Guidance For The Pregnant Athlete Flashcards

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1
Q

Define infecundity and infertility

A

Infecundity: unable to get pregnant or carry child to term

Infertility: inability to get pregnant after 12 months of trying

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2
Q

What are benefits of exercise for pregnant athletes

A

Lower maternal weight

Decreased odds of cesarean delivery

Reduce odds of a large newborn, without altering risk of having a small newborn

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3
Q

What is vigorous intensity physical activity defined as

A

6.0 metabolic equivalents of training

60-84% of aerobic capacity reserve (or heart rate reserve)

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4
Q

Signs stress may be too high in the pregnant athlete

A

Low energy availability

Menstrual dysfunction

Low bone mineral density

Substantial loss of weight

BMI less than 18.5

Body fat <12%

Elevated blood pressure

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5
Q

List adverse reproductive outcomes for those experiencing prepartum obesity

A

Gestational diabetes

Hypertension

Preeclampsia

Miscarriage

Caesarian delivery

Preterm delivery

Postpartum weight retention

Fetal growth disorders

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6
Q

Even a reduced energy availability of less than 45 kcal/kg of FFM in female athletes can lead to

A

Menstrual irregularities

Decreased bones mass

Slow metabolic rate

Trigger hypoglycemia

Elevate blood cholesterol

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7
Q

What diet is associated with a reduced risk of impaired ovulation

A

Plant based diet

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8
Q

What nutrient is linked to supporting infertility and what blood values are associated with a successful fertility

A

Trans fat

Folate and vitamin B6

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9
Q

The use of what has been linked with a 73% lower incidence of infertility in women

A

Prenatal vitamin likely due to improving ovarian function

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10
Q

List benefits of folate for pregnancy

A

Enhance ovarian response to internal gonadotropin resulting in enhanced ovulation and fertility

Reduced risk of miscarriage

Reduce risk for neural defects such as spina bifida and anencephaly

Reduce risk of congenital heart disease and cleft lip and palate

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11
Q

Fetal benefits of a mother who eats healthy and exercises

A

Decreased fat mass

Improved stress tolerance

Advanced neurobehavioral maturation

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12
Q

List symptoms of pregnancy

A

Unusual fatigue

Abnormal eating habits

Dyspnea

Nausea

Bouts of dizziness

Heartburn

Constipation

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13
Q

During what trimester(s) is fatigue most likely to be present

A

First and third trimesters

Second trimester is usually accompanied by an increase in energy

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14
Q

What is severe nausea and vomiting called

A

Hyperemesis gravidarum

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15
Q

What negative effects can hyperemesis gravidarum lead to

A

Intrauterine growth retardation

Childhood insulin resistance

Psychological disorders in adulthood

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16
Q

Treatment protocols for morning sickness

A

Eat small, frequent meals to avoid an empty stomach or feelings of hunger

Eat dry, salty, and bland foods such as crackers

Incorporate protein rich foods at each feeding

Use an electrolyte enhanced effervescent in water, homemade oral rehydration solution, or sports drinks to aid in rehydration in cases of vomiting

Use vitamin B6 up to 200 mg/day

Use ginger products up to 1000 mg/day

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17
Q

Treatments for constipation during pregnancy

A

Increase fluid intake

Be physically active

Increase fiber intake

Supplement fiber with adding 4-6 tablespoons of bran or a daily dose of psyllium, methylcellulose, or polycarbophil

Use probiotics such as bifodobacterium lactis

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18
Q

Treatment of GERD symptoms during pregnancy

A

Avoid acidic and spicy food, caffeine, carbonated beverages, chocolate, and peppermint

Limit intake of animal fats, plant based diets can help

Eat smaller, more frequent meals not close to bedtime

Wear loose fitting clothes

Medications include histamine 2 receptor antagonists, proton pump inhibitor, and antacids

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19
Q

Treatment for frequent urination during pregnancy

A

Reduce fluid intake before bedtime

Don’t resist the need to urinate

Wear a sanitary pad

Perform kegel exercises

20
Q

Treatment options for musculoskeletal dysfunction during pregnancy

A

Physical therapy

Bracing or external support

Passive stretching and deep tissue massage

Inconclusive evidence to support the use of magnesium, calcium, and vitamin C

21
Q

What is the increase in BMR for healthy and overweight/obese women along with recommended energy intake during the first, second, and third trimester

A

First trimester
Healthy BMI: 5%
Elevated BMI: 7% increase
Energy needs: 45 kcal/kg prepregnancy fat mass + energy exhausted during physical activity

Second trimester:
Healthy BMI: 11%
Elevated BMI: 16%
Energy needs: 45 kcal/kg prepregnancy fat mass + energy exhausted during physical activity + 340 kcal

Third trimester:
Healthy BMI: 24%
Elevated BMI: 36%
Energy needs: 45 kcal/kg prepregnancy fat mass + energy exhausted during physical activity + 452 kcal

22
Q

What is the estimated overall energy cost from conception through delivery

A

75000-85000 kcal

23
Q

What food and beverage options are allowed in low risk women in the active phase of labor and why

A

Small amounts of clear liquids and foods:

Water
Fruit juice without pulp
Broth
Gelatin products
Carbonated beverages
Tea and black coffee
Sports drinks
Ice pops

