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Nutrition through life Part 2 > Micronutrient Requirements during Pregnancy > Flashcards

Micronutrient Requirements during Pregnancy Flashcards

1
Q

What major physiological adaptation takes place for Calcium in pregnant women and why?

A

Increased efficiency in intestinal absorption (double!),

for the increased demands because a lot of calcium is transferred to the fetus

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2
Q

True or False. Vitamin D levels decrease during pregnancy.

A

False, they increase

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3
Q

What factors increase the levels of calcium absorption?

A

not likely happening here because of vitamin D
Not because of diet high in Calcium
know that somehow absorption is increased
probably because of calciotropic hormones (play a role in bone growth and remodeling)

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4
Q

True or False. Number of pregnancies affects your bone mass.

A

False. No correlation has been found between numbers of pregnancies and bone mineral density.

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5
Q

Why is Phosphorus RDA the same during pregnancy?

A

No evidence to support an increase.

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6
Q

True or False. The absorption of phosphorus increases during pregnancy.

A

True

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7
Q

What happens to the concentration of Magnesium in the blood during pregnancy?

A

It decreases

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8
Q

Why does the concentration of Magnesium in the blood decrease during pregnancy?

A

likely because of hemodilution, not magnesium status

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9
Q

What physiological changes related to magnesium happen during pregnancy?

A

Unlike other minerals, there is NO increased absorption

and NO extra conservation

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10
Q

What is the increased pregnancy requirement for magnesium based on?

A 
Weight gain (lean mass) of pregnancy
under assumption that increased weight means more magnesium
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11
Q

What factors are included in the factorial method of calculating iron requirement during pregnancy?

A

Basal Losses
Fe deposited in fetus and related tissues
Fe in expansion of Hb mass

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12
Q

At which point in the pregnancy is there the greatest need for iron? Why?

A

3rd trimester

least at first because least growth

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13
Q

True or False. The absorption rate of iron for a pregnant women increases as the pregnancy progresses.

A

True

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14
Q

A iron anemia can lead to what?

A

Perinatal Maternal mortality for severe
even moderate has increased rate of deaths
from heart failure, infection, hemorrhage
also perinatal infant mortality

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15
Q

a high Fe serum concentration can we associated with what?

A

adverse pregnancy outcomes like SGA

could be because low plasma levels (which could be signs of preeclampsia or hypertension)

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16
Q

A low Fe status can lead to limited Hb for the mother, how?

A

Limits the mother’s ability to produce Hb for herself.

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17
Q

Could the mother use her own stores to supply Iron to the fetus if her stores are sufficient?

A

Yes to some degree. The mother can supply some of the requirement from her stores to the fetus but it isn’t optimal.

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18
Q

Is the maternal skeleton used as a reserve to provide Calcium for the fetus?

A

No, the maternal skeleton is not used as a reserve

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19
Q

What change for calcium intake is required for pregnant women?

A

None, no increase

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20
Q

What change is there for the magnesium requirement?

A

increase

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21
Q

Iron stores are directly correlated with what aspect of the baby?

A

birth weight

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22
Q

Why are Fe supplements recommended?

A

The normal Canadian diet cannot meet Fe RDA.

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23
Q

True or False. The iron recommendation for pregnant women despite no more menstrual losses.

A

true

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24
Q

When would Fe supplementation not be necessary? (even though we don’t take the chance)

A

normal stores before pregnancy because supplementation works under the assumption that they are inadequate

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25
Q

How are the requirements for Iron made for pregnancy?

A

uses the estimates for requirement for third trimester, then applied to whole pregnancy to establish stores at the beginning

26
Q

Is there a change in requirement for potassium?

A

no

27
Q

Is there a change in sodium requirement?

A

increase to maintain plasma osmolality

28
Q

Why is the AI for Sodium the same for pregnant and non pregnant women?

A

The change per day would be way to small for it do be significant

29
Q

What is the requirement for chloride based on?

A

equi-molar with sodium

30
Q

Do pregnant women have a different sodium UL than non pregnant women?

