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HUNT243 > Lecture 5 > Flashcards

Lecture 5 Flashcards

Maternal weight gain during pregnancy

1
Q

(Twins) healthy weight (BMI 18.5 to 24.9)

A

Recommended weight gain =17kg- 25kg

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2
Q

(Twins) overweight (BMI 25 to 29.9)

A

Recommended weight gain =14kg- 23kg

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3
Q

(Twins) Obese (BMI 30 or more)

A

Recommended weight gain =11kg - 19kg

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4
Q

Gestational weight gain (made up of several components)

A
  • Water 62%
  • Fat mass 30%
    -Fat-free mass 8%
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5
Q

Fetal weight gain is about …. of ….

A

Fetal weight gain is about 25% of total weight gained

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6
Q

How much percent of fetal growth occuring in the second half of pregnancy

A

90%

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7
Q

The rate of gestational weight gain in the 1st trimester

A

Low

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8
Q

The rate of gestational weight gain in the 2nd trimester

A

1/3

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9
Q

The rate of gestational weight gain in the 3rd trimester

A

2/3rds

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10
Q

Maternal fat stores are gained predominantly between

A

The 10th and 30th week of gestation

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11
Q

1st and early 2nd trimester reflects

A

deposition and expansion of maternal tissue

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12
Q

what are the two things that are gained in late in 2nd trimester to end of pregnancy

A

Fetal placental and accumulation of amniotic fluid

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13
Q

NZ guidlines: Pre pregnancy

A

Focus on obese women

Higher BMI and lower education is associated with greater GWG

2/3rd women incorrectly identified appropriate weight gain

Overweight and obese women were more likely to overestimate appropriate weight gain vs normal weight women

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14
Q

During pregnancy someone of a high BMI and lower education has higher

A

GWG

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15
Q

Meta -analysis of GWG what percentage were above or below the recommended GWG

A

70%

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16
Q

Midwives knowledge of GWG

A

midwives and obstetricians knowledge level of GWG is generally low

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17
Q

GWG Bottom Line

A

awareness of weight monitoring and target weight guidlines

Improved training in communication skills and behaviour for health professionals

standardisation of registration of BMI and GWG in perinatal database

Future research studies on the effectiveness of preconception and during pregnancy health programs

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18
Q

Higher GWG can lead to higher BMI for

A

adolescent life and you maintain the weight after the first pregnancy for your second pregnancy and so on

19
Q

Obesity is arguably the biggest challenge facing maternity services today. It is a challenge not only because of the magnitude of the problem… but also

A

because of the impact that obesity has on womens reproductive health and that of their babies

20
Q

Maternal obesity : pecentage in the world and is it higher for men or women

A

39% of adults in the world= excess weight

Rate is higher among women than men

21
Q

Problems with maternal obesity

A
  • A metabolic and reproductive complication
  • A technical problem affecting clinical issues such as ultrasound scanning “high risk” pregnancy
22
Q

with an obese mother it increases the risk of

A

miscarriage and stillbirths by 25-37%

Pregnancy induced hypertension

Venous throboembolism (Blood clot within vein

Delivery complications

Gestational diabetes mellitus

23
Q

Gestation diabetes

A

Gestational diabetes mellitus is a condition in which women without previously diagnosed diabetes exhibit high blood glucose levels during pregnancy few symptoms

24
Q

How common is gestational diabetes

A

affects 3-10% of pregnancies

25
Q

gestational diabetes accounts for ? percentage of cases of diabetes in pregnancy

A

90%

26
Q

In NZ how many women are diagnosed with gestational diabetes per year

A

3000-4000

27
Q

how much is gestational diabetes increasing per year

A

8-9%

28
Q

Prevoius diagnosis of gestational diabetes or prediabtes impaired

A

glucose tolerance, or impaired fasting glycaemia

29
Q

you are more at risk for GDM if

A

family history

maternal age- a womens risk factor increases as she gets older (especially above the age of 35)

Previous pregnancy which resulted in a child with a high birth weight

30
Q

Gestational diabetes: complications for the baby

A

High maternal blood glucose exposes the fetus to higher glucose

31
Q

Higher blood glucose for the baby leads to

A

Increased fetal levels of insulin (insulin itself cannot cross the placenta)

32
Q

The growth stimulating effects of insulin can lead to

A

excessive growth and macrosomia (fetal overgrowth)

33
Q

Having gestational diabetes will increase the risk of what latter in life

A

T2DM

34
Q

Gestational diabetes: Complications for the mother

A
  • A high risk of developing gestational diabetes during a future pregnancy

-Mother has increased risk of developing Type 2 diabetes

-Caesarean section is more likely if the baby is large

-Induction of labour if the baby is growing too big

35
Q

Screening and diagnosis

A

all non-diabetic women offered/recommended screening for GDM

36
Q

Implications of maternal obesity for the baby

A

Increased risk of congenital (present from birth) abnormalities

-Orofacial cleft
-Hydrocephalus

37
Q

For every incremental unit increase in BMI of the mother the risk of birth defects increased by

A

7%

38
Q

Small for gestational age

A

Birth weight below the 10th percentile for age

39
Q

Stillborn infants born to obese mother are smaller than those

A

born normal body weight mother

40
Q

Large for gestational age

A

fetal overgrowth

Birth weight above the 90th percentile for age

> 400g

41
Q

Delivery of infant with birth weight more than 400g increases risk of

A

caesarean delivery, fetal hypoglycemia and shoulder dytocia

42
Q

Risk of death 18 months post birth was

A

4 times greater in infants born to obese mothers

43
Q

weight loss during pregnancy

A

dieting to lose weight is not recommended during pregnancy

HUNT243 (9 decks)

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