[6] PRELIMS | RISK FACTORS Flashcards
DEMOGRAPHIC FACTORS
LOW INCOME LEVEL/LOW EDUCATIONAL LEVEL
* Preterm birth and intrauterine growth restriction have been consistently associated with lower socioeconomic status, in particular within ____. It is estimated that ____ of low birth weights could be attributed to a mother’s lower social class low [and] educational level.
* Explanations for these disparities in birth outcomes include ____, ____ and ____ among lower income pregnant women.
- Preterm birth and intrauterine growth restriction have been consistently associated with lower socioeconomic status, in particular within poor urban populations. It is estimated that 30% of low birth weights could be attributed to a mother’s lower social class [and] low educational level.
Explanations for these disparities in birth outcomes include higher rates of maternal smoking, poorer nutrition and a higher prevalence of genitourinary tract infections among lower income pregnant women.
DEMOGRAPHIC FACTORS
MULTIPARITY
* Complications arise in multiple-birth pregnancies because ____. Because of the limited amount of space and the additional strain multiple fetuses put on a woman, these babies are more likely to ____. Many pregnancy complications, like ____ and ____, are more common in multiple pregnancies.
* If you’ve had ____ previous pregnancies, you’re more susceptible to an ____ and ____ during future labors.
- Complications arise in multiple-birth pregnancies because more than one baby is growing in the womb. Because of the limited amount of space and the additional strain multiple fetuses put on a woman, these babies are more likely to arrive prematurely. Many pregnancy complications, like high blood pressure and diabetes, are more common in multiple pregnancies.
- If you’ve had five or more previous pregnancies, you’re more susceptible to an abnormally quick labor and accompanying excessive blood loss during future labors.
DEMOGRAPHIC FACTORS
AGE < 18
* ____. Young women’s bodies are still growing and changing. An ____ can lead to difficulties during childbirth.
* ____. Young women are more likely to have poor eating habits. Nutritional deficiency can lead to ____ that causes more complications for both the mother and child.
* ____ can trigger premature labor. This can lead to premature or underweight babies who require ____ to survive.
- Underdeveloped pelvis. Young women’s bodies are still growing and changing. An underdeveloped pelvis can lead to difficulties during childbirth.
- Nutritional deficiencies. Young women are more likely to have poor eating habits. Nutritional deficiency can lead to extra strain on the body that causes more complications for both the mother and child.
- Developing high blood pressure in pregnancy can trigger premature labor. This can lead to premature or underweight babies who require specialized care to survive.
DEMOGRAPHIC FACTORS
AGE > 35
If you’re pregnant and over the age of 35, you may have heard the term ____. Because a woman has the same eggs that she is born with her entire life, there is a higher risk of ____ during pregnancies that happen later in life
If you’re pregnant and over the age of 35, you may have heard the term “geriatric pregnancy.” Because a woman has the same eggs that she is born with her entire life, there is a higher risk of abnormalities during pregnancies that happen later in life
SOCIAL-PERSONAL
LIVING AT HIGH ALTITUDE
High altitude is generally defined as being above 5,000 feet (1,500 m) Some studies suggest that living above 8,000 feet or more increases certain pregnancy complications. However, if you live at a low altitude and you then travel to a high altitude such as above 5,000 feet, you may be actually at increased risk because you are not accustomed to living at a higher altitude. It takes some time to get used to living at a higher altitude.
High altitude is generally defined as being above 5,000 feet (1,500 m) Some studies suggest that living above 8,000 feet or more increases certain pregnancy complications. However, if you live at a low altitude and you then travel to a high altitude such as above 5,000 feet, you may be actually at increased risk because you are not accustomed to living at a higher altitude. It takes some time to get used to living at a higher altitude.
SOCIAL-PERSONAL
LIVING AT HIGH ALTITUDE: MATERNAL AND FETAL IMPLICATIONS
* Fetal growth ____
* An increased incidence of the complications of ____
* ____ at high altitude suggested that the sustained elevation in ____ because there is a hematologic response to decreased oxygen availability at high altitude, resulting in ____ accompanied by ____.
* Increase hemoglobin: This is because blood contains ____ – a specialized protein that binds to oxygen in the lungs so that the oxygen can be transported to the rest of the body. The amount of haemoglobin in blood ____ at high altitude.
- Fetal growth retardation
- An increased incidence of the complications of pre-eclampsia
- Neonatal hyperbilirubinemia at high altitude suggested that the sustained elevation in bilirubin because there is a hematologic response to decreased oxygen availability at high altitude, resulting in increased bilirubin production accompanied by delayed bilirubin clearance.
- Increase hemoglobin: This is because blood contains haemoglobin – a specialized protein that binds to oxygen in the lungs so that the oxygen can be transported to the rest of the body. The amount of haemoglobin in blood increases at high altitude.
