Module 2: Pregnancy I Flashcards
major stages of pregnancy for offspring
Embryo Period: first 8 weeks
Fetal Period: 8-40 weeks
Neonatal Period: 40+ weeks
major stages of pregnancy for mother
Pre-conception (LMP)
Pregnancy
- 1st trimester
- 2nd trimester
- 3rd trimester
Postnatal
maternal anabolic phase when is it
0-20 weeks
maternal anabolic phase
Increased maternal plasma volume
Increased cardiac output
Buildup of fat, nutrient & liver glycogen stores
Increased appetite and food intake
- Sometimes increased ghrelin: we need a physiological way to increase energy
Decreased exercise tolerance
Increased placental weight
10% of fetal growth
maternal catabolic phase when is it
20+ weeks
maternal catabolic phase what is it
Increased uterine blood flow
Increased fetal weight
Mobilization of fat and nutrient stores
Increased blood glucose, triglycerides, and fatty acids
Accelerated metabolism
90% of fetal growth
what are energy needs in pregnant women used for?
Synthesis of fetal, placental, uterine, and breast tissues
Buildup of maternal fat stores
Increased metabolic activity
Fetus accounts for ⅓ of energy needs
nutritional considerations for preconception
fish consumption
folate
iron
vitamin A
why do we limit fish consumtion
limit methyl-mercury
folate in preconception nutrition
Begin folic acid supplementation (400 mcg) at least 1 month before conception to decrease neural tube defects (prenatal vitamins
If history of NTDs need 4000 mcg
iron in preconception nutrition
Iron deficiency anemia may increase risk of preterm delivery and anemia in childhood
vitamin A in preconception nutrition
Excess is harmful
Should caffeine be consumed during pregnancy? When is it most critical?
Limit to 200 mg/day (one 11oz cup)
New recommendations: none during 1st trimester
Reductions in blood flow could hinder placentation and placental transport
vegetarian/vegan mother concerns
Nutrients of concern: iron, calcium, vitamin B12
Blood tests every trimester
Replacement as needed
dairy free mother concerns
nutrient of concern: calcium
gluten free/low carb mother concerns
Nutrient of concern: folate
A lot of folate comes from fortified foods which are often wheat products
complex carbohydrates requirements and why
a lack can lead to reflux!
Minimum 175g/day
45-65% of intake
Complex carbs
No alcohol
proteins requirements and why
71 g/day
Too little or excessive protein intake can be detrimental
Too much protein can lead to kidney damage because the kidneys are already processing a lot more fluids than usual
healthy fats requirements and why
33% of total calories
Fat soluble vitamins
Essential fatty acids
water requirements and why
2.5 L per day (~10 cups)
Can be from other liquids, but water is best
Dehydration can contribute to:
Constipation
Hemorrhoids
urinary/bladder infections
Excessive swelling
Extended Braxton-Hicks contractions
Preterm birth
benefits of exercise
Daily moderate aerobic and strength exercise recommended, 30-45 minutes a day
Trained athletes may continue more intense exercise
Benefits:
Physical fitness
Weight management
Decreases risk of gestational diabetes in obese women
Psychologic well-being
Better labor and delivery?
Increasing evidence, but there is currently mixed data
Individuals with higher BMI can start with low-intensity, short term exercise during pregnancy
What are the general weight gain guidelines/trends for pregnancy? How/where is weight gain distributed during pregnancy? Why is weight gain essential?
Steady weight gain throughout pregnancy
In first half, the weight gain goes towards energy stores, placenta
In second half, we see the maternal weight gain contribute to increase in adipose and weight in the fetus
We do not want to lose weight during pregnancy → lipolysis during pregnancy is dangerous!
Early weight gain goes towards maternal plasma volume (making sure we have enough blood flow for placenta and fetus)
multifetal pregnancies and weight gain
Dietary intake in twin pregnancy
Higher caloric need
Benefits from increases in essential fatty acids, iron, and calcium
What are the macronutrient and micronutrient requirements? What should be avoided?
Required: folate, iron, vitamin D, calcium, vitamin A, omega-3 fatty acids, water
Avoided: methylmercury, caffeine, alcohol
