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HUNT 243 > Lecture 5 - Maternal Weight Gain During Pregnancy > Flashcards

Lecture 5 - Maternal Weight Gain During Pregnancy Flashcards

1
Q

what is the average birth weight of a baby

A

between 2.5-4kg, anything above or below this is considered to be a high or low birth weight

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2
Q

why are fat stores important for a mother during pregnancy

A

stored energy is needed during pregnancy and after birth where the baby will be breast fed

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3
Q

what is the recommended weight gain for someone with a BMI that is underweight (<18.5)

A

13-18 kg

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4
Q

what is the recommended weight gain for someone with a BMI that is healthy (18.5-24.9)

A

11-16kg

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5
Q

what is the recommended weight gain for someone with a BMI that is overweight (25-29.9)

A

7-11kg

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6
Q

what is the recommended weight gain for someone with a BMI that is obese (>30)

A

5-9kg

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7
Q

is weight loss recommended during pregnancy

A

weight loss is never recommended during pregnancy

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8
Q

what are the weight gain recommendations like during pregnancy for a mother with twins

A

higher recommendation that if it is just a single pregnancy

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9
Q

why is there no recommendation for a mother with twins for weight gain if her BMI is underweight pre pregnancy

A

no recommendation because they should just gain as much weight as possible

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10
Q

twin pregnancy often have a lower …..

A

often have a lower gestation and the babies are often smaller at birth

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11
Q

what are the weight gain recommendations for a mother with twins who has a healthy BMI weight before pregnancy

A

17-25kg

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12
Q

what are the weight gain recommendations for a mother with twins who has a overweight BMI weight before pregnancy

A

14-23kg

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13
Q

what are the weight gain recommendations for a mother with twins who has a obese BMI weight before pregnancy

A

11-19kg

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14
Q

gestational weight gain is made up of several components, what are they

A
  • water (62%)
  • fat mass (30%)
  • fat free mass (8%)
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15
Q

fetal weight is around what % of the total weight gained

A

about 25% of total weight gained

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16
Q

what % of fetal growth occurs in the second half of pregnancy

A

90% of fetal growth occurs in the second half of pregnancy

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17
Q

1/3 of gestational weight gain happens in what trimester

A

2nd trimester

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18
Q

2/3 of gestational weight gain occurs in what trimester

A

3rd trimester

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19
Q

maternal fat stores are gained predominantly between what weeks gestation

A

10th and 30th week gestation

20
Q

global study finds what % of pregnant women dont have healthy weight gain in pregnancy

A

75%

21
Q

midwives and obstetricians knowledge level of GWG is generally ….

A

low

22
Q

what is the link between postpartum weight retention and health effects later in life

A
  • 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
23
Q

during pregnancy, obesity is associated with increased risk of …… by 25-37% higher compared with lean women

A

increased risk of miscarriage and still births

24
Q

during pregnancy obesity is associated with : pregnancy induced …..

A

pregnancy induced hypertension

25
Q

during pregnancy, obesity is associated with higher risk of venous …..

A

higher risk of venous thromboembolism

26
Q

what is venous thromboembolism

A

blood clot within vien, if transported, embolism travels to right side of heart and into lungs ( can be fatal)

27
Q

delivery complications and gestational diabetes is associated with what in pregnancy

A

obesity

28
Q

what is gestational diabetes mellitus

A

a condition in which women without previously diagnosed diabetes exhibit high blood glucose levels during pregnancy

29
Q

how many pregnancies are affected by gestational diabetes

A

3-10%, prevalence

30
Q

what is believed to be the cause of gestational diabetes

A

believed that hormonal changes during pregnancy interfere with the action of insulin as it binds to the receptor resulting in increased insulin resistance

31
Q

what are risk factors for gestational diabetes

A
  • being overweight
  • previous diagnosis of gestational diabetes or prediabetes
  • family history
  • maternal age
  • previous pregnancy which resulted in a child high birth weight
32
Q

what are the complications for the baby when the mother has gestational diabetes

A
  • 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
33
Q

what are the complications for the mother if she has gestational diabetes during pregnancy

A
  • 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
34
Q

what is the screening that happens for gestational diabetes during pregnancy in NZ

A

all non-diabetic women offered / recommended screening for GDM

35
Q

what is the test that happens in the first 20 weeks that can be a way of screening for gestational diabetes

A

HbA1z at antenatal blood tests
- this would be an early indication of GDM

36
Q

what is the main screening method for GDM, at about 24-28 weeks

A

oral glucose tolerance test (OGTT)

37
Q

what does the oral glucose tolerance test involve

A
  • 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
38
Q

women can choose to do a polycose test instead of the OGTT, but what must happen if this comes back positive

A

is polycose test is positive then they must go and do OGTT to confirm diagnosis

39
Q

maternal obesity increases risk for congenital (present from birth) abnormalities such as

A

CNS and heart including cardiovascular defects, orofacial clefts, hydrocephalus (fluid on the brain) and limb reductions

40
Q

what does small for gestational age refer to

A

birth weight below the 10th percentile, for age

41
Q

what does large for gestational age refer to and what is it often called

A

“fetal overgrowth”

birth weight above the 90th percentile for age

42
Q

delivery of infant with birth weight more than 4000g increases risk for what

A
  • caesarean delivery
  • fetal hypoglycemia
  • shoulder dystocia
43
Q

what is a neonate

A

new baby

44
Q

what happens to the mortality rate of a pre term baby birthed by an obese mother

A

the mortality rate will be higher than the same baby birthed by a mother that was not obese

45
Q

is weight loss advised during pregnancy

A

never

46
Q

obese mothers have what times greater odds of a C section compared to non obese mothers

A

1.3 greater odds

47
Q

what are implications for the mother if she is obese

A

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

HUNT 243 (17 decks)

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