Chapter 10 book notes

Question 1

In preparation for a healthy pregnancy, a woman can establish
the following habits:

Answer 1

-achieve and maintain a healthy body weight
-choose an adequate and balanced diet
-be physically active
-receive regular medical care
-avoid harmful substances

Question 2

Infant birthweight correlates with:

Answer 2

-most important predictor of the infant’s future health and survival
–prepregnancy weight and weight gain during pregnancy

Question 3

AN underweight women has a high risk of having a:

Answer 3

-low birthweight infant

Question 4

low-birthweight (LBW):

Answer 4

• a birthweight less than 5½ lb (2500 g);
  -indicates poor health in the newborn and poor nutrition
  status of the mother during pregnancy.

Question 5

Low-birthweight infants are of
two different types:

Answer 5

-Some are premature; they are born early and are of a weight appropriate
for gestational age (AGA).
-Others have suffered growth failure in the uterus; they may or may not be
born early, but they are small for gestational age (SGA)

Question 6

Low birthweight infants are more likely to:

Answer 6

-contract diseases and are nearly 40 times more likely to die in the first month of life.

Question 7

Optimal birthweight
for a full-term infant is:

Answer 7

-6.8 to 7.9 lb (about 3100 to 3600 g).

Question 8

Infants born to women who are obese are more likely to be
large for gestational age, weighing:

Answer 8

-more than 9 pounds.

Question 9

Women who are obese are likely to suffer from: what during pregnancy:

Answer 9

-gestational diabetes, hypertension, and complications during and infections
and hemorrhage after the birth.

Question 10

Women who are overweight have a higher risk of giving birth to infants that have:

Answer 10

-heart defects or other abnormalities.
-long term effects include: child obesity, heart disease, type 2 diabetes, and asthma throughout life.

Question 11

A major reason that the mother’s prepregnancy nutrition is so crucial is that it determines
whether her

Answer 11

-uterus will be able to support the growth of a healthy placenta during the first month of gestation

Question 12

placenta:

Answer 12

-an organ that develops inside the uterus early in pregnancy,
-maternal and fetal blood circulate in close proximity and exchange materials.
-The fetus receives nutrients and oxygen across the placenta
-waste from fetus is picked up from mother to be excreted by kidneys or lungs

Question 13

The placenta also produces numerous and diverse of:

Answer 13

-hormones that act to maintain pregnancy and prepare the mothers breasts for lactation.

Question 14

A healthy placenta is essential for the developing:

Answer 14

-fetus to attain its full potential.

Question 15

amniotic:

Answer 15

-the “bag of water” in the uterus in which the fetus floats.

Question 16

umbilical cord:

Answer 16

-the ropelike structure through which the fetus’s veins and arteries reach the placenta;
-the route of nourishment and oxygen into the fetus and the route of waste
disposal from the fetus.

Question 17

A newly fertilized ovum is called a:

Answer 17

-zygote

Question 18

A zygote begins as a single cell and rapidly divides to become a:

Answer 18

-blastocyst, 5 days old and ready for implantation
-blastocysts floats down into the uterus where it will embed itself in the inner uterine wall.

Question 19

Adverse effects such as smoking, drug abuse, and malnutrition during implantation can lead to:

Answer 19

-failure to implant
-or abnormalities such as neural tube defects that can cause the loss of developing embryo.

Question 20

At eight weeks, the fetus has a complete:

Answer 20

-central nervous system,
-a beating heart,
-a fully formed digestive system,
-fingers and toes,
-beginnings of facial features.

Question 21

During the last 7 months of pregnancy (fetal period) what happens?

Answer 21

-fetus grows
-critical periods of cell division and development occur in organ after organ.

Question 22

Most successful pregnancies last:

Answer 22

38 to 42 weeks and produce a healthy infant weighing between 6.8 and 7.9 pounds.

Question 23

critical period:

Answer 23

-a period of rapid cell division.
-a period during development in which certain events occur that will have irreversible
effects on later developmental stages;

Question 24

Fetus brain and heart are developed at ?? weeks=
what about their lungs?

Answer 24

-14 weeks
-24 weeks

Question 25

can the effects of malnutrition during critical periods be reversible?

Answer 25

-NO

Question 26

The effects of malnutrition during critical periods of pregnancy are seen in defects of the:

Answer 26

-nervous system of the embryo, in the child’s poor dental health, -and in the adolescent’s and adult’s vulnerability to infections and possibly higher risks of diabetes, hypertension, stroke, or heart disease.