SOCIAL-PERSONAL
POOR DIET
* Lack of adequate nutrition of good quality and quantity during pregnancy can cause ____ for both the mother and her fetus.
* Maternal malnutrition increases the risk of ____, ____, ____ and ____ during pregnancy, pre-term delivery and maternal mortality.
* Eating a nutritious diet during pregnancy is linked to ____, ____, and ____.
* Good nutrition is thought to help balance ____ and it may improve ____ as well.
* A well-balanced pregnancy diet includes ____.
- Lack of adequate nutrition of good quality and quantity during pregnancy can cause health problems for both the mother and her fetus.
- Maternal malnutrition increases the risk of gestational anemia, hypertension, miscarriages and fetal deaths during pregnancy, pre-term delivery and maternal mortality.
- Eating a nutritious diet during pregnancy is linked to good fetal brain development, a healthy birth weight, and it reduces the risk of many birth defects.
- Good nutrition is thought to help balance mood swings and it may improve labor and delivery as well.
- A well-balanced pregnancy diet includes protein.
SOCIAL-PERSONAL
WEIGHT < 45.5 kg (110 lbs)
Maternal Implication
* Poor ____
* ____ disproportion (CPD)
* Prolonged labor
Fetal Implication
* ____
* ____ associated with difficult labor and birth
* Decreased ____
Maternal Implication
* Poor nutrition
* Cephalopelvic disproportion (CPD)
* Prolonged labor
Fetal Implication
* IUGR
* Hypoxia associated with difficult labor and birth
* Decreased fetal nutrition
SOCIAL-PERSONAL
WEIGHT < 45.5 kg (110 lbs)
If you are in the healthy weight range before becoming pregnant (BMI ____), ideally you should gain between ____; ____ in the first three months then ____ each month until you give birth.
If you are in the healthy weight range before becoming pregnant (BMI 18.5-24.9), ideally you should gain between 11.5 kg and 16 kg; 1 to 1.5 kg in the first three months then 1.5 to 2 kg each month until you give birth.
WEIGHT > 91 kg (200 lbs)
Obesity-Related Health Risks for Mothers
* Women who are overweight or obese during pregnancy face several possible health risks, including ____, ____, and an increased chance of needing a ____.
* ____ is diabetes that begins during pregnancy.
- Women who are overweight or obese during pregnancy face several possible health risks, including high blood pressure, gestational diabetes, and an increased chance of needing a Cesarean delivery.
- Gestational diabetes is diabetes that begins during pregnancy.
WEIGHT > 91 kg (200 lbs) - MACROSOMIA
* The term ____ is used to describe a newborn who’s significantly larger than average.
* A baby diagnosed with fetal macrosomia has a birth weight of ____, regardless of his or her gestational age.
* About ____ of babies born worldwide weigh more than ____, 13 ounces. However, the risks associated with fetal macrosomia increase greatly when birth weight is more than ____.
* Fetal macrosomia may ____ and could put the baby at risk of ____.
* Fetal macrosomia also puts the baby at increased risk of health problems after birth.
- The term “fetal macrosomia” is used to describe a newborn who’s significantly larger than average.
- A baby diagnosed with fetal macrosomia has a birth weight of more than 8 pounds, 13 ounces (4,000 grams), regardless of his or her gestational age.
- About 9 percent of babies born worldwide weigh more than 8 pounds, 13 ounces. However, the risks associated with fetal macrosomia increase greatly when birth weight is more than 9 pounds 15 ounces (4,500 grams).
- Fetal macrosomia may complicate vaginal delivery and could put the baby at risk of injury during birth.
- Fetal macrosomia also puts the baby at increased risk of health problems after birth.
SOCIAL-PERSONAL
HEIGHT 60”/153 cm OR LESS
* Woman’s height can affect length of pregnancy. A woman’s height may determine when she goes into labor during a pregnancy
* The Telegraph reports - after studying ____ women and their babies, researchers found that ____ women have ____ pregnancies and ____ babies and higher risk for a preterm birth.
* New research has found that a mother’s height directly influences her risk for preterm birth
- Woman’s height can affect length of pregnancy. A woman’s height may determine when she goes into labor during a pregnancy
- The Telegraph reports - after studying 3,485 Nordic women and their babies, researchers found that shorter women have shorter pregnancies and smaller babies and higher risk for a preterm birth.
- New research has found that a mother’s height directly influences her risk for preterm birth
SOCIAL-PERSONAL
SMOKING ONE PACK/DAY OR MORE
* Pregnant women should avoid tobacco, alcohol, and drug use. Even ____ carries risks for health issues in the baby, including short- and long-term conditions or even death.
* Stop using tobacco, alcohol, and drugs if you are pregnant, trying to become pregnant, or think you may be pregnant. This is because anything you consume ____ through your ____ and the ____.
* The ____ is most critical to your baby’s development.
