—a review. Placenta
14. Butte NF. 2000. Carbohydrate and lipid
Annu. Rev. Nutr. 2006.26:271-291. Downloaded from
Access provided by Texas A&M University – College Station on 02/06/21. For personal use only.
metabolism in pregnancy: normal compared
with gestational diabetes mellitus.
Am. J. Clin. Nutr. 71:1256–61S
15. Butte NF, Ellis KJ, Wong WW, Hopkinson
JM, Smith EO. 2003. Composition of
gestational weight gain impacts maternal
fat retention and infant birth weight. Am.
J. Obstet. Gynecol. 189:1423–32
16. Butte NF, Hopkinson JM, Nicolson MA.
1997. Leptin in human reproduction:
serum leptin levels in pregnant and lactating
women. J. Clin. Endocrinol. Metab.
17. Butte NF, Wong WW, Treuth MS, Ellis
KJ, Smith EO. 2004. Energy requirements
during pregnancy based on total energy
expenditure and energy deposition. Am.
J. Clin. Nutr. 79:1078–87
18. Castro LC, Avina RL. 2002. Maternal
obesity and pregnancy outcomes. Curr.
Opin. Obstet. Gynecol. 14:601–6
19. Catalano P, Nizielski S, Shao J, Preston
L, Qiao L, Friedman JE. 2002. Downregulated
IRS-1 and PPARgamma in obese
women with gestational diabetes: relationship
to FFA during pregnancy. Am.
J. Physiol. Endocrinol. Metab. 282:E522–
20. Catalano PM. 1999. Pregnancy and lactation
in relation to range of acceptable
carbohydrate and fat intake. Eur. J. Clin.
Nutr. 53:S131–35
21. Catalano PM. 2003. Editorial: obesity
and pregnancy—the propagation of a vicious
cycle? J. Clin. Endocrinol. Metab.
22. Catalano PM, Huston L, Amini SB,
Kalhan SC. 1999. Longitudinal changes
in glucose metabolism during pregnancy
in obese women with normal glucose
tolerance and gestational diabetes mellitus.
Am. J. Obstet. Gynecol. 180:903–
23. Catalano PM, Kirwan JP, Haugel-de
Mouzon S, King J. 2003. Gestational diabetes
and insulin resistance: role in shortand
long-term implications for mother and
fetus. J. Nutr. 133:1674–83S
24. Catalano PM, Thomas A, Huston-Presley
L, Amini SB. 2003. Increased fetal adiposity:
a very early marker of abnormal
in utero development. Am. J. Obstet. Gynecol.
25. Catalano PM, Tyzbir ED, Wolfe RR,
Calles J, Roman NM, et al. 1993. Carbohydrate
metabolism during pregnancy in
control subjects and women with gestational
diabetes. Am. J. Physiol. 264:E60–
26. Chevalier S, Marliss EB, Morais JA,
Lamarche M, Gougeon R. 2005. Wholebody
protein anabolic response is resistance
to the action of insulin in obese
women. Am. J. Clin. Nutr. 82:355–65
27. Clapp JF. 1998. Effect of dietary carbohydrate
on the glucose and insulin response
to mixed caloric intake and exercise in
both nonpregnant and pregnant women.
Diabetes Care 21:B107–12
28. Clapp JF. 2002. Maternal carbohydrate intake
and pregnancy outcome. Proc. Nutr.
Soc. 61:45–50
29. Cnattingius S, Bergstrom R, Lipworth L,
Kramer MS. 1998. Prepregnancy weight
and the risk of adverse pregnancy outcomes.
New Engl. J. Med. 338:147–52
30. Collinson A, Moore S, O’Connell M,
Charalambos C, Prentice A. 2005. Developmental
changes in leptin as a measure
of energy status in human infants in a natural
ecologic setting. Am. J. Clin. Nutr.
31. Dabelea D, Pettitt DJ. 2001. Intrauterine
diabetic environment confers risks for
type 2 diabetes mellitus and obesity in
the offspring, in addition to genetic susceptibility.
J. Pediatr. Endocrinol. Metab.
32. Dornhorst A, Frost G. 2002. The principles
of dietary management of gestational
diabetes: reflection on current evidence. J.
Hum. Nutr. Dietet. 15:145–56
33. Duggleby SL, Jackson AA. 2001. Relationship
of maternal protein turnover and
lean body mass during pregnancy and
birth length. Clin. Sci. 101:65–72