Question 27

Energy needs change as the

Answer 27

-pregnancy progresses

Question 28

How many extra kcalories are needed during the second trimester? what about the third?

Answer 28

-340 -450

Question 29

Ample carbohydrates (ideally how much ??) is necessary to fuel the:

Answer 29

-175 grams or more per day but no less than 135 grams -the fetal brain and spare protein needed for fetal growth.

Question 30

protein RDA for pregnancy calls for ?? grams per day more than for nonpregnant women:

Answer 30

-25

Question 31

Vitamins famous in their roles in cell reproduction and needed in large amounts during pregnancy:

Answer 31

-folate and vitamin B12

Question 32

Why are more vitamins needed during pregnancy?

Answer 32

-the mothers blood volume rises, the number of red blood cells rise, which requires more cell division thus more vitamins.

Question 33

recommendation for folate during pregnancy increases from 400 to:

Answer 33

-600 micrograms a day.

Question 34

folate plays an important role in preventing

Answer 34

-neural tube defects

Question 35

neural tube:

Answer 35

- the embryonic tissue that later forms the brain and spinal cord.

Question 36

By the time a woman suspects she is pregnant, usually around the sixth week of pregnancy, the embryo’s

Answer 36

-neural tube normally has closed.

Question 37

NTD occurs when

Answer 37

-the tube fails to close properly

Question 38

Each year in the United States, an estimated ??? pregnancies are affected by an NTD

Answer 38

-3000

Question 39

Two most common types of NTD are:

Answer 39

-anencephaly (no brain) -spine bifida (split spine)

Question 40

Anenceohaly

Answer 40

-upper end of neural tube fails to close -brain is either missing or fails to develop -end in miscarriage or infants die shortly after birth

Question 41

spina bifida:

Answer 41

-one of the most common types of neural tube defects; -characterized by the incomplete closure of the spinal cord’s bony encasement -allowing the spinal cord to bulge through.

Question 42

moderate cases of spina bifida include: severe cases will lead to:

Answer 42

-curvature of spine, muscle weakness, mental handicaps, and other ills -death

Question 43

Risk factors for neural tube defects:

Answer 43

-family history of NTD -maternal diabetes or obesity -overheating or fever -maternal use of certain medications -inadequate folate

Question 44

Pregnant women need a greater amount of vitamin B12 in order to:

Answer 44

-assist folate in the manufacture of new cells.

Question 45

Choline:

Answer 45

-choline is needed for normal brain and spinal cord development of fetus -large amounts are transported from mother to fetus via placenta, which depletes maternal stores.

Question 46

Prenatal supplements do not include:

Answer 46

-choline -so choline is rich in eggs, dairy products, legumes, and meats/seafood

Question 47

Vitamin D and minerals (calcium, phosphorous, fluoride, and magnesium) are in great demand during pregnancy and help build:

Answer 47

-skeleton -insufficient intake will produce abnormal fetal bone growth and tooth developemnt.

Question 48

In the final weeks of pregnancy, more than ???? milligrams of calcium a day is transferred to the fetus.

Answer 48

-300

Question 49

Why does the body conserve iron especially well during preganacy?

Answer 49

-menstruation ceases -absorption of iron increases up to 3fold and due to rise in transferrin.

Question 50

To improve iron status of women before & during pregnancy, they are advised to eat:

Answer 50

-heme iron foods (meat, poultry, and seafood)

Question 51

The developing fetus draws heavily on the mother’s iron stores to create stores of its own to last through the first:

Answer 51

-four to six months after birth

Question 52

During the second and third trimesters of pregnancy, the hormone ?? , which regulates iron balance, is suppressed, and the mobilization of iron from maternal stores is enhanced.

Answer 52

-hepcidin

Question 53

Women who enter pregnancy with iron-deficiency anemia are at increased risk of delivering

Answer 53

-low-birthweight or preterm infants

Question 54

Women most likely to benefit from prenatal supplements during pregnancy include those who:

Answer 54

-do not eat adequately - those carrying twins or triplets -those who smoke cigarettes, -those with alcohol use disorder or substance abuse disorder.

Question 55

Special Supplemental Nutrition Program for Women, Infants, and Children (WIC):

Answer 55

-a high-quality, costeffective health care and nutrition services program administered by the U.S. Department of Agriculture for low-income women, infants, and children who are nutritionally at risk. -WIC provides supplemental foods, nutrition education, and referrals to health care and other social services.

Question 56

How many people recieve WIC benefits each month? and most of them are?