* Smoking can increase your risk of miscarriage and preterm birth. Your baby could have a ____ or certain birth defects. Smoking during and/or after pregnancy also has been linked to ____.
- Pregnant women should avoid tobacco, alcohol, and drug use. Even minor use carries risks for health issues in the baby, including short- and long-term conditions or even death.
- Stop using tobacco, alcohol, and drugs if you are pregnant, trying to become pregnant, or think you may be pregnant. This is because anything you consume gets passed to the baby through your blood and the placenta.
- The first trimester is most critical to your baby’s development.
- Smoking can increase your risk of miscarriage and preterm birth. Your baby could have a low birth weight or certain birth defects. Smoking during and/or after pregnancy also has been linked to sudden infant death syndrome (SIDS).
SOCIAL-PERSONAL
USE OF ADDICTING DRUGS
* Using illegal drugs, such as ____, ____, and ____ (still illegal for recreational use in most states), carry major risks. They can cause ____, ____, and ____. Your baby could be born with a drug addiction. This is called ____. It causes your baby to go through withdrawal, which is very painful. It often has lasting health effects.
* The use of ____ during pregnancy can be harmful as well. In addition to the risks above, you could have ____ or your baby could have ____.
* If you take opioids for a medical issue, ____. If you have an opioid addiction, your doctor may prescribe more serious treatment. One option is ____.
- Using illegal drugs, such as cocaine, heroin, and marijuana (still illegal for recreational use in most states), carry major risks. They can cause miscarriage, preterm birth, and birth defects. Your baby could be born with a drug addiction. This is called neonatal abstinence syndrome. It causes your baby to go through withdrawal, which is very painful. It often has lasting health effects.
- The use of opioids during pregnancy can be harmful as well. In addition to the risks above, you could have placental abruption or your baby could have fetal growth problems.
- If you take opioids for a medical issue, talk to your doctor about when and how to quit. If you have an opioid addiction, your doctor may prescribe more serious treatment. One option is medication-assisted therapy (MAT).
SOCIAL-PERSONAL
ANTIBIOTIC USAGE
* Drugs such as ____, ____ given late in pregnancy, and ____
* Fetal/Neonatal Implication (4)
Brownish staining of deciduous teeth
Premature cessation of growth of the long bones
Cardiac failure in the neonate
Congenital deafness
RECHECK PPT
SOCIAL-PERSONAL
EXCESSIVE ALCOHOL CONSUMPTION
* Alcohol can increase your baby’s risk of major birth defects. One example is ____. It can cause problems such as ____, ____, ____, and a ____.
- Alcohol can increase your baby’s risk of major birth defects. One example is fetal alcohol disorder. It can cause problems such as slow growth, brain damage, developmental problems, and a small head.
EXISTING MEDICAL DISORDER
DIABETES MELLITUS
* Maternal Implication (2)
* Fetal/Neonatal Implication (5)
Maternal Implication:
* Increased risk for preeclampsia, hypertension, episodes of hypoglycemia and hyperglycemia
* Increased risk for caesarean birth
Fetal/Neonatal Implication:
* LBW
* Macrosomia
* Neonatal hypoglycemia
* Increased risk for congenital anomalies
* Increased risk for respiratory distress syndrome (RDS)
EXISTING MEDICAL DISORDER
DIABETES MELLITUS
* During pregnancy, the ____ makes hormones that can lead to a build-up of glucose in your blood. Usually, your ____ can make enough ____ to handle that. If not, your blood sugar levels will rise and can cause ____.
* Hypoglycemia and hyperglycemia are both common in women with ____. Hypoglycemia occurs when blood glucose levels are too low. When blood glucose levels are low, your body cannot get the energy it needs.
- During pregnancy, the placenta makes hormones that can lead to a build-up of glucose in your blood. Usually, your pancreas can make enough insulin to handle that. If not, your blood sugar levels will rise and can cause gestational diabetes.
- Hypoglycemia and hyperglycemia are both common in women with pre-existing diabetes. Hypoglycemia occurs when blood glucose levels are too low. When blood glucose levels are low, your body cannot get the energy it needs.
EXISTING MEDICAL DISORDER
DIABETES MELLITUS - Hypoglycemia
* Can be trigered by: (3)
* Typically, hypoglycemia is treated by eating or drinking something containing sugar, such as orange juice. Hyperglycemia is when your body doesn’t have enough insulin or can’t use insulin correctly.
* You may be experiencing this if you are: (3)
- Can be trigered by: (1) skipping or delaying meals, (2) eating portions that are too small, or (3) overextering yourself physically
- Typically, hypoglycemia is treated by eating or drinking something containing sugar, such as orange juice. Hyperglycemia is when your body doesn’t have enough insulin or can’t use insulin correctly.
- You may be experiencing this if you are: (1) always thirsty, (2) suddenly losing weight, or (3) using the bathroom often