Annu. Rev. Nutr. 2006.26:271-291. Downloaded from
Access provided by Texas A&M University – College Station on 02/06/21. For personal use only.
288 KING
34. Duggleby SL, Jackson AA. 2002. Protein,
amino acid and nitrogen metabolism
during pregnancy: How might the mother
meet the needs of her fetus? Curr. Opin.
Clin. Nutr. Metab. Care 5:503–9
35. Ehrenberg H, Huston-Presley M, Catalano
PM. 2003. The influence of obesity
and gestational diabetes mellitus on accretion
and the distribution of adipose tissue
in pregnancy. Am. J. Obstet. Gynecol.
36. Friedman JE, Ishizuka T, Shao J, Huston
LP, Highman T, et al. 1999. Impaired
glucose transport and insulin receptor tyrosine
phosphorylation in skeletal muscle
from obese women with gestational diabetes.
Diabetes 48:1807–14
37. Galtier-Dereure F, Boegner C, Bringer J.
2000. Obesity and pregnancy: complications
and cost. Am. J. Clin. Nutr. 71:1242–
38. Gluckman P, Hanson M. 2005. The Fetal
Matrix: Evolution, Development and
Disease. London: Cambridge Univ. Press
39. Godfrey KM, Barker DJ. 2001. Fetal programming
and adult health. Public Health
Nutr. 4:611–24
39a. Greenberg AS, Obin MS. 2006. Obesity
and the role of adipose tissue in inflammation
and metabolism. Am. J. Clin. Nutr.
40. Grundy S. 2004. Obesity, metabolic
syndrome, and cardiovascular disease.
J. Clin. Endocrinol. Metab. 89:2595–
41. Hales CN, Barker DJ. 2001. The thrifty
phenotype hypothesis. Br. Med. Bull.
42. Havel PJ. 2004. Update on adipocyte hormones.
Regulation of energy balance and
carbohydrate/lipid metabolism. Diabetes
43. Herrera E. 2000. Metabolic adaptations in
pregnancy and their implications for the
availability of substrates to the fetus. Eur.
J. Clin. Nutr. 54(Suppl. 1):S47–51
44. Herrera E. 2002. Lipid metabolism in
pregnancy and its consequences in the fetus
and newborn. Endocrinology 19:43–
45. Highman RJ, Friedman JE, Huston LP,
Wong WW, Catalan PM. 1998. Longitudinal
changes in maternal serum leptin
concentrations, body composition, and
resting metabolic rate in pregnancy. Am.
J. Obstet. Gynecol. 178:1010–15
46. Hytten FE. 1980. Nutrition. In Clinical
Physiology in Obstetrics, ed. F Hytten, G
Chamberlain, pp. 163–92. Oxford: Blackwell
46a. Institute of Medicine. 2002. Dietary Reference
Intakes for Energy, Carbohydrate,
Fiber, Fat, Fatty Acids, Cholesterol, Protein,
and Amino Acids. Part I. Washington,
DC: Natl. Acad. Press
47. Jovanovic L. 1998. American Diabetes
Association’s Fourth International
Workshop-Conference on Gestational Diabetes
Mellitus: summary and discussion.
Therapeutic interventions. Diabetes Care
48. Kac G, BenicioMH,Velasquez-Melendez
G, Valente JG, Struchiner CJ. 2004. Gestational
weight gain and prepregnancy
weight influence postpartum weight retention
in a cohort of Brazilian women.
J. Nutr. 134:661–66
49. Kalhan SC. 2000. Protein metabolism in
pregnancy. Am. J. Clin. Nutr. 71:1249–
50. Kalhan SC, Rossi KQ, Gruca LL, Super
DM, Savin SM. 1998. Relation between
transamination of branched-chain
amino acids and urea synthesis: evidence
from human pregnancy. Am. J. Physiol.
51. King JC. 2000. Physiology of pregnancy
and nutrient metabolism. Am. J. Clin.
Nutr. 71:1218–25S
52. Kitzmiller JL. 1980. The endocrine
pancreas and maternal metabolism. In
Maternal-Fetal Endocrinology, ed. D
Tulchinsky, KJ Ryan, pp. 58–83. Philadelphia,
PA: Saunders
53. Knopp RH, Magee MS, Raisys V,
Benedetti T. 1991. Metabolic effects
Annu. Rev. Nutr. 2006.26:271-291. Downloaded from
Access provided by Texas A&M University – College Station on 02/06/21. For personal use only.
of hypocaloric diets in management of

