Foetal Growth Flashcards
Outline nutritional requirements in neonates, children, adolescents and pregnant women and apply this knowledge to clinical scenarios of dietary insufficiency i.e. calorie insufficiency, vit D deficiency, iron deficiency.
Trimesters in weeks
1 = 0-13 wks 2 = 14-26 wks 3 = 27 - 40 wks
3 main stages off foetal growth
wks 0-2 Blastogenesis Stage
Zygote rapidly divides & embeds into endometrial lining; uterus wall.
wks 2-8 Embryonic Stage
Rudiments of principle organs and membranes develop. Nutrients are primarily from maternal blood.
wks 8-40 Foetal Stage
Nutrients supplied via placenta. The tissues and organs continue to grow.
Periconceputal
Immediately prior to conception and early gestational Phase
Critical Period of Development
Embryonic Stage wk 2 -8
as a lack of certain nutrients may cause specific congenital abnormalities
Majority of Foetal growth takes place
90% of Foetal growth takes place during the second half of pregnancy
Estimated Energy Requirements for Pregnancy
estimated energy cost of 40wk pregnancy is 322MJ/7700kcal
Energy Requirements for Pregnancy
1st trimester has a low rate energy demand, whilst third trimester needs additional increment to cope with increased energy demand.
Neural Tube Defects
Anencephaly - incomplete closure of upper end of the neural rube
Spina Bifida - incomplete closure of Spinal cord (Split spine)
Nutrients in Pregnancy
Vit A
In pregnancy recommended:
Avoiding excess and deficiency;
ensuring avoiding retinol food like liver, oils and supplements. Instead incorporating milk, eggs, carrots and leafy greens B-carotene’s the body naturally changes to retinol in excess
Nutrients in Pregnancy
Vit D
In pregnancy recommended:
Low vit D leads to congenital rickets and impaired foetal/infant skeletal growth in absence of rickets.
RNI is 10µg a day
Nutrients in Pregnancy
Calcium
In pregnancy recommended:
Required for calcification of foetal skeleton
RNI 700mg a day
Maternal adaptions for Ca requirements
The female body adapts to meet calcium requirements by
– ↑ intestinal absorption of dietary Ca
– ↑ reabsorption of Ca by kidneys = enhanced retention
– ↑ bone turnover to release Ca
Nutrients in Pregnancy
Iron
The maternal requirement increases as pregnancy progresses.
There can be infant Fe deficiency anaemia due to maternal Fe deficiency anaemia
Fe insufficency can increase chance of preterm delivery
Maternal adaptions for Fe requirements
Female body adapts via Amenorrhoea, ↑ absorption of dietary of non-haem Fe Mobilisation of maternal stores Foetus also acts like a parasite drawing on maternal stores
Exclusive breastfeeding
No food or drink inc water except for breast milk
