Maternal Nutrition and Diabetes Flashcards
How much weight gain during pregnancy?
15-25 lbs
How many more kcal a day in pregnancy?
350-450 kcal/day
Iron requirements in pregnancy
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
Folic acid in pregnancy
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)
Calcium and vitamin D requirements in pregnancy
Required for bone metabolism
Calcium 1000 mg/day
VitD = 5 mcg/day or 200 IU/day
From diet and supplement combined
Zinc in pregnancy
Required for neurodevelopment
Worldwide more a concern than NA
No specific supplement we recommend
Omega 3, 6, 9 in pregnancy
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
Vitamin B12 in pregnancy
Required for fetal neurodevelopment as well as hematopoiesis
Concerns in certain populations: vegan, gastric bypass, celiac, crohn’s, UC
Vitamin A in pregnancy
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
Choline in pregnancy
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
3 infections to avoid in pregnancy
Listeria
Toxoplasmosis
Salmonella
Complications with
- Cigarettes
- Marijuana
- Alcohol
- Low birth weight, still birth, miscarriage, premature delivery, abruption, SIDS
- Still birth, neurocognitive development
- FASD
Who do we screen for gestational diabetes? When?
Everyone from 24-26 weeks
High risk pregnancies from 12-16 weeks
Who is high risk for gestational diabetes?
Previous gestational diabetes Macrosomic babies Certain racial minorities Those over 35 BMI > 30 Steroid use
Cut offs for 50 gm glucose test
Normal: under 7.8
GDM: > 11
Do step two if 7.8-11