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HUNT243 > Lecture 6b: Maternal Nutrition > Flashcards

Lecture 6b: Maternal Nutrition Flashcards

1
Q

What is iodine essential for?

A

The production of thyroid hormones

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2
Q

What are thyroid hormones required for?

A
  • Regulating body’s metabolism
  • Normal growth
  • Neurocognitive development of fetus/infant
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3
Q

What does severe iodine deficiency cause?

A

Intellectual disability

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4
Q

What does NZ iodine fortification look like?

A

Mandatory iodine in bread flour

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5
Q

What does WHO recommend for prevention of iodine deficiency?

A

Universal salt iodisation

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6
Q

What is the RDI for non-pregnant VS pregnant women?

A

100 vs 160

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7
Q

When should a women take iodine?

A

As soon as a women becomes aware she is pregnant - throughout entire pregnancy and breastfeeding

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8
Q

What is Vitamin A important for?

A

Cell differentiation - recommended intakes increase by 10% in pregnancy

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9
Q

How common is Vitamin A deficiency?

A

Rare in industrialised countries - major problem in developing nations

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10
Q

What can Vitamin A deficiency cause?

A

Malformations in:
- Fetal lungs
- Urinary tract
- Heart

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11
Q

What is the UL for Vitamin A intake?

A

> 3000 RE per day (10,000 IU)

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12
Q

No more than 100g of ?? should be eaten once a week during pregnancy

A

Liver

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13
Q

What can excessive intake of Vitamin A cause?

A

Fetal abnormalities

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14
Q

What forms can vitamin A be taken in excessive intakes?

A

Retinol or Retinoic Acid (not beta-caotene)

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15
Q

Why is excessive vitamin A easily done?

A

A number of supplements taken by pregnant women contain Vitamin A, so can be taking too much very easily

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16
Q

What is retinoic acid syndrome?

A

Collection of birth defects including:
- Craniofacial
- Cardiovascular
- Thymus dysfunction
- Microcephaly

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17
Q

What is a common defect from retinoic acid syndrome?

A

Small ears or no ears, abnormal or missing ear canals

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18
Q

When is Vitamin D deficiency at increased risk for pregnant women?

A
  • Dark skin tone
  • Live south of Nelson during winter or spring
  • Limited time outdoors
  • Minimal sun exposure
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19
Q

What are sources of Vitamin D?

A

Sunlight, only a few foods

20
Q

What is maternal vitamin D insufficiency linked to?

A
  • Gestational diabetes
  • Pre-eclampsia
21
Q

What is infantile vitamin D insufficiency linked to?

A
  • LBW
  • Dental decay
  • Acute respiratory infections
22
Q

What are food safety considerations during pregnancy?

A
  • Listeriosis
  • Toxoplasmosis
23
Q

What is listeriosis?

A

Develops as a result of infection with listeria monocytogenes - usually from a food

24
Q

What does listeriosis cause?

A

Influenze type symptoms and can result in premature labour and reduced fetal movements

25
Q

What happens if listerosis is not treated?

A

Life-threatening to fetus via infection of:
- Placenta
- Membranes
- Amniotic fluid
Causes:
- Sepsis and death

26
Q

What are precautions for listeria?

A
  • Foods heated thoroughly to steaming hot (>70)
  • Avoid unsafe foods
27
Q

What are unsafe foods for listeria?

A
  • Uncooked, smoked or ready to eat seafood
  • Pate, hummus, spreads
  • Pre-cooked meat products
  • Pre-prepared/stored salads
  • Unpasteurised milk
  • Soft-serve ice cream
  • Soft, semi-soft cheese
28
Q

How many listeria infections are reported per year?

A

19-30

29
Q

How many cases of listeria had the infection spread to fetus?

A

96% of cases

30
Q

How many causes of listeria saw major foetal or neonatal complications?

A

In 83% of infants of infected mothers

31
Q

What is toxoplasmosis?

A

A parasitic disease caused by toxoplasma gondii

32
Q

What can toxoplasmosis cause?

A

Eye or brain damage in unborn babies

33
Q

What can a toxoplasmosis infection come from?

A
  • Unwashed vegetables
  • Undercooked meat
  • Ready to eat meats
  • Unpasteurised milk
  • Cross-contamination of cat faeces
34
Q

How does alcohol pass through the fetus?

A

Alcohol readily passes the placenta such as fetal blood alcohol levels will be similar to maternal blood alcohol levels

35
Q

What is the most recognisable outcome of maternal alcohol drinking?

A

Fetal Alcohol Syndrome (FAS)

36
Q

What are features of FAS?

A
  • Growth deficiency/Development delays
  • CNS dysfunction
  • Facial characteristics
37
Q

What are examples of CNS dysfunction?

A
  • Microcephaly
  • Delayed development hyperactivity
  • Attention deficits
  • Learning disabilities
  • Intellectual deficits
38
Q

What are the facial characteristics of FAS?

A
  • Short palpebral fissures
  • Thin upper lip
  • Underdeveloped jaw
  • Smooth and/or long philtrum
39
Q

What is does the Fetal Alcohol Spectrum Disorder (FASD) include?

A
  • Full FAS
  • Alcohol related neurodevelopment disorder (ARND)
  • Alcohol related birth defects (ARBD)
40
Q

When is the full spectrum of FAS seen?

A

Only seen with heavy drinking during pregnancy regularly OR high concentrations at critical development periods

41
Q

What are the alcohol recommendations during pregnancy in NZ?

A
  • Stop drinking if you could be or are pregnant
  • Fermented drinks that may contain low levels should be avoided
42
Q

What packaged alcohol contains a pregnancy warning label?

A

Containing more than 1.15%

43
Q

What is the gold standard of evidence assessment?

A

Meta-analyses

44
Q

What is the order of quality of evidence?

A
  1. Critical Appraisal
  2. Experimental studies
  3. Observational studies
45
Q

What are examples of critical appraisal?

A
  • Meta analyses
  • Systematic reviews
  • Critically appraised literature
46
Q

What are examples of experimental studies?

A
  • RCT
  • Non-randomised CT
47
Q

What are examples of observation studies?

A
  • Cohort studies
  • Case studies
  • Individual case reports

HUNT243 (11 decks)

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