End of Maternal Nutrition (2)

Question 1

Pregravid Obesity

Answer 1

• Still Birth
• LGA
• C-Section
• Bariatric Surgery
  
  • Delay for 1-2 years b/c absorption and metabolism problems
  • Thiamine, folate, Fe, Ca, Vit D, B12

Question 2

Pregravid HTN

Answer 2

• Requires close BP monitoring
• BP often declines in first trimester
• Prevent weight extremes
• Moderate (if not restricted) sodium intake

Question 3

Pregravid DM

Answer 3

• Associated with increased incidence of preeclampsia, fetal morbidity and mortality
• Close **BG monitoring **→ Avoid high glucose
• High BG → more calories to baby → larger babies
• Lower insulin requirements in 1st half b/c hormonal changes
• Increased insulin required in 2nd half
• Frequent changes with diet and insulin dosage
• Dramatic decreased insulin at delivery
• After delivery, infant hypoglycemia is concern

Question 4

Maternal PKU

Answer 4

• Uncommon inherited disorder
• Strict low phenylalanine diet - supplement with specialized formulas of AA (tyrosine) prior to conception and during preg
• Circulating phenylalanine → brain damage, microcephaly (small head), LBW and heart defects
  
  • Strict compliance is no guarantee for normal intelligence → some advise PKU women not to have kids
  • Only risk-free choice is to avoid preg
• All newborns now screened for PKU at birth