Answer 56

-7 billion -infants and young children

Question 57

Supplemental Nutrition Assistance Program (SNAP) provides-

Answer 57

-a debit card that can also help to stretch the grocery dollars of those in need

Question 58

Pregnancy weight gains within the recommended ranges are associated with fewer

Answer 58

-surgical births, -greater number of healthy birthweights

Question 59

Excessive weight gain in the U.S. is ?? than inadequate weight gain.

Answer 59

-more common

Question 60

Recommended weight gain for: underweight BMI= healthy weight= overweight= obese=

Answer 60

- 28 to 40lbs -25 to 35lbs -12-25lbs -11 to 20lbs

Question 61

ideal weight gain pattern for a woman who begins pregnancy at a healthy weight

Answer 61

-is 3½ pounds during the first trimester and 1 pound per week thereafter

Question 62

A sudden, large weight gain is a danger signal, however, because it may indicate the onset of

Answer 62

-preeclampsia

Question 63

The weight the pregnant woman gains includes

Answer 63

-maternal and fetal fat & lean tissue -as well as the placenta and amniotic fluid. -fat she gains is used later for lactation.

Question 64

Pregnant women and physical activity

Answer 64

-low impact activities and avoid sports in which they might be fall or be hit by other people or objects -avoid saunas, steam rooms, and hot whirlpools

Question 65

Food aversions and cravings that arise during pregnancy are probably due to:

Answer 65

-hormone induced changes in taste and sensitivities to smells, and they quickly disappear after the birth.

Question 66

Common nutrition related concerns of pregnancy:

Answer 66

-food sensitivities, nausea, heartburn, and constipation.

Question 67

Heartburn

Answer 67

-burning sensation in the lower esophagus near the heart -benign -as growing fetus puts increasing pressure on womens stomach, acid may back up and create burning sensation in throat.

Question 68

Why does constipation happen during pregnancy?

Answer 68

-hormones of pregnancy alter muscle tone and thriving infant crowds intestinal organs.

Question 69

Women with preexisting diabetes can give birth to infants that are :

Answer 69

-large -suffer physical and mental abnormalities -or experience other complications like hypoglycemia or respiratory distress

Question 70

gestational diabetes:

Answer 70

-glucose intolerance during pregnancy -resolves after birth but some women can develop type 2 diabetes later especially if they are overweight.

Question 71

Weight gains after pregnancy increase the risk of

Answer 71

-gestational diabetes in the next pregnancy

Question 72

Gestational diabetes can lead to:

Answer 72

-fetal or infant sickness or death, surgical birth and high infant birthweight. -though the risk of these outcomes falls dramatically when it is identified early and managed properly

Question 73

At first prenatal visit women who are (two factors) will be screened for gestational diabetes

Answer 73

-overweight (BMI higher than 25) -have one or more additional risk factors for type 2 diabetes (family history, high blood pressures, etc.)

Question 74

All pregnant women not previously diagnosed with diabetes are tested for glucose intolerance at:

Answer 74

-24 to 28 weeks’ gestation

Question 75

2 types of hypertension during pregnancy:

Answer 75

1)chronic hypertension 2)gestational hypertension

Question 76

chronic hypertension:

Answer 76

-in pregnant women, hypertension that is present and documented before pregnancy;

Question 77

gestational hypertension:

Answer 77

-high blood pressure that develops in the second half of pregnancy and usually resolves after childbirth.

Question 78

Both types of hypertension produce risk factors in mother and fetus such as:

Answer 78

-heart attack & stroke -growth restriction, preterm birth, and separation of placenta from the wall of the uterus before birth. -preeclampsia

Question 79

preeclampsia:

Answer 79

-a condition characterized by hypertension and protein in the urine during pregnancy. -multisystem syndrome involving placental stress, inflammation, and metabolic dysfunction.

Question 80

WHO recommends what to women at high risk of preeclampsia

Answer 80

-calcium supplementation

Question 81

Preeclampsia usually occurs:

Answer 81

-with first pregnancies and almost always appear after 20 weeks gestation

Question 82

What is the cure of preeclampsia?

Answer 82

-delivery of baby, leading cause of preterm deliver -symptoms regress after 48 hours of delivery

Question 83

What organs does preeclampsia affect?

Answer 83

-circulatory system -liver -kidneys -brain

Question 84

Ecampsia

Answer 84

-severe complication during pregnancy in which seizures occur -happens when preeclampsia continues to occur.

Question 85

signs and symptoms of preeclampsia (8):

Answer 85

-hypertension -protein in urine -upper abdominal pain -severe headaches -swelling of hands, feet, and face -vomiting -blurred vision -sudden gain (1lb per day)

Question 86

What % of pregnant women in the U.S. smoke?

