Nutrition Flashcards
What 2 supplements are pregnant women recommended to take ?
- 400 micrograms Folic acid pre-conception & first 12wks (5mg if either obese, diabetics, history of baby with NTD or FH, on anti-epileptics)
- 10 micrograms Vitamin D through pregnancy & continuation if breast feeding
What foods are folates (==> folic acid) found in ?
Found in green leafy vegetables, fruits (such as oranges), cereals and offal.
What foods is iron found in ?
Meat and fish, but also legumes and green leafy vegetables
Is iron supplementation recommended in pregnant women ?
No - should not be offered routinely to all pregnant women.
What foods is calcium found in ?
Bioavailability of calcium highest in milk and derivatives and in mineral water
What is the major polyunsaturated fat found in the human brain and retinal rods and ==> what is recommended to women to achieve adequate intake of this fat during pregnancy ?
- Docosahexaenoic Acid (DHA: is the major polyunsaturated fatty acid contained in the human brain and retinal rods)
- 2 to 3 servings of fish per week during pregnancy recommended for optimal fetal development
What is the function of vitamin D in relation to pregnancy?
Involved in the regulation of cytokine metabolism and in the modulation of the immune system, thereby contributing to the embryo implantation and regulating the secretion of several hormones
What are the maternal and fetal risks of inadequate vitamin D intake ?
Maternal Risks:
- Osteomalacia, Pre-eclampsia, Gestational diabetes, Caesarean section, Bacteria vaginosis
Fetal Risks:
- SGA, Neonatal Hypocalcaemia ,Asthma/Respiratory Infection, Rickets
What foods should a women avoid during pregnancy ?
- Soft cheese
- Undercooked meat, cured meats, game
- Tuna
- Raw/partially cooked eggs
- Pate
- Liver
- Vitamin & Fish Oil Supplements
What pregnant women are eligable for the UK healthy start scheme and what vitamins are given ?
- Available to pregnant women who are either; on benefits or <18 yrs old
- Vitamin supplements given = vit C, vit D & folic acid
Define low BMI/underweight
BMI ≤ 18.5
What are the risks associated with being underweight with respect to pregnancy?
- Fertility reduced- >2X more likely to take more tan 1 year to become pregnant ( hormonal imbalances)
- Maternal- nutritional depletion esp if hyperemesis develops
- Fetal- Intrauterine growth restriction, Low Birthweight, Preterm Labour
What is the management of low BMI/underweight during pregnancy?
- Exclude eating disorders- manage appropriately
- USS for growth 28, 32, 36 weeks
Define obesity
BMI ≥30
What are the maternal risks of obesity during pregnancy ?
- Fertility (ovulatory dysfunction) – longer time to conception
- Risk of miscarriage
- Risk of gestational diabetes
- Risk of pre-eclampsia
- Risk of thromboembolic disease ↑
- Risk of infection ↑
- Risk of labour dystocia ↑
- Risk of shoulder dystocia ↑
- Risk of C/S/operative delivery increased ↑
- Risk of PPH ↑
- Risk of infection↑
- Risk for depression/MH issues ( social isolation, loss of confidence, unemployment) ↑
- Reduced breastfeeding rates↑
What are the fetal risks of obesity during pregnancy ?
- Fetal anomalies ↑
- Miscarriage ↑
- Macrosomia ↑
- Still Birth ↑
- Neonatal Death ↑
- Less likely to be breastfed
- ↑Later life risks- Type 2 diabetes, Cardiovascular disease
What is the management of obesity during pregnancy?
- Antenatal red pathway
- Folic Acid 5mg till 12 weeks
- Vitamin D 10mg ( healthy start vitamins – Vit C, Vit D, Folic acid 400ug)
- Low Dose Aspirin ( 150 mg daily from 12/40 until delivery)
- VTE score- (fragmin from booking/28 weeks – beware BMI>50)
- OGTT 24-28 weeks
- USS growth from 28 weeks
What percentage of bariatric surgery is done in women of child bearing age ?
70%
What are the main types of bariatric surgery ?
gastric bypass, sleeve gastrectomy, gastric banding
What supplements should be given to a pregnant women who has had bariatric surgery ?
- A-Z supplents- use beta carotene
- Adcal D3 1Tablet BD
- Vit D 25mcg
- Ferrous gluconate 300mg/ IV Fe
- Thiamine B12 50-100mg
- Folic acid 5mg
- Vit B12 1mg IM 3 monthly
What type of contraception should be avoided in women with bariatric surgery ?
Oral contraceptives
