Maternal Nutrition and Diabetes Flashcards

1
Q

How much weight gain during pregnancy?

A

15-25 lbs

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2
Q

How many more kcal a day in pregnancy?

A

350-450 kcal/day

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3
Q

Iron requirements in pregnancy

A

Required for maternal and fetal hematopoiesis, and fetal neurocognitive development
16-20 mg elemental iron per day in a supplement for prevention of iron deficiency
Treatment of anemia with more iron if low Hb or ferritin at any time in pregnancy

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4
Q

Folic acid in pregnancy

A

Required for maternal hematopoiesis and fetal neural tube development
Supplementation with 0.4 mg/day
Smokers and those on seizure meds need more (5 mg/day)

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5
Q

Calcium and vitamin D requirements in pregnancy

A

Required for bone metabolism
Calcium 1000 mg/day
VitD = 5 mcg/day or 200 IU/day
From diet and supplement combined

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6
Q

Zinc in pregnancy

A

Required for neurodevelopment
Worldwide more a concern than NA
No specific supplement we recommend

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7
Q

Omega 3, 6, 9 in pregnancy

A

Required for fetal neurodevelopment and retinal development
Fish consumption more effective than supplementation
Recommend 150 gm of fish/week or 2 servings
Mercury concern in certain fish
Alternates: walnuts, flax seed oil, canola oil

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8
Q

Vitamin B12 in pregnancy

A

Required for fetal neurodevelopment as well as hematopoiesis

Concerns in certain populations: vegan, gastric bypass, celiac, crohn’s, UC

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9
Q

Vitamin A in pregnancy

A

Required and easily available in typical NA diet
Upper limit recommended as higher doses are teratogenic is 10,000 IU/day from combined retinol, retinoids, betacarotene in supplements and diet

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10
Q

Choline in pregnancy

A

Required for cell membrane synthesis, neurotransmission, and overall essential to fetal brain development
Too little intake associated with decreased placental function and reduced fetal tolerance to stress
450 mg/day recommended in diet
Not yet recommended or included in supplements

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11
Q

3 infections to avoid in pregnancy

A

Listeria
Toxoplasmosis
Salmonella

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12
Q

Complications with

  1. Cigarettes
  2. Marijuana
  3. Alcohol
A
  1. Low birth weight, still birth, miscarriage, premature delivery, abruption, SIDS
  2. Still birth, neurocognitive development
  3. FASD
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13
Q

Who do we screen for gestational diabetes? When?

A

Everyone from 24-26 weeks

High risk pregnancies from 12-16 weeks

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14
Q

Who is high risk for gestational diabetes?

A
Previous gestational diabetes
Macrosomic babies
Certain racial minorities
Those over 35
BMI > 30
Steroid use
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15
Q

Cut offs for 50 gm glucose test

A

Normal: under 7.8
GDM: > 11
Do step two if 7.8-11

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16
Q

Diagnostic cut offs for 75 gm GTT

A

Fasting: > 5.3
1 hour: > 10.6
2 hours: > 9

17
Q

Screening cut offs for 75 gm GTT

A

Fasting: > 5.1
1 hour: > 10.0
2 hours: > 8.5

18
Q

Gestational diabetes nutritional advice

A

3 meals, 3 snacks per day with one snack at bed time
Avoid low calorie intake (ketones), avoid obvious sugars and sugar substitutes, avoid high fats, have protein with all meals and most snacks

19
Q

Do you need more calories in pregnancy or breastfeeding? By how much?

A

400-600 calories more during breastfeeding

On top of the extra calories you need during pregnancy