Answer 86

-10%

Question 87

What substances in cigarette smoke are toxic to fetus?

Answer 87

-nicotine, carbon monoxide, arsenic, and cyanide.

Question 88

What does smoking do to the fetus?

Answer 88

-restricts blood supply -limits delivery of oxygen nutrients and removal of wastes -damage fetal blood vessels (seen at age 5)

Question 89

SIDS

Answer 89

-sudden infant death syndrome -unexplained death that sometimes occurs in a healthy infant, linked to smoking

Question 90

Lead contaminant in pregnant women:

Answer 90

-moves readily across placenta, inflects severe damage on developing fetal nervous system. -dietary calcium will help

Question 91

Mercury contaminant in pregnant women:

Answer 91

-impairs fetal growth and harms the developing brain and nervous system

Question 92

FDA and EPA encourage pregnant and lactating women to eat at least

Answer 92

8 ounces to 12 ounces of seafood weekly.

Question 93

listeriosis:

Answer 93

-a serious foodborne infection that can cause severe brain infection or death in a fetus or newborn; -caused by the bacterium Listeria monocytogenes, which is found in soil and water.

Question 94

Which vitamin, in excess, can be harmful to pregnant women?

Answer 94

-all of them but in particular A (fetal malformations)

Question 95

Pregnancy and caffeine;

Answer 95

-less than 200 milligrams per day -more than 3 cups of coffee a day can lead to miscarriage and low birthweight. -1-2cups a day is good

Question 96

fetal alcohol spectrum disorders:

Answer 96

-a spectrum of physical, behavioral, and cognitive disabilities caused by prenatal alcohol exposure.

Question 97

fetal alcohol syndrome (FAS):

Answer 97

-most severe end of spectrum -the cluster of symptoms seen in an infant or child whose mother consumed excessive alcohol during her pregnancy. -FAS includes, but is not limited to, brain damage, delayed growth, intellectual disabilities, and facial abnormalities.

Question 98

alcohol-related neurodevelopmental disorder (ARND):

Answer 98

-a condition caused by prenatal alcohol exposure -conditions include cognitive impairments, learning difficulties, and behavioral problems

Question 99

For every child diagnosed with FAS, many more with FASD go undiagnosed until:

Answer 99

-problems develop in the preschool years

Question 100

Common complications among adolescent mothers include:

Answer 100

-iron deficiency anemia -prolonged labor, due to mother physical immaturity)

Question 101

a pregnant teenager with a BMI in the normal range is encouraged to gain about ?? pounds to reduce the likelihood of a low-birthweight infant

Answer 101

35

Question 102

The AAP recommends that infants receive breast milk for at least the first ?? months of life and beyond for as long as mutually desired by mother and child

Answer 102

12

Question 103

The AAP and the AND recognize exclusive breastfeeding for ?? months and breastfeeding with complementary foods for at least 12 months as an optimal feeding pattern for infants

Answer 103

-6

Question 104

What is the only acceptable alternative to breast milk?

Answer 104

-iron fortified formula

Question 105

A nursing women produces about how many ounces of milk a day?

Answer 105

-25

Question 106

during the first 6 months of lactation a women should eat an additional ?? kcalories per day above regular intake

Answer 106

-330 because she spends 500kcalories in order to produce milk

Question 107

During the second 6 months of lactation, an additional ?? kcalories each day is recommended

Answer 107

400

Question 108

Many women who follow recommendations for gestational weight gain and breastfeeding can readily return to prepregnancy weight by ?? months.

Answer 108

6

Question 109

nutritional deprivation of the mother USUALLY reduces the ??, not the ??, of her milk

Answer 109

-quantity -quality

Question 110

The nutrients in breast milk that are most likely to decline in response to prolonged inadequate intakes are:

Answer 110

-vitamins—especially vitamins B6, B12, A, and D

Question 111

The volume of breast milk produced depends on:

Answer 111

-how much milk the infant demands, not on how much fluid the mother drinks

Question 112

How much water is a nursing women advised to drink?

Answer 112

-13 cups a day

Question 113

Foods with strong or spicy flavors (such as onions or garlic) may alter:

Answer 113

- the flavor of breast milk

Question 114

Birth control pills that combine the hormones estrogen and progestin seem to:

Answer 114

-suppress milk output, -lower the nitrogen content of the milk, -shorten the duration of breastfeeding

Question 115

progestin-only contraceptive pills have:

Answer 115

-no effect on breast milk or breastfeeding and are considered appropriate for lactating women