4.1a Nutrition Needs Before Contraception

Question 1

Nutrition Care

Answer 1

Based on

• Current health status
• Pre-pregnancy height and weight
• Medical history
• Health habits
• Socioeconomic status
• Access to food
• Cultural beliefs and practices

Question 2

Nutrition Related Problems/Risk Factors

Answer 2

• Diabetes
• Phenylketonuria (PKU)
• Obesity
• Bariatric Surgery
• Eating disorders
• Adolescent pregnancy

Question 3

Folate (Folic Acid)

Answer 3

• Imperative to reduce neural tube defects
• 0.4 mg (400mcg) of folic acid a day in addition to dietary sources
• Woman who had a child with neural tube defects already should take 4mg a day beginning at least 1 month before attempting to conceive and continuing throughout 1st trimester

Question 4

Nutrients during 1st trimester

Answer 4

• Relatively few demands on maternal nutrition

Question 5

Nutrients during last trimester

Answer 5

• Most fetal stores of energy and minerals are deposited
• Growth of uterine-placental fetal unit
• Increase in maternal blood volume
• 25% increase in metabolic rate

Question 6

Dietary Reference Intake (DRI)

Answer 6

• Dietary recommendations for daily nutritional intake for all healthy members of the population

Question 7

Energy Needs

Answer 7

1st trimester - 1800 kcal/day
2nd trimester - 2200 kcal/day
3rd trimester - 2400 kcal/day

Question 8

Weight Management

Answer 8

• Primary factor for recommendations depends on appropriateness of pre-pregnancy weight for the women’s height
• Fetal risks are higher when mother is under or overweight or when weight gain is too much or too little during pregnancy
  UNDERWEIGHT WOMEN
• More likely to have preterm labor and LBW babies

Normal/Underweight women with inadequate weight gain have increased risk of giving birth to a baby with Intrauterine Growth Restriction

Question 9

BMI Formula

Answer 9

BMI = Weight / Height^2

Question 10

BMI Stats

Answer 10

Underweight - <18.5
Normal - 18.5-24.9
Overweight - 25-29.9
Obese - >30

Question 11

Optimal Weight Gain Normal/Underweight

Answer 11

1st trimester - 2-4 lb total weight

2nd and 3rd Trimester - 1 lb per week

Question 12

Optimal Weight Gain Overweight/Obese

Answer 12

Overweight - 2nd and 3rd trimester 0.6 lb a week

Obese - 2nd and 3rd trimester 0.5 lb a week

Question 13

Recommended Total Weight Gain

Answer 13

Underweight - 28-40 pounds
Normal - 25-35 pounds
Overweight - 15-25 pounds
Obese - 11-20 pounds

Question 14

Inadequate weight gain during pregnancy

Answer 14

• Risk of preterm birth and SGA (small gestational age)

Question 15

Influences of weight gain

Answer 15

• Financial resources for food
• Low pre-pregnancy weight
• Figure conscious and purposeful restriction of weight

Question 16

Obesity Risks

Answer 16

• Miscarriage
• Birth defects
• Stillbirth
• Abnormal Fetal Growth
• Preterm Birth

Question 17

Maternal Risks

Answer 17

• Gestational Diabetes
• Hypertensive disorders
• Vacuum and forceps-assisted births
• Cesarean birth
• Surgical site infection
• Venous Thromboembolism
• Depression
• Excessive weight gain can be hard to lose after

Question 18

Risks of Overweight during Pregnancy

Answer 18

• Preeclampsia
• Gestational Diabetes
• Macrosomia (excessive birth weight)
• Cephalopelvic Disproportion (baby head or pelvis too big to fit through mothers pelvis)
• Emergency c-section
• Postpartum hemorrhage
• UTI

Question 19

Risks of being Overweight During Pregnancy

Answer 19

• Miscarriage
• Congenital Anomalies
• Stillbirth

Question 20

Excessive Weight Gain during Pregnancy Risks

Answer 20

• Risk of chronic obesity
• Hypertension
• Diabetes
• Heart Disease
• Infants risk of obesity if mother is obese

Question 21

Priority for Someone who gains too much weight during Pregnancy

Answer 21

• Education about proper nutrition
• Dietician
• 24 Hour Recall Assessment
• Income assessment
• Ask about PICA and food cravings
• Qualifications of assistance through WIC (low income food assistance)