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FN 2241 > Lecture 3 - Part II > Flashcards

Lecture 3 - Part II Flashcards

1
Q

Why is being underweight a bad thing if you are trying to conceive?

A

Increase risk of preterm birth and perinatal mortality

-BMI less than 18.5kg/m^

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2
Q

If you are underweight, what is the recommendation if you are trying to conceive?

A

Should gain extra weight during pregnancy (28-40lbs) in order to retain some weight gained for own stores

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3
Q

Why is being overweight a bad thing if you are trying to conceive?

A
  • Increase risk of GDM and postpartum infections
  • More likely to have complications at labor and delivery
  • infant more lily to be born post term, high BW or macrocosmic
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4
Q

If you are overweight, what is the recommendation if you are trying to conceive?

A

Should avoid excessive Wt gain during pregnancy (15-25lbs) because they already have the extra fat stored you would normally need if they were at a normal wt

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5
Q

How much weight should each person gain depending on their weight pre-pregnancy?

A

Under: 28-40lbs
Normal: 25-35lbs
Over: 15-25lbs
Obese: 11-20lbs

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6
Q

When pregnant, how much weight gained goes towards what baby needs?

A 
Breasts: 1-2lbs
Baby: 6-8lbs
Placenta: `1-2lbs
Uterus: 1-2lbs
Amniotic fluid: 2-3lbs
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7
Q

When pregnant, how much weight gained goes towards what mom needs?

A

Your blood: 3-4lbs
Your protein and fat storage: 8-10lbs
Body fluids: 3-4lbs

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8
Q

When do body fat stores increase the most?

A

Between 10 and 20 weeks then decrease towards the end

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9
Q

What % of the placenta males up the baby weight?

A

15-20%

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10
Q

How does mom get rid of the extra fluid in her body?

A

Mom pees a lot of it out in the first 48hrs

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11
Q

What happens when mom breastfeeds?

A

uterus contracts a little so it can get back down to the size it was, can be painful cramp feeling

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12
Q

How much weight should you gain in the 1st T?

A

2-8lbs

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13
Q

For the 2nd and 3rdT, how much weight should you gain?

A 
~1lb/wk (norm)
>1lb/wk (under)
~0.7lb/wk (over)
~0.5lb/wk (obese)
~1.5lb/wk (twins)
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14
Q

What rate of weight gain is more stable during pregnancy, maternal or fetal?

A

Maternal is more steady

Fetal has more variation in exponential growth periods

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15
Q

What are the risks of inadequate wt gain?

A

Increase maternal factors such as:

  • low SES
  • single moms
  • minority groups
  • cigarette smokers
  • history of eating disorders
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16
Q

What happens when you have a large weight gain over a short period of time?

A

Water retention leads to signs of preeclampsia which is very risky for mom and baby

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17
Q

What is preeclampsia characterized by?

A

Hypertension
Water retention
Proteinuria (abnormal quantities of protein in the urine)

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18
Q

what is the recommended amount of weight to be lost after having a baby?

A

Initially you lose weight from baby and water but after should do 1-4 pounds per month until pre-pregnancy weight it achieved.

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19
Q

What happens if weight is lost too quickly after birth?

A

Can sacrifice milk production and effect quality and energy status

Should nourish adequately and exercise cautiously

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20
Q

What happens if you gain more weight than needed while pregnant in terms of weight loss?

A

The more the weight will be retained and it may take longer to lose

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21
Q

What is the placenta?

A

Organ that develops inside thee uterus in pregnancy, in which maternal and fetal blood circulate in close proximity so that materials can be exchanged between them

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22
Q

What are the main functions of the placenta?

A

Hormone and enzyme production
Site of breathing and exchange
Protection from harmful elements

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23
Q

What is able to cross into the placenta if mom ingests it/

A

Alcohol
Excess Vitamins
Drugs
Viruses

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24
Q

When does the placenta develop?

A

Precedes fetal development

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25
Q

How much does the placenta weigh in relation to the baby?

A

Its larger than the fetus for most of the pregnancy

Weight about 15% of the weight of the fetus at birth

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26
Q

How does the moms blood enter the placenta?

A

Enters through uterine arteries

  • bathes placental villi
  • Leaves via uterine veins with waste products
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27
Q

How does the baby blood interact with the placenta?

A

Circulatesfrom umbilical artery

  • into placental villi
  • out through umbilical vein
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28
Q

What is the hCG and what does it do?

A

Human chorionic gonadotropin

  • produced bu chorionic villi in placenta
  • incfreases progesterone and estrogen secretion
  • increases rapidly in early pregnancy
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29
Q

When we are taking a pregnancy test what is the test looking for?