A

no because not enough evidence to support that it would have health benefits

31
Q

What happens to the requirement of Thiamin? Why?

A

Increases
account for more growth in maternal and fetal compartments
increased energy utilization

32
Q

What happens to the requirement of Riboflavin and why?

A

Increased

more growth and energy utilization

33
Q

What happens to the requirement of Niacin and Why?

A

increased

34
Q

What is the change in niacin requirement based on?

A

no evidence for need of the change but it was estimated based on growth and energy utilization increase

35
Q

True or False. There is a minimum amount of fetal uptake of vitamin B6.

A

FALSE, significant

36
Q

Supplementation during pregnancy of B6 is necessary to maintain plasma [ ] ?

A

pyridoxal phosphate

37
Q

What is the increased need of B6 based on?

A

avoiding negative effects

but you can also look at physiological changes affecting needs

38
Q

How do folate requirements change and why?

A

increased

more single-carbon transfer reactions and cell division (nucleotide synthesis)

39
Q

How do we know that folate is actively transferred to the fetus?

A

higher concentration of folate in the cord blood than the maternal blood

40
Q

What happens with inadequate folate intake?

A

maternal serum and erythrocyte folate decreases

leads to megaloblastic marrow changes which leads to megaloblastic anemia

41
Q

How is folate adequacy in pregnant women measured?

A

same as in non pregnant, erythrocyte folate concentration

42
Q

What is the EAR of folate based on?

A

the ear of non pregnant women + a set amount based on studies (this amount alone is inadequate)

43
Q

What happens to the absorption of B12?

A

increases because of more intrinsic B12 receptors

44
Q

What happens to the serum B12 during pregnancy?

A

decreases (cannot be justified by hemodilution)

45
Q

What is the most important source of B12 for the fetus?

A

current diet intake,

maternal stores are less important because only newly absorbed B12 is readily transported across the placenta

46
Q

What is the most important source of B12 for the fetus?

A

current diet intake,

maternal stores are less important because only newly absorbed B12 is readily transported across the placenta

47
Q

What changes happen in the normal physiology of biotin during pregancy?

A

increase in biotin metabolite (3-hydroxyisovaleric acid)
decrease in excretion of biotin
ratio of metabolite/biotin in ruine increases

48
Q

what happens to the requirement of Biotin?

A

nothing, so many factors don’t know if it changes up or down

49
Q

What factos affect biotin requirement?

A

raw egg whites (avidin
biotidinase deficiency
anticonvulsants
pregnancy

50
Q

What happens to the Choline requirement and why?

A

increase, we know because a large amount of choline delivered to fetus which can deplete maternal stores

51
Q

What happens to the choline requirement and why?

A

Nothing, not enough info that usual intakes are not enough

52
Q

What happens to vitamin C requirement?

A

no precise data on how much vit C is transferred, so we added the amount to prevent scurvy in small children to normal requirement

53
Q

What happens to vitamin C during pregnancy?

A

Decreased serum vitamin C

because of hemodilution and transfer to fetus

54
Q

What happens to vitamin C during pregnancy?

A

Decreased serum vitamin C

because of hemodilution and transfer to fetus

55
Q

What happens to vitamin A requirement during pregnancy?

A

increased

56
Q

What is the EAR for vitamin A during pregnancy based on?

A

accumulation in fetal liver
absorption is about 70%
accumulates mostly in last 90 days

57
Q

What is the vitamin A UL for pregnant women based on compared to normal women?

A

teratogenicity vs liver abnormalities

58
Q

What happens to the Vitamin D requirement during pregnancy?

A

nothing

59
Q

What happens to vitamin E requirement during pregnancy?

A

Same

60
Q

Is vitamin E deficiency for newborns possible?

A

yes
premature newborns
no reports during pregnancy
no evidence that supplementation would prevent it in premature newborns

61
Q

What happens to the requirement for vitamin K during pregnancy?

A

nothing

Nutrition through life Part 2 (4 decks)

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