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HUNT 243 > Lecture 6 - Maternal Nutrition During Pregnancy > Flashcards

Lecture 6 - Maternal Nutrition During Pregnancy Flashcards

1
Q

pregnancy is considered a what state

A

anabolic state

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2
Q

during pregnancy, hormonal changes alter nutrient metabolism to support :

A
  • fetal growth and development
  • reproductive tissue accretion
  • maternal homeostasis
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3
Q

what happens to basal energy expenditure (BEE) during pregnancy

A

increase over the non pregnant state due to added metabolism of uterus and fetus increased work of the maternal heart and lungs

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4
Q

what happens to the thermic effect of food during pregnancy

A

remains unchanged

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5
Q

what happens to the energy cost of physical activity during pregnancy

A

energy cost remains the same

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6
Q

what is equivalent to total energy expenditure

A
  • basal energy expenditure
  • thermic effect of food
  • physical activity
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7
Q

what is the recommended energy intake during the first trimester of pregnancy

A

extra energy not required

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8
Q

what is the recommended energy intake during the second trimester of pregnancy

A

1,400kJ/day added to estimated energy requirement of non pregnant women

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9
Q

what is the recommended energy intake during the third trimester of pregnancy

A

1,900kJ/day added to estimated energy requirement of non pregnant women

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10
Q

what are linoleic (18:2n-6, LA) and a-linolenic acid (18:3n-3, LNA) and what are they used to make

A

essential fatty acids omega 3 and omega 6, used to make LCPUFA’s

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11
Q

what is desaturation of LCPUFAs

A

inserting of double bonds into the fatty acid chain

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12
Q

what are LCPUFAs

A

long chain polyunsaturated fatty acids

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13
Q

what is elongation of LCPUFAs

A

adding two carbon atoms onto the carboxyl end of the fatty acid chain

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14
Q

what is desaturation of LCPUFAs catalysed by

A

desaturase enzyme

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15
Q

what is elongation of LCPUFAs facilitated by

A

elongase enzyme

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16
Q

what are LCPUFAs essential for

A

for normal fetal development, particularly neural and visual function

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17
Q

endogenous synthesis of AA is far more effective than …

A

DHA

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18
Q

what is DHA (LCPUFAs)

A

a critical component of cell membranes, especially in the brain and retina

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19
Q

what is AA (LCPUFAs)

A

both a membrane component and a precursor to potent signalling molecules, the prostaglandins and leukotrienes (mediate inflammatory response)

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20
Q

how does n-3 fatty acid deposition in the developing fetal brain and retina occur

A

initially occurs fairly slowly and then rapidly accumulates during the last trimester

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21
Q

why is the fetus dependent on placental supply for both LCPUFAs and essential fatty acids

A

the fetus has active desaturases but limited ability to make LCPUFAs

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22
Q

what influences the cord blood concentrations of LCPUFAs

A

maternal diet

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23
Q

in NZ most of us get enough of what essential fatty acid but we get less of what one

A

most of us get enough of linoleic acid (omega 6) but we get less of a-linoleic acid (omega 3)

