Lecture 5 - Maternal Weight Gain During Pregnancy Flashcards
what is the average birth weight of a baby
between 2.5-4kg, anything above or below this is considered to be a high or low birth weight
why are fat stores important for a mother during pregnancy
stored energy is needed during pregnancy and after birth where the baby will be breast fed
what is the recommended weight gain for someone with a BMI that is underweight (<18.5)
13-18 kg
what is the recommended weight gain for someone with a BMI that is healthy (18.5-24.9)
11-16kg
what is the recommended weight gain for someone with a BMI that is overweight (25-29.9)
7-11kg
what is the recommended weight gain for someone with a BMI that is obese (>30)
5-9kg
is weight loss recommended during pregnancy
weight loss is never recommended during pregnancy
what are the weight gain recommendations like during pregnancy for a mother with twins
higher recommendation that if it is just a single pregnancy
why is there no recommendation for a mother with twins for weight gain if her BMI is underweight pre pregnancy
no recommendation because they should just gain as much weight as possible
twin pregnancy often have a lower …..
often have a lower gestation and the babies are often smaller at birth
what are the weight gain recommendations for a mother with twins who has a healthy BMI weight before pregnancy
17-25kg
what are the weight gain recommendations for a mother with twins who has a overweight BMI weight before pregnancy
14-23kg
what are the weight gain recommendations for a mother with twins who has a obese BMI weight before pregnancy
11-19kg
gestational weight gain is made up of several components, what are they
- water (62%)
- fat mass (30%)
- fat free mass (8%)
fetal weight is around what % of the total weight gained
about 25% of total weight gained
what % of fetal growth occurs in the second half of pregnancy
90% of fetal growth occurs in the second half of pregnancy
1/3 of gestational weight gain happens in what trimester
2nd trimester
2/3 of gestational weight gain occurs in what trimester
3rd trimester
maternal fat stores are gained predominantly between what weeks gestation
10th and 30th week gestation
global study finds what % of pregnant women dont have healthy weight gain in pregnancy
75%
midwives and obstetricians knowledge level of GWG is generally ….
low
what is the link between postpartum weight retention and health effects later in life
- women with greater gestational weight gain are more likely to retain this weight post
- this leads to a greater BMI going into their second pregnancy and then are more likely to retain more weight post birth
- this can then lead to complications further in life if the weight is retained
during pregnancy, obesity is associated with increased risk of …… by 25-37% higher compared with lean women
increased risk of miscarriage and still births
during pregnancy obesity is associated with : pregnancy induced …..
pregnancy induced hypertension
during pregnancy, obesity is associated with higher risk of venous …..
higher risk of venous thromboembolism
what is venous thromboembolism
blood clot within vien, if transported, embolism travels to right side of heart and into lungs ( can be fatal)
delivery complications and gestational diabetes is associated with what in pregnancy
obesity
what is gestational diabetes mellitus
a condition in which women without previously diagnosed diabetes exhibit high blood glucose levels during pregnancy
how many pregnancies are affected by gestational diabetes
3-10%, prevalence
what is believed to be the cause of gestational diabetes
believed that hormonal changes during pregnancy interfere with the action of insulin as it binds to the receptor resulting in increased insulin resistance
what are risk factors for gestational diabetes
- being overweight
- previous diagnosis of gestational diabetes or prediabetes
- family history
- maternal age
- previous pregnancy which resulted in a child high birth weight
what are the complications for the baby when the mother has gestational diabetes
- high maternal blood glucose exposes the fetus to higher glucose levels
- this leads to increased fetal levels of insulin (insulin itself can not cross the placenta)
- the growth stimulating effects of insulin can lead to excessive frowth and macrosomia
- higher risk of developing T2DM later in life
what are the complications for the mother if she has gestational diabetes during pregnancy
- higher 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
what is the screening that happens for gestational diabetes during pregnancy in NZ
all non-diabetic women offered / recommended screening for GDM
what is the test that happens in the first 20 weeks that can be a way of screening for gestational diabetes
HbA1z at antenatal blood tests
- this would be an early indication of GDM
what is the main screening method for GDM, at about 24-28 weeks
oral glucose tolerance test (OGTT)
what does the oral glucose tolerance test involve
- fasted (overnight, 8-10 hours)
- 75g oral glucose load
- assessment of blood glucose after 2 hours via finger prick
- GDM diagnosed if fasting blood glucose is >5.5mmol/L and or 2 hour post load >9.0 mmol/L
women can choose to do a polycose test instead of the OGTT, but what must happen if this comes back positive
is polycose test is positive then they must go and do OGTT to confirm diagnosis
maternal obesity increases risk for congenital (present from birth) abnormalities such as
CNS and heart including cardiovascular defects, orofacial clefts, hydrocephalus (fluid on the brain) and limb reductions
what does small for gestational age refer to
birth weight below the 10th percentile, for age
what does large for gestational age refer to and what is it often called
“fetal overgrowth”
birth weight above the 90th percentile for age
delivery of infant with birth weight more than 4000g increases risk for what
- caesarean delivery
- fetal hypoglycemia
- shoulder dystocia
what is a neonate
new baby
what happens to the mortality rate of a pre term baby birthed by an obese mother
the mortality rate will be higher than the same baby birthed by a mother that was not obese
is weight loss advised during pregnancy
never
obese mothers have what times greater odds of a C section compared to non obese mothers
1.3 greater odds
what are implications for the mother if she is obese
obesity in pregnancy is associated with increased risk of :
- venous thromboembolism
- pregnancy induced hypertension
- increased risk of miscarriage and still births (25-37%)
- delivery complications
- gestational diabetes