Get Professional Assignment Help Cheaply

Buy Custom Essay

Don't use plagiarized sources. Get Your Custom Essay on
Maternal Diet and Pregnancy Outcomes
Just from $9/Page
Order Essay

Are you busy and do not have time to handle your assignment? Are you scared that your paper will not make the grade? Do you have responsibilities that may hinder you from turning in your assignment on time? Are you tired and can barely handle your assignment? Are your grades inconsistent?

Whichever your reason is, it is valid! You can get professional academic help from our service at affordable rates. We have a team of professional academic writers who can handle all your assignments.

Why Choose Our Academic Writing Service?

  • Plagiarism free papers
  • Timely delivery
  • Any deadline
  • Skilled, Experienced Native English Writers
  • Subject-relevant academic writer
  • Adherence to paper instructions
  • Ability to tackle bulk assignments
  • Reasonable prices
  • 24/7 Customer Support
  • Get superb grades consistently

Online Academic Help With Different Subjects


Students barely have time to read. We got you! Have your literature essay or book review written without having the hassle of reading the book. You can get your literature paper custom-written for you by our literature specialists.


Do you struggle with finance? No need to torture yourself if finance is not your cup of tea. You can order your finance paper from our academic writing service and get 100% original work from competent finance experts.

Computer science

Computer science is a tough subject. Fortunately, our computer science experts are up to the match. No need to stress and have sleepless nights. Our academic writers will tackle all your computer science assignments and deliver them on time. Let us handle all your python, java, ruby, JavaScript, php , C+ assignments!


While psychology may be an interesting subject, you may lack sufficient time to handle your assignments. Don’t despair; by using our academic writing service, you can be assured of perfect grades. Moreover, your grades will be consistent.


Engineering is quite a demanding subject. Students face a lot of pressure and barely have enough time to do what they love to do. Our academic writing service got you covered! Our engineering specialists follow the paper instructions and ensure timely delivery of the paper.


In the nursing course, you may have difficulties with literature reviews, annotated bibliographies, critical essays, and other assignments. Our nursing assignment writers will offer you professional nursing paper help at low prices.


Truth be told, sociology papers can be quite exhausting. Our academic writing service relieves you of fatigue, pressure, and stress. You can relax and have peace of mind as our academic writers handle your sociology assignment.


We take pride in having some of the best business writers in the industry. Our business writers have a lot of experience in the field. They are reliable, and you can be assured of a high-grade paper. They are able to handle business papers of any subject, length, deadline, and difficulty!


We boast of having some of the most experienced statistics experts in the industry. Our statistics experts have diverse skills, expertise, and knowledge to handle any kind of assignment. They have access to all kinds of software to get your assignment done.


Writing a law essay may prove to be an insurmountable obstacle, especially when you need to know the peculiarities of the legislative framework. Take advantage of our top-notch law specialists and get superb grades and 100% satisfaction.

What discipline/subjects do you deal in?

We have highlighted some of the most popular subjects we handle above. Those are just a tip of the iceberg. We deal in all academic disciplines since our writers are as diverse. They have been drawn from across all disciplines, and orders are assigned to those writers believed to be the best in the field. In a nutshell, there is no task we cannot handle; all you need to do is place your order with us. As long as your instructions are clear, just trust we shall deliver irrespective of the discipline.

Are your writers competent enough to handle my paper?

Our essay writers are graduates with bachelor's, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college degree. All our academic writers have a minimum of two years of academic writing. We have a stringent recruitment process to ensure that we get only the most competent essay writers in the industry. We also ensure that the writers are handsomely compensated for their value. The majority of our writers are native English speakers. As such, the fluency of language and grammar is impeccable.

What if I don’t like the paper?

There is a very low likelihood that you won’t like the paper.

Reasons being:

  • When assigning your order, we match the paper’s discipline with the writer’s field/specialization. Since all our writers are graduates, we match the paper’s subject with the field the writer studied. For instance, if it’s a nursing paper, only a nursing graduate and writer will handle it. Furthermore, all our writers have academic writing experience and top-notch research skills.
  • We have a quality assurance that reviews the paper before it gets to you. As such, we ensure that you get a paper that meets the required standard and will most definitely make the grade.

