Nutrition Flashcards

1
Q

What 2 supplements are pregnant women recommended to take ?

A
  1. 400 micrograms Folic acid pre-conception & first 12wks (5mg if either obese, diabetics, history of baby with NTD or FH, on anti-epileptics)
  2. 10 micrograms Vitamin D through pregnancy & continuation if breast feeding
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2
Q

What foods are folates (==> folic acid) found in ?

A

Found in green leafy vegetables, fruits (such as oranges), cereals and offal.

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3
Q

What foods is iron found in ?

A

Meat and fish, but also legumes and green leafy vegetables

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4
Q

Is iron supplementation recommended in pregnant women ?

A

No - should not be offered routinely to all pregnant women.

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5
Q

What foods is calcium found in ?

A

Bioavailability of calcium highest in milk and derivatives and in mineral water

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6
Q

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 ?

A
  • 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
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7
Q

What is the function of vitamin D in relation to pregnancy?

A

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

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8
Q

What are the maternal and fetal risks of inadequate vitamin D intake ?

A

Maternal Risks:

  • Osteomalacia, Pre-eclampsia, Gestational diabetes, Caesarean section, Bacteria vaginosis

Fetal Risks:

  • SGA, Neonatal Hypocalcaemia ,Asthma/Respiratory Infection, Rickets
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9
Q

What foods should a women avoid during pregnancy ?

A
  • Soft cheese
  • Undercooked meat, cured meats, game
  • Tuna
  • Raw/partially cooked eggs
  • Pate
  • Liver
  • Vitamin & Fish Oil Supplements
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10
Q

What pregnant women are eligable for the UK healthy start scheme and what vitamins are given ?

A
  • Available to pregnant women who are either; on benefits or <18 yrs old
  • Vitamin supplements given = vit C, vit D & folic acid
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11
Q

Define low BMI/underweight

A

BMI ≤ 18.5

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12
Q

What are the risks associated with being underweight with respect to pregnancy?

A
  • 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
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13
Q

What is the management of low BMI/underweight during pregnancy?

A
  • Exclude eating disorders- manage appropriately
  • USS for growth 28, 32, 36 weeks
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14
Q

Define obesity

A

BMI ≥30

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15
Q

What are the maternal risks of obesity during pregnancy ?

A
  • 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↑
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16
Q

What are the fetal risks of obesity during pregnancy ?

A
  • Fetal anomalies ↑
  • Miscarriage ↑
  • Macrosomia ↑
  • Still Birth ↑
  • Neonatal Death ↑
  • Less likely to be breastfed
  • ↑Later life risks- Type 2 diabetes, Cardiovascular disease
17
Q

What is the management of obesity during pregnancy?

A
  • 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
18
Q
A
19
Q

What percentage of bariatric surgery is done in women of child bearing age ?

A

70%

20
Q

What are the main types of bariatric surgery ?

A

gastric bypass, sleeve gastrectomy, gastric banding

21
Q

What supplements should be given to a pregnant women who has had bariatric surgery ?

A
  • 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
22
Q

What type of contraception should be avoided in women with bariatric surgery ?

A

Oral contraceptives