A

hCG in urine/plasma

-higher the level the further along you are

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30
Q

What is hCS and what does it do?

A

Human chorionic Somatotropin

  • produced by placenta during second half of pregnancy
  • increase maternal insulin resistance
  • increase protein synthesis
  • increase fat breakdown
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31
Q

What does the increase in estrogen lead to when the placenta tells it to increase it levels?

A

Increase in:

  • lipid formation and storage
  • Protein synthesis
  • uterine blood flow
  • development of uterus and Brest ducts

Promotes flexibility in ligaments

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32
Q

What does the increase in progesterone lead to when the placenta tells it to increase it levels?

A
  • Maintains implanted embryo
  • Stimulates endometrial growth
  • Relaxes smooth muscles
  • Increase breast development
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33
Q

What is the amniotic sac?

A

Fluid filled ballon structure that houses the developing fetus
-fetus can drink some water and nutrients from the amniotic fluid in the second half of pregnancy

34
Q

What is the umbilical cord?

A

Ropelike structure containing blood vessels that extend from fetus umbilicus to placenta

35
Q

Who gets priority for nutrients, baby or mom?

A

It varies based on:

  • Short term malnutrition
  • Longterm malnutrition
  • Vitamins/minerals
  • Maternal weight and age
36
Q

What can maternal malnutrition lead to?

A

Limits placental development
Decrease blood flow and nutrient availability across placenta
Impairs fetal development
Exerts effect during critical periods of development

37
Q

when does maternal nutrient metabolism in pregnancy start and why?

A

Immediately

To accommodate needs of fetus

38
Q

What is affected during maternal nutrient metabolism in pregnancy?

A

Macros
Minerals
Fasting

39
Q

When do we need carbs throughout pregnancy and why?

A

All throughout, but mrore in 3rdT

To make glucose available to fetus because its the preferred energy source

40
Q

What happens with carbs in the first 20wks vs the last 20wks?

A

First
-E&P cause an increase in insulin production which leads to an increase in conversion of glucose to glycogen and fat

Second

  • moms pituitary secretes hCS which decreases the conversion of glucose to fat and glycogen
  • Slight insulin resistance in mom leads to decrease use of glucose
  • increased liver production of glucose for fetal development
41
Q

When do we need protein throughout pregnancy and why?

A

All throughout, protein storage needs to be continually met

Nitrogen and protein are needed for synthesis of new maternal and fetal tissue

42
Q

What happens to protein in the body when you’re pregnant?

A
  • Body excretes less nitrogen and conserves amino acids
  • Mom needs to increase intake of protein
  • About 2 pounds of protein accumulate during pregnancy
43
Q

When do we need fat throughout pregnancy and why?

A

Throughout

Major reason: need essential fatty acid (DHA)

  • Accumulation on fat stores in baby in 3rdT,
  • mom fat stores for post birth
44
Q

What happens with fat in the first 20wks vs the last 20wks?

A

First:
-Increase accumulation of fat stores

Second:
-Increase use of fat for energy

45
Q

What happens when blood lipids levels increase?

A
  • Used by placenta for steroid hormones synthesis

- Used by fetus for nerve and cell membrane formation

46
Q

What might high levels of triglycerides indicate during pregnancy?

A

High levels of TG during pregnancy may indicate insulin resistance pre-pregnancy and therefore increase risk of GDM and hypertension development during pregnancy

47
Q

When do we need water and minerals throughout pregnancy and why?

A

Throughout

To ensure baby gets what baby needs and also what mom needs

48
Q

What happens when we consume these minerals?

A

Ca: increase bone turnover and reformation

Na: kidneys support extra retention

49
Q

When do we see fasting metabolism throughout pregnancy and why?

A

When: fasting for longer than 12 hours

  • poorly controlled diabetes
  • focus on weight loss instead of the caloric needs of pregnancy

Why: to spare glycogen stores/glucose sfor fetus
• Body will give baby what it needs to the sacrifice of mom but only to a certain extent

50
Q

What happens when the metabolism is fasting?

A

Glucogenic amino acid use
Fat oxidation
Production of ketones

51
Q

When the fetus is relying on ketones what are the results?

A

Reduced growth

Impaired intellectual development

52
Q

since energy needs increase during pregnancy, what % of the energy goes towards the fetus?

A

Fetus accounts for ~33% of the increased energy needs

53
Q

What is the recommended energy intake for all the trimesters?

A

1: 0
2: 340
3: 452

54
Q

What are the energy needs during pregnancy if you are not active?

A

Considerably lower

-common to have low levels of energy expenditure from physical activity in the first T

55
Q

What type of physical activity is recommended and not recommended?

