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Maternal Adaptations During Pregnancy > Micronutrient Requirements in Pregnancy > Flashcards

Micronutrient Requirements in Pregnancy Flashcards

1
Q

what are micronutrients

A
  • vitamins and minerals
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2
Q

micronutrients are needed in body in ___ amounts

A

small

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3
Q

do micronutrients provide any energy

A

no

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4
Q

why is it important to eat a variety of foods for balanced nutrition when it comes to micronutrients

A

because micronutrients are contained in many foods in different amounts

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5
Q

for optimal foetal development when are micronutrients required in pregnancy

A

at different periods of pregnancy

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6
Q

what are possible complications from deficient maternal micronutrient status in pregnancy

A

(maternal)
- anaemia
- hypertension
(neonate)
- impair foetal function, growth, development
- influence offspring metabolism -> lead to increased risk of chronic disease

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7
Q

list some key micronutrients in pregnancy and what they promote

A
  • folate, iron, zinc, calcium, vitamin D
  • promote red blood cell production, enzyme activity, bone development, brain development
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8
Q

what does folate do

A
  • (neonate) prevent neural tube defects
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9
Q

what does calcium do

A
  • (maternal) prevent hypertensive disorders
  • esp recommended in women with low calcium intakes or who at high risk of hypertensive disorders in pregnancy
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10
Q

what does iodine do

A
  • prevent iodine deficiency disorders, recommended only in women at high risk of IDDs
  • improve cognitive function
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11
Q

what does iron do

A
  • reduce maternal anaemia
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12
Q

what micronutrients have insufficient evidence to recommend additional intake during pregnancy to support birth outcomes (although may have higher intake recommended)

how should they exist in pregnant and normal women

A
  • vitamin B, vitamin C, vitamin E, zinc
  • included in a healthy dietary pattern
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13
Q

what is guidelines around vitamin D in pregnancy and why

A
  • no addition is recommended to support pregnancy outcomes
  • but should be given if woman vit D deficient
    => routine screening of pregnant women for vit D deficiency is recommended
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14
Q

what are guidelines around alcohol during pregnancy

A
  • no alcohol is safest
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15
Q

what are guidelines around caffeine in pregnancy

A
  • small evidence to suggest benefit from reducing caffeine intake
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16
Q

what is reducing caffeine intake preventing

A
  • pregnancy loss
  • low birth weight infants
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17
Q

what is increased requirement for iron in pregnant women compared to non-pregnant women

A

9 milligrams per day

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18
Q

what is increased requirement for zinc in pregnant women compared to non-pregnant women

A

2-3 milligrams per day

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19
Q

list the micronutrients with recommended increased requirements in pregnant women

how can these be obtained, esp for those not recommended due to lack of evidence

A
  • iron, zinc, iodine, selenium, vitamin A, vitamin B, vitamin C
  • by eating food from 5 food groups
  • supplement if recommended
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20
Q

which micronutrients do not require a change in daily micronutrient intake in pregnant women (some are key micronutrients in pregnancy)

A
  • calcium, phosphorus, vitamin D, vitamin E
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21
Q

maternal adjustments in calcium absorption during pregnancy occur how (2) ways

A
  • increased parathyroid hormone
  • increased parathyroid hormone receptor protein
    => maintain serum calcium level
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22
Q

what maternal adaptations have occurred that would require maintenance of serum calcium level

A
  • extracellular fluid volume expansion
  • renal function increase
  • placental calcium transfer
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23
Q

what increases during pregnancy to allow intestinal absorption of calcium to double

A
  • maternal blood concentrations in active form of vitamin D (125-dihydroxy vitamin D)
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24
Q

what increases during pregnancy to lead to increased active form of vitamin D

A
  • one alpha hydroxylase (enzyme) in placenta increases
  • which increases conversion inactive form of vitamin D (25-hydroxy) to active form of vitamin D (125-dihydroxy)
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25
in addition to consuming additional food sources, do we need supplements to meet additional requirements
- for most women, not needed despite marketing - for malnourished women and women from low income countries - supplementing can improve birth outcomes
26
what micronutrients are the only 2 supplements recommended during pregnancy
- iodine - folic acid
27
what is recommended amount of iodine in supplementation
- 220 micrograms iodine per day in total - recommended to take 150 microgram iodine supplement daily to reach total intake
28
when does iodine supplementation and recommendation change again
- when breastfeeding - to 270 micrograms
29
what is recommended amount of folic acid in supplementation
- 600 micrograms per day in total - 200 micrograms higher
30
how manu micrograms in a typical folic acid supplement
400 micrograms
31
when is folic acid supplementation recommended
- recommended to supplement in the month preceding conception and in first trimester of pregnancy
32
although no other supplements are recommended, what else may be supplemented and to who
- iron - to women at risk - anaemic or very low iron levels
33
what does trace mineral mean
only found in very small amounts inbody
34
what is iodine
trace mineral essential mineral
35
where is iodine found in body
- most stored in thyroid - some circulating in blood
36
why is iodine stored in thyroid
- thyroid uses iodine to produce thyroid hormones
37
what happens if consume too much iodine
- it is excreted
38
important thing iodine contributes to & a MoA
- normal foetal brain development - since foetus entirely dependent in early pregnancy on maternal thyroid hormones for brain development
39
if iodine is inadequate there may be maternal deficiency that results n low supply of iodine for unborn baby, which can lead to...
- problems in brain and nervous system development in unborn children and infants - reduced IQ in foetus
40
what can severe iodine deficiency result in
- endemic goiter - hypothyroidism - cretinism - decreased fertility - miscarriage - increased infant mortality - hypothyroxinaemia - trophoblastic or embyronic foetal disorders - foetal mental retardation
41
when does foetal thyroid gland develop which is capable of
- 10-12 wks gestation - capable of iodine organification & thyroid hormone production around 16-20wks gestation
42
what are the likely effects from mild to moderate iodine deficiency
- subtle cognitive and neurological impairments
43
is adequate iodine difficult to get from food alone
yes
44
what has been implemented to increase iodine intake in population in Australia
- mandatory iodine fortified bread (all breads that used salt are required to contain iodised salt; organic bread not contain)
45
since fortification, has iodine intakes improved
yes
46
what other sources of food contain iodine (without fortification)
- dairy - seafood (and eggs)
47
what is folate
- type of B vitamin
48
functions of folate
- make DNA - form red blood cells - grow and repair cells and tissues
49
what does folate contribute to in preganncy
- growth and formation of neural tube in early pregnancy
50
women in what areas are at increased risk of folate insufficiency
- areas where malaria prevalent - areas where sickle cell disease prevalent
51
when is folic acid supplementation recommended
- during preconception and early pregnancy = critical
52
folic acid vs folate
- folic acid: man-made synthetic form of folate - used in supplements and fortified foods
53
what can folic acid supplementation during preconception and early pregnancy prevent
- 40-80% of neural tube defects
54
when do neural tube defects occur in pregnancy
during 3rd and 4th week of pregnancy
55
what do neural tube defects involve
- failure of neural tube to close properly
56
what deficiency can folic acid supplementation sometimes mask & what can this lead to
- vitamin B12 deficiency -> can contribute to unwanted side effects such as multiple pregnancies (higher risk of perinatal complications)
57
what is perinatal
a number of weeks immediately before and after birth
58
how is the neural tube formed
- a layer of cells that goes on to form brain and spinal cord
59
how do we get folate through fortification
- fortified bread (excluding organic bread) - folic acid required in flour
60
other sources of dietary folate (non-fortified)
- green leafy vegetables - legumes - eggs

Maternal Adaptations During Pregnancy (4 decks)

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