In the event that you don’t like your paper:

  • The writer will revise the paper up to your pleasing. You have unlimited revisions. You simply need to highlight what specifically you don’t like about the paper, and the writer will make the amendments. The paper will be revised until you are satisfied. Revisions are free of charge
  • We will have a different writer write the paper from scratch.
  • Last resort, if the above does not work, we will refund your money.

Will the professor find out I didn’t write the paper myself?

Not at all. All papers are written from scratch. There is no way your tutor or instructor will realize that you did not write the paper yourself. In fact, we recommend using our assignment help services for consistent results.

What if the paper is plagiarized?

We check all papers for plagiarism before we submit them. We use powerful plagiarism checking software such as SafeAssign, LopesWrite, and Turnitin. We also upload the plagiarism report so that you can review it. We understand that plagiarism is academic suicide. We would not take the risk of submitting plagiarized work and jeopardize your academic journey. Furthermore, we do not sell or use prewritten papers, and each paper is written from scratch.

When will I get my paper?

You determine when you get the paper by setting the deadline when placing the order. All papers are delivered within the deadline. We are well aware that we operate in a time-sensitive industry. As such, we have laid out strategies to ensure that the client receives the paper on time and they never miss the deadline. We understand that papers that are submitted late have some points deducted. We do not want you to miss any points due to late submission. We work on beating deadlines by huge margins in order to ensure that you have ample time to review the paper before you submit it.

Will anyone find out that I used your services?

We have a privacy and confidentiality policy that guides our work. We NEVER share any customer information with third parties. Noone will ever know that you used our assignment help services. It’s only between you and us. We are bound by our policies to protect the customer’s identity and information. All your information, such as your names, phone number, email, order information, and so on, are protected. We have robust security systems that ensure that your data is protected. Hacking our systems is close to impossible, and it has never happened.

How our Assignment Help Service Works

1. Place an order

You fill all the paper instructions in the order form. Make sure you include all the helpful materials so that our academic writers can deliver the perfect paper. It will also help to eliminate unnecessary revisions.

2. Pay for the order

Proceed to pay for the paper so that it can be assigned to one of our expert academic writers. The paper subject is matched with the writer’s area of specialization.

3. Track the progress

You communicate with the writer and know about the progress of the paper. The client can ask the writer for drafts of the paper. The client can upload extra material and include additional instructions from the lecturer. Receive a paper.

4. Download the paper

The paper is sent to your email and uploaded to your personal account. You also get a plagiarism report attached to your paper.

smile and order essay GET A PERFECT SCORE!!! smile and order essay Buy Custom Essay

Place your order
(550 words)

Approximate price: $22

Calculate the price of your order

550 words
We'll send you the first draft for approval by September 11, 2018 at 10:52 AM
Total price:
The price is based on these factors:
Academic level
Number of pages
Basic features
  • Free title page and bibliography
  • Unlimited revisions
  • Plagiarism-free guarantee
  • Money-back guarantee
  • 24/7 support
On-demand options
  • Writer’s samples
  • Part-by-part delivery
  • Overnight delivery
  • Copies of used sources
  • Expert Proofreading
Paper format
  • 275 words per page
  • 12 pt Arial/Times New Roman
  • Double line spacing
  • Any citation style (APA, MLA, Chicago/Turabian, Harvard)

Our guarantees

Delivering a high-quality product at a reasonable price is not enough anymore.
That’s why we have developed 5 beneficial guarantees that will make your experience with our service enjoyable, easy, and safe.

Money-back guarantee

You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.

Read more

Zero-plagiarism guarantee

Each paper is composed from scratch, according to your instructions. It is then checked by our plagiarism-detection software. There is no gap where plagiarism could squeeze in.

Read more

Free-revision policy

Thanks to our free revisions, there is no way for you to be unsatisfied. We will work on your paper until you are completely happy with the result.

Read more

Privacy policy

Your email is safe, as we store it according to international data protection rules. Your bank details are secure, as we use only reliable payment systems.

Read more

Fair-cooperation guarantee

By sending us your money, you buy the service we provide. Check out our terms and conditions if you prefer business talks to be laid out in official language.

Read more
error: Content is protected !!
Open chat
Need assignment help? You can contact our live agent via WhatsApp using +1 718 717 2861

Feel free to ask questions, clarifications, or discounts available when placing an order.
  +1 718 717 2861           + 44 161 818 7126           [email protected]
  +1 718 717 2861         [email protected]