4.1a Nutrition Needs Before Contraception Flashcards
Nutrition Care
Based on
- Current health status
- Pre-pregnancy height and weight
- Medical history
- Health habits
- Socioeconomic status
- Access to food
- Cultural beliefs and practices
Nutrition Related Problems/Risk Factors
- Diabetes
- Phenylketonuria (PKU)
- Obesity
- Bariatric Surgery
- Eating disorders
- Adolescent pregnancy
Folate (Folic Acid)
- 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
Nutrients during 1st trimester
- Relatively few demands on maternal nutrition
Nutrients during last trimester
- 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
Dietary Reference Intake (DRI)
- Dietary recommendations for daily nutritional intake for all healthy members of the population
Energy Needs
1st trimester - 1800 kcal/day
2nd trimester - 2200 kcal/day
3rd trimester - 2400 kcal/day
Weight Management
- 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
BMI Formula
BMI = Weight / Height^2
BMI Stats
Underweight - <18.5
Normal - 18.5-24.9
Overweight - 25-29.9
Obese - >30
Optimal Weight Gain Normal/Underweight
1st trimester - 2-4 lb total weight
2nd and 3rd Trimester - 1 lb per week
Optimal Weight Gain Overweight/Obese
Overweight - 2nd and 3rd trimester 0.6 lb a week
Obese - 2nd and 3rd trimester 0.5 lb a week
Recommended Total Weight Gain
Underweight - 28-40 pounds
Normal - 25-35 pounds
Overweight - 15-25 pounds
Obese - 11-20 pounds
Inadequate weight gain during pregnancy
- Risk of preterm birth and SGA (small gestational age)
Influences of weight gain
- Financial resources for food
- Low pre-pregnancy weight
- Figure conscious and purposeful restriction of weight
Obesity Risks
- Miscarriage
- Birth defects
- Stillbirth
- Abnormal Fetal Growth
- Preterm Birth
Maternal Risks
- 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
Risks of Overweight during Pregnancy
- 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
Risks of being Overweight During Pregnancy
- Miscarriage
- Congenital Anomalies
- Stillbirth
Excessive Weight Gain during Pregnancy Risks
- Risk of chronic obesity
- Hypertension
- Diabetes
- Heart Disease
- Infants risk of obesity if mother is obese
Priority for Someone who gains too much weight during Pregnancy
- 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)
