Maternal Nutrition

Question 1

How can we optimise maternal nutrition preconception

Why is this useful

Answer 1

Improve pregnancy outcomes and health
Interventions in pregnancy are too late
-Healthy BMI
-Balanced diet with daily folate
-Physical activity
-No smoking, alcohol, drugs, limit caffeine

Question 2

What are the consequences of maternal obesity on

• the mother
• fetus
• childhood

Answer 2

Mother

• decreased fertility
• increased miscarriage, GD, PET, CSection

Fetus
-increased stillbirth, dev/metabolic abnormalities, NICO admission

Childhood
-increased obesity, diabetes, HTN

Question 3

How would you improve maternal nutrition on an individual basis

Answer 3

Normalise conversation about planning

Increase awareness of optimising preconceptive health

Identify those planning pregnancy

Question 4

How would you improve maternal nutrition on a population basis

Answer 4

Decrease risk factors

Address determinants of health

Advocate

Create a society that is conducive to improved WH

Question 5

What are the consequences of malnutrition during pregnancy

• Throoughout
• Embryonic (wk2-8)
• Fetal (wk8-40)

Answer 5

Alter gene expression => long term effects on child

Embryonic

• lack of nutrients/maternal blood => congenital abnormalities
• main period for organ and membrane development

Fetal
-most development is complete but tissue, organ growth is impacted

Question 6

How does your caloric intake change during each trimester

Answer 6

1st
-slowest rate of growth

2nd-3rd
-most rapid growth but due to decreased maternal movement => 200 extra calories

Question 7

Folate supplementation

• when
• how much
• why

Answer 7

Preconception
-400mcg

PC+obesity
-5mg

Reduce NTD incidence by wk12

Question 8

Vitamin D supplementation

• when
• from where
• why

Answer 8

Pregnant
-10ug

Fetal skeleton accumulates Ca from maternal stored
-requires vitamin D from sun and diet (fish, egg, meat)

Question 9

Micronutrients

-how does this requirement change during pregnancy and why

Answer 9

Requirements increase to aid fetal development

Metabolic adpatations minimise need to increased intake to meet requirements