5: Nutrition - preconception, pregnancy and postpartum Flashcards
Being (underweight / overweight) carries risk for a pregnant woman and her unborn child.
both
being overweight AND underweight carries risk
What are the BMI thresholds for being
a) underweight
b) overweight?
c) obese?
a) < 18.5 = underweight
b) 25.0 - 29.9 = overweight
c) 30+ = obese
What menstrual problem do underweight women suffer from?
Amenorrhoea
What causes amenorrhoea in women who are underweight?
Hormonal changes
Body doesn’t ovulate because it knows it isn’t strong enough to support a pregnancy
What sexual problem do both underweight and overweight women suffer from?
Infertility
Overweight and underweight women take longer to ___ a child.
conceive
Which endocrine problem are overweight women more likely to develop when they are pregnant?
(Gestational) diabetes
What is macrosomia?
A fetus which is significantly larger than average (4kg+)
What complications of pregnancy can occur as a result of an overweight mother?
Miscarriage / Stillbirth
Pre-eclampsia
Macrosomia
Fetal abnormalities
Gestational diabetes
Paradoxically, malnourished fetuses are at risk of developing which condition when they are born?
Type 2 diabetes
Fetus is prepared for a nutrient-sparse environment and then overloaded with sugar upon birth
What is the generic dietary advice you would give to any patient?
Meals based on starchy foods
Five portions of fruit and vegetables a day
High in fibre
Low in saturated fat
What generic lifestyle advice would you give to pregnant woman?
Eat a balanced diet
Exercise regularly
Don’t smoke or drink too much (no smoking, up to 4 units/week)
Which supplements are pregnant women given?
Folic acid
Vitamin C & D
Why are pregnant women given folic acid supplements?
To prevent NEURAL TUBE DEFECTS (e.g spina bifida) in their children
Which dietary supplement is given to pregnant women to prevent neural tube defects in their children?
Folic acid
What dose of folic acid is given to pregnant women?
400 micrograms
(Exception: 5 MILLIgrams in women at high risk)
Which women are at increased risk of having children with neural tube defects?
Overweight
Diabetic
History of NTDs in previous children
Women on antiepileptics
Which doses of folic acid are given to women with
a) an average risk of children having neural tube defects
b) increased risk?
a) 400 micrograms
b) 5 milligrams
Apart from supplements, where does most of a woman’s folic acid intake come from?
Diet
Leafy greens
Apart from folic acid, which other dietary supplements are given to pregnant women?
Vitamin C & D
What dose of Vitamin D is given to pregnant women?
10 micrograms / day
Are iron supplements regularly given to pregnant women?
No
Thought to cause more harm (re: side effects) than good
What doses of
a) Folic acid
b) Vitamin C
c) Vitamin D
are given to pregnant women as part of the Healthy Start scheme?
a) 400 micrograms
b) 70 milligrams
c) 10 micrograms
What is a foetal consequence of maternal Vitamin D deficiency?
Rickets
Which
a) supplements
b) vouchers
are pregnant women offered as part of the Healthy Start Scheme?
a) Vitamin C & D, Folic acid
b) Food vouchers (roughly £3.10 a week, for basic foods like bread and fruit/veg)
Which foods should pregnant women avoid?
Soft cheese - Listeria
Uncooked meats
Raw eggs
Tuna
Vitamin supplements (apart from this recommended already)
What are some maternal complications of being overweight during pregnancy?
Diabetes
Hypertension
Thrombosis
Infection
What are some foetal complications of (the mother) being overweight during pregnancy?
Macrosomia
Miscarriage / Stillbirth
Do pregnant women need to “eat for two”?
No
But they do need to eat a healthy, well-balanced diet
Which type of diabetes can overweight women develop in pregnancy?
Gestational diabetes
How is gestational diabetes managed?
Diet modification
Patients are advised to eat more ___ than ___.
fruit, veg
eat more VEG than FRUIT
Which food group is supposed to make up part of every meal?
Complex carbohydrates i.e starchy foods like potatoes, rice and pasta
When choosing starchy foods, what is the better alternative?
Wholemeal
Which type of fat is
a) good
b) bad for you?
a) Unsaturated fats
b) Saturated and trans fats
Dairy products consumed by pregnant women should be low in ___ and ___.
fat
sugar