Reduce likelihood of ketone production leading to ketoacidosis

24
Q

What are contraindications for providing food during labor

A

Eclampsia

Preeclampsia

Obesity

Use of opioids to manage pain

25
Q

Carbohydrate recommendations for sedentary and moderately physically active women prepregnancy and pregnancy

A

Sedentary

Prepregnancy: 130 g/day carbs
Pregnancy: 175 g/day carbs

Moderately physically active

Prepregnancy: 5-7 g/kg/day carbs
Pregnancy: 5-7 g/kg/day + 45 g carbs

26
Q

Protein recommendations for sedentary and physically active pregnant women

A

Sedentary women:
First trimester: 0.8 g/kg/day
Second and third trimester: 1.1 g/kg/day of prepregnancy weight or an additional 25 G protein for single pregnancies and 1.4 g/kg/day of prepregnancy weight or an additional 50 G protein for twins

Physically active women:
- Typically consuming 1.2-2.0 g/kg/day already
- Recommend to add 25 g for single pregnancies and 50 g for twins

27
Q

What are daily fat, omega 3, and omega 6 recommendations for pregnancy

A

Daily fat: 20-35%

Omega 3: 1.4 g/day

Omega 6: 13 g/day

28
Q

Iron recommendations during pregnancy

Daily
Ferritin greater than 70 ug/L
Ferritin between 31-70 ug/L
Ferritin between 15-30 ug/L
Ferritin less than 15 ug/L

A

Daily: 27 mg/day

Ferritin greater than 70 ug/L: no iron supplements

Ferritin between 31-70 ug/L: 30-40 mg ferrous iron/day

Ferritin between 15-30 ug/L: 60-80 mg ferrous iron/day

Ferritin less than 15 ug/L: 100 mg ferrous iron/day

29
Q

Folate needs prepregnancy and pregnancy

A

Prepregnancy: 200 mcg/d

Pregnancy: 600 mcg/d

30
Q

Foods high in folate

A

Asparagus

Avocado

Dried beans

Fortified grains

Green leafy vegetables

Oranges

Peas

31
Q

RDA for vitamin b12 during pregnancy and food sources

A

2.6 mcg/day

Eggs, cheese, milk products, meat, fish, shellfish, poultry, soy foods, fortified grains

32
Q

RDA for zinc in prepregnancy and pregnancy and what 2 populations are at risk for deficiency

A

Prepregnancy: 8 mg/d

Pregnancy: 11 mg/d

At risk: plant based dieters and low income

33
Q

RDA for vitamin d prepregnancy and pregnancy

A

Prepregnancy: 10 mcg or 400 IU

Pregnancy: 15 mcg or 600 IU

34
Q

List most common micronutrients associated with pregnancy issues if deficient

A

Folate

Choline

Vitamin B12

Vitamin D

Iron

Iodine

Zinc

35
Q

Fluid requirements during pregnancy

A

3 L/day

36
Q

What food or beverage products are contraindicated for use during pregnancy

A

Raw fish and shellfish
Seafood with high mercury content
Undercooked meat and poultry
Raw or soft cooked eggs
Unpasteurized foods
Unwashed fruits and vegetables
Raw sprouts
Caffeine
Alcohol
Dietary supplements

37
Q

List foods or food products containing raw or undercooked eggs

A

Eggnog
Custard
Cookie dough
Cake batter
Hollandaise
Mayonnaise
Caesar salad

38
Q

List raw sprouts

A

Alfalfa

Clover

Radish

Mung beans

39
Q

List unpasteurized soft cheeses

A

Queso

Camembert

Brie

Feta

Blue cheese

40
Q

Recommendation for caffeine intake during pregnancy and hidden sources of caffeine

A

Less than 200 mg/day

Guarana
Yerba mate
Kola or kola nut
Cocoa
Citrus aurantium (bitter orange)

41
Q

How does caffeine, alcohol, and certain dietary supplements reach the fetus

A

By crossing over the placenta

42
Q

Singleton weight gain recommendations per IOM and American College of Obstetricians and Gynecologists

Underweight athlete
Healthy BMI
Overweight BMI
Obese BMI

A

Underweight athlete: 28-40 lbs

Healthy BMI: 25-40 lbs

Overweight BMI: 15-25 lbs

Obese BMI: 11-20 lbs

43
Q

Twin pregnancy weight gain recommendations per IOM

Healthy BMI
Overweight BMI
Obese BMI

A

Healthy BMI: 37-54 lbs

Overweight BMI: 31-50 lbs

Obese BMI: 25-42 lbs

44
Q

Rate of weight gain for pregnant women in second and third trimester

Healthy BMI
Singleton
Twins
Overweight
Obese

A

Healthy BMI
Singleton: 1 lb/week
Twins: 1.5 lb/week

Overweight: 0.6 lb/week

Obese: 0.5 lb/week

45
Q

What is mean milk production and energy cost of it

A

Mean milk production: 749 g/day or 26 oz/day

Energy cost: 453 kcal/day or 17 kcal/oz

46
Q

Daily energy recommendations for breastfeeding women

A

45 kcal/kg of FFM/day + 300-500 kcal/day + physical activity energy expenditure

47
Q

Recommended weight loss postpartum should not exceed

A

4.5 lbs/month