A

Recommended: Swimming, walking, prenatal yoga, strengthen pelvic floor

Not recommended: anything that makes mom too hot

56
Q

What is the recommended protein intake during pregnancy?

A

71g/day

or 0.8g/kgBw/day + 25g

Protein supplements offer no benefit

57
Q

What are the carb requirements for pregnancy?

A

45-65% of total caloric intake during pregnancy should be form carbs

175g/day - but most women need more than this

58
Q

How much fat should pregnant women consume?

A

33% fat
-fat consumed in food is used for energy

Need adequate good fats like non and polyunsaturated, should minimize saturated and trans

59
Q

Why is DHA important?

A

For growth and development of the fetal brain and nervous system

Adequate DHA and EPA and lactation liked to increased intelligence, better vision and More mature CNS

60
Q

What is the recommendation for EPA and DHA?

A

No more than 3g/day
-can thin blood and not clot properly and lead to increase in haemorrhage at birth

Min 300mg/day

61
Q

What is the serving of fish and what fish should we chose?

A

150g of cooked fish each week

CHose with low contaminants:

  • salmon
  • trout
  • Herring
  • Canned light tuna
  • Pollock
62
Q

What are the recommendations for pregnant women for folate B12 Fe and Zn

A 
Folate: 600mcg/day
-assumes 400 from a supplement
B12: 2.6mcg/day
Fe: 27mg/day
Zn: 11mg
63
Q

Why is folate needed?

A

Normal development of spine, Brian and skull of the fetus during the first 4 weeks of pregnancy

  • day 21-27 is the most important
  • problem is most women don’t know that they are pregnant during this stage
64
Q

What could a deficiency in folate lead to I pregnancy?

A

Abnormal cell dividsion and tissue formation

Mehtionine shortage
-due to inadequate conversion of homocysteine to methionine as folate is needed for this process

65
Q

Why is B12 important for pregnancy?

A

Women with B12 deficiency early in pregnancy are more likely to have a child with a neural tube defect

It is critical to effective functioning of the nervous system and production of red blood cells

66
Q

Why is Fe important during pregnancy?

A

More Fe is needed to make hemoglobin

  • for the growth of the baby and placenta in 2nd and 3rdT
  • if a women is pregnant with insufficient store her requirement is even more
67
Q

How long do baby Fe store last when born?

A

4-6 months

68
Q

What is the deficiency that can occur from low Fe?

A

Fe-deficiency anemia

-results in LBW, PTB and infant mortality

69
Q

What can help with Fe absorption in baby?

A

Allowing the cord to be attached for 10-15 min or at least until the placenta stops pulsing

70
Q

Why is Zn important during pregnancy?

A

Very important for rapid cell growth

-associated with LBW and miscarriage

71
Q

What are sources folate?

A 
Dark leafy greens
Dried beans
Broccoli
Asparagus
Oranges/Pineapple juice
Fortified lour and grains
72
Q

What are sources of B12?

A 
Animal products
Milk products
Ready to eat cereals
Nutritional Yeast
Fortified Soy
73
Q

What are sources of Fe?

A 
Meat
Legume
Tofu
Spinach
Prunes/apricots/figs
Fortified Cereals
74
Q

What are sources of Zn?

A 
Meat
Grains/bread
Milk products
Black beans
Ready to eat cereals
Nuts
75
Q

What are the recommendation for Ca and Vitamin D during pregnancy?

A

Ca: RDA 1000MG/DAY

VIT D: RDA 15MINCROGRAMS/DAY OR 600IU

76
Q

What can insufficient Ca intake lead to?

A

Baby will draw its stores from moms bones and can impair maternal health over time

77
Q

Why is vitamin D need during pregnancy?

A

Helps maintain proper levels of Ca which are related to the growth of the baby bones and teeth

Growth retardation, skeletal deformities, preeclampsia, are all associated with Vitamins D deficiency

78
Q

what are the water needs during pregnancy?

A

AI= 3L/d

79
Q

What is the purpose of water during pregnancy?

A
  • drinking extra helps with swollen ankles and feet
  • Carries nutrients through women blood to baby
  • inadequate consumption can cause contractions that can trigger PTB
  • Need a lot for breastfeeding cause you are losing water from your body by having a baby so need to keep that level up
80
Q

What is the fibre recommendation during pregnancy?

A

AI= 28g/day

-prevent and reduce indigestion, constipation and heartburn

81
Q

What should be in a prenatal supplement?

A

Fe: 30g
Folic Acid: 600microgram
Ca

82
Q

If you are a vegetarian during pregnancy what should you be cautious of?

A

Protein sources: soy, yogurt, tofo quinoa

-complementary proteins

FN 2241 (12 decks)

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