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HUNT243 > Lecture 2 > Flashcards

Lecture 2 Flashcards

Preconception, Pregnancy and Lactation

1
Q

Before pregnancy

A

Increasing evidence demonstrating that parents diet and lifestyle can have profound implications for the growth, development, and long-term health of their children before their conception.

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2
Q

What has a big influence on the placental development and function

A

The maternal nutrition at the time of conception

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3
Q

what is directly tied to maternal periconception

A

Fetal genomic imprinting and programming at conception is directly tied to maternal periconception nutrition and childs long term health

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4
Q

Preconception time frame

A

The period before (at least 2 years) and between consecutive pregnancies.

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5
Q

What does Preconception improve

A

To improve health related outcome for women (regardless of their pregnancy status), newborns and children up to 5 years of age.

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6
Q

Boundary of preconception is divided into

A

Proximal and distal period

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7
Q

Proximal preconception

A

Period preceding pregnancy (up to 2 years prior to conception

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8
Q

Distal preconception

A

Adolescence or in general a longer time before pregnancy

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9
Q

Periconception time frame

A

The period preceding, including and immediately following human conception

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10
Q

what does periconception improve

A

to improve health related outcomes for women, newborns and children up to 5 years

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11
Q

Periconception boundary

A

3 months before pregnancy to up to the first trimester

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12
Q

Criticial window of opportunity (5 stages)

A
  • Pre conception
  • Pregnancy
  • Birth- 6 months
  • 6-12 months
  • 1-3 years
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13
Q

Number of days for critical window

A

First 1000 days of life= Critical window

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14
Q

Nutrition during pregnancy and the two years of the childs life is key for

A

brain development, healthy growth and a strong immune system

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15
Q

The 5 steps to periconception period

A

Gametogensis
Fertilisation
Implantation
Embryogenesis
Placentation

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16
Q

what are the 5 important factors that we need to keep in mind for a health status

A

-Optimise Health
-Folic acid
-Iodine
-Healthy diet and lifetyle
-Excess weight

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17
Q

Optimise Health

A

Ensure any existing health conditions are being treated and managed

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18
Q

Folic acid

A

Supplement at least a month before trying to conceive

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19
Q

Iodine

A

Supplement if planning to conceive

20
Q

Healthy Diet and lifestyle

A

Follow a healthy diet and lifestyle and cease smoking

21
Q

Excess weight

A

Reduce excess weight for both men and women

22
Q

Obesity generally indicated by a BMI

A

> 30 kg/ m^2

23
Q

Are Obese men and women infertile or sub-fertile

A

Subfertile

24
Q

Obese women tend to have higher levels of

A

estrogen, androgens and leptin than non-obese

25
Q

By how much more of a percent is menstrual cycle irregularity in obese women

as well as

A

30-47%

ovulatory failure and amenorrhea

26
Q

Obesity in men is associated with lower levels of

A

Testosterone and increased estrogen and leptin levels

27
Q

What are two other things that are increased for obese men

A

Reduced sperm production and increased erectile dysfunction

28
Q

weight loss exceeding 10-15% decreases

A

estrogen, LH and FSH

29
Q

what is the critical body fat which can sustain normal reproductive functions

A

BMI >20 kg /m^2

30
Q

Long term consequences of undernutrition on fertility and offspring health revealed during country famines

A

Dutch famin in 1944-45

31
Q

Periconception and the important micronutrients that need to be considered (7)

A

Choline
Iron
Iodine
Zinc
Omega 3 fatty acids and B12
Multivitamins
Folic acid

32
Q

Folic acid

A

Neural tube defects
Congenital Malformations
Preeclampsia
Autism Spectrum Disorder
Increased sperm count and viability

33
Q

Periconceptional folic acid

A

2010 Cochrane review confirmed that folic acid supplementation prevents the first and second time occurence of neural tube defects

34
Q

Neural tube defects happen

A

even before some women even know they are pregnant

35
Q

If you are planning a pregnancy you need to take how much folic acid

A

Take 800mcg folic acid tablet at least 4 wks before and 12 wks after becoming pregnant

36
Q

Women who ten to take folic acid are people of a

A

higher education, higher income, older age, NZ European

37
Q

Unplanned pregnancies

A

40% mistimed
60% Unwanted

38
Q

Folic acid fortification

A

Over 80 countries have introduced mandatory folic acid fortification

39
Q

Mandatory folic acid fortification in what in NZ

A

Bread

40
Q

Bread increases the folic acid amount per day and
Decreases the chance of

A

136ug folic acid per day to women of childbearing age

expected to reduce the annual rate of NTD-affected pregnancies between 4 to 14

41
Q

why withdraw from fortification

A

-Safety concerns
-“Nanny” state critics
-Bakers worried about the cost and safety

42
Q

There are still concerns for some people in what categories not getting enough folic acid

A

No gain for individuals with wheat allergy or coeliac disease

43
Q

Dutch famine = Hunger winter

A

Famine that took plave in the German ossipied part of the Netherlands especially in the densely populated western provinces, during the winter of 1944-45, near the end of world war II

44
Q

The dutch famine found that children of pregnant women exposed to the famine were more

A

susceptible to diabetes, obesity, cardiovascular disease, microalbuminuria and other health problems

45
Q

Children were not only smaller but

A

Their children were also smaller

46
Q

Barker Hypothesis

A

The fetal origins hypothesis states that fetal under nutrition in middle to late gestation, which leads to disproportionate fetal growth, programmes later coronary heart disease

47
Q

New Zealand recommendations supplementation during pregnancy

A

Folic acid (800ug), iodine (150ug), vitamin D and Iron

Only take other supplements on the advice of a doctor or midwife

HUNT243 (9 decks)

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