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24
Q

a rich supply of n-3 fatty acids during pregnancy is associated with what

A

reduced incidence of low birth weight

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25
higher DHA and / or EPA intake during pregnancy increases
increases gestational age and heavier infants (better healthy weight)
26
why do maternal and fetal fatty acid requirements during pregnancy depend on maternal genetic variation in LCPUFA synthesis
because it was found FADS (homozygous minor allele) had shorter pregnancies and lighter infants
27
a meta-analysis found that omega-3 intake during pregnancy reduced risk of
peanut and egg allergy
28
what is monomethylmercury
occurs naturally in the environment and in industrial pollution accumulating in streams and seas
29
monomethylmercury is taken up by what
taken up by aquatic organisms and concentrated in fish
30
what fish have higher concentrations of monomethylmercury
higher concentrations in longer living fish such as shark, ray, swordfish etc
31
tuna for canning is often lower in monomethylmercury why ?
the fish are often smaller
32
an estimated 40% of the mercury that eventually finds its way into fish originates with .....
coal burning power plants and chlorine production plants
33
maternal methylmercury exposure is directly related to :
related to fish consumption
34
what is the concern of methylmercury
neurotoxin, large amounts can damage the developing nervous system of the fetus and delay mental development
35
what is the recommendation for eating longer living fish during pregnancy
less than three to four times per week
36
what is the recommendation for eating fish such as shark, southern bluefin tuna and trout while pregnanct
only once a week or once a fortnight
37
what is the most common micronutrient deficiency during pregnancy
iron
38
why does iron intake need to increase during pregnancy
- expansion of our maternal red blood cells (because we are developing a temporary organ) - fetal erythropoiesis - allow for enough blood loess that will likely occur at delivery
39
what is the RDI of iron for pregnant women aged 14-50 years, and how much is this an increase compared to non pregnant women
27mg/day, 9mg increase
40
what is the upper limit of iron intake
45mg/day
41
low Hb indicative of moderate or severe anaemia has been associated with an increase risk of what for the infant
- low birth weight - small gestational age - preterm birth - decreased infant iron stores - consequent impaired cognition and growth of the child
42
low Hb indicative of moderate or severe anaemia has been associated with an increase risk of what for the mother
- severe anaemia may increase the risk of cardiac failure or death from peripartum hemorrhage
43
an estimated what % of pregnant women have anaemia globally
40%
44
what is peripartum
occurring during the last month of gestation or first few months after delivery
45
what is the WHO recommendation of iron supplementation in areas of the world where this is an issue in pregnancy (this doesn't apply to NZ)
routine iron supplements of 60mg daily for pregnant women living in areas where malnutrition is prevalent
46
how does iron status screening work for pregnant women in NZ
iron status at booking (<20 weeks) and 26-28 weeks gestation
47
how to reduce the side effects of iron medication
- start with half the dose then gradually increase - taking the supplement in divided doses with food
48
what is delayed 'optimal' cord clamping mean and what does it improve
means changing the time of cord clamping from immediately after delivery to 1-3 minutes after delivery, this improves iron status of the infant
49
how much blood will be transferred from the placenta to the infant at 1 minute after birth, and at 3 minutes
about 80ml, reaching 100ml at 3 minutes
50
iodine is essential for the production of what
production of thyroid hormones, required for regulating the babies metabolism, for normal growth and neurocognitive development of the fetus, infant and child
51
severe iodine deficiency causes
intellectual disabilties
52
what is the RDA for iodine in non pregnant women vs pregnant
150mcg/d 220mcg/d
53
recommended intakes of vitamin A increase by what in pregnancy
~10%
54
intakes of vitamin A above 10,000 IU per day increase risk of
fetal abnormalities
55
what is retinoic acid syndrome
collection of birth defects including crainofacial, cardiovascular, thymus dysfunction and microcephaly
56
vitamin D deficiency linked to maternal health outcomes such as
- gestational diabetes - pre eclampsia
57
vitamin D deficiency linked to infant health outcomes such as
- low birth weight - dental decay - acute respiratory infections
58
what is listeria and what does it cause in healthy people and pregnant people
food borne bacteria : widely distributed yet does not cause symptoms in healthy individuals, but can cause listeriosis in pregnant women and newborn infants
59
what does listeriosis develop as a result of
infection with listeria monocytogenes, usually from a food
60
what symptoms does listeriosis cause
causes influenza type symptoms and can result in premature labour and reduced fetal movements
61
listeria can multiply over a wide range of temperatures from ...
-1.5 to 50 degrees
62
what temperature should you heat foods to, to minimise the risk of listeria
70 degrees
63
foods that are considered unsafe in terms of listeria
- uncooked, smoked or ready to eat fish or seafood - pate, hummus - cold - pre cooked chicken - ham and other chilled pre cooked meats - pre prepared or stored salads - raw unpasteurised milk - soft serve ice creams - soft cheeses
64
what is toxoplasmosis
a parasitic disease cause by toxoplasma gondii, can cause eye or brain damage in unborn babies
65
toxoplasmosis infection can come from :
- eating unwashed vegetables, undercooked meat or ready to eat meat - drinking raw unpasteurised milk - cross contamination of coming in contact with cats or their faeces
66
what symptoms do pregnant women usually show when they have toxoplasmosis
a pregnant women is often asymptomatic
67
alcohol readily passes the what and what does this mean
alcohol readily passes the placenta such that fetal blood alcohol levels will be similar to maternal blood alcohol levels
68
what are the key features of fetal alcohol syndrome (FAS)
- growth deficiency of prenatal onset - central nervous system dysfunction - a specific pattern of facial characteristics
69
what are the central nervous system dysfunction related to alcohol examples include
microcephaly delayed development hyperactivity attention deficits learning disabilities intellectual deficits
70
fetal alcohol spectrum disorder includes
- full FAS - alcohol related neurodevelopment disorder - alcohol related birth defects
71
full FAS is generally only present when ....
with exposure of fetus to regular heavy alcohol intake, or to very high alcohol concentrations at critical periods
72
what does alcohol related neurodevelopment disorder include
difficulties with mathematical skills, difficulties with memory or attention poor school performance and poor impulse control and / or judgement
73
alcohol related birth defects includes
problems with the heart, kidneys, bones and / or hearing
74
packaged alcohol containing more then 1.15% alcohol requires ...
to have a "pregnancy warning label"

HUNT 243 (30 decks)

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