Nutrition During Pregnancy

Question 1

why is preterm delivery and low birth weight higher in African American infants than in other infants

Answer 1

• racial discrimination
• poor access to nutritious foods
• lack of access to health care
• poverty

Question 2

infants weighing ______ are least likely to die within the first year of life

Answer 2

3,500g-4,500g or 7lb 12oz to 10lb

Question 3

the common way of measuring pregnancy duration includes

Answer 3

2 nonpregnant weeks at the beginning

Question 4

maternal circulating nutrients, some of which are drawn from maternal nutrient stores, are utilized to support

Answer 4

• plasma volume expansion
• the physiological processes that follow

Question 5

metabolic and functional changes occur within

Answer 5

• the mother
• uterus
• placenta
• embryo
• fetus
• this places high demands on maternal nutrient reserves available at conception

Question 6

attempts to bring maternal physiological changes back to non-pregnant levels may cause more harm than good to the pregnancy

Answer 6

true

Question 7

changes in maternal body composition and functions occur in a specific sequence during pregnancy. the order of the sequence is absolute because the successful completion of each change depends on the one before it

Answer 7

true

Question 8

the mother must first expand the _____ that can be circulated to provide the fetus with sufficient energy, nutrients, and oxygen for growth.

Answer 8

volume of plasma

Question 9

duration of pregnancy varies somewhat based on

Answer 9

maternal parity and age

• it tends to be several days shorter for parous women
  older than 35 yrs

Question 10

the maximal rate of placental growth is timed to precede that of fetal weight gain

Answer 10

true

Question 11

the sequence of physiological changes that take place during pregnancy ensures that the _____ is fully prepared for the high level of functioning that will be needed as fetal weight increases most rapidly

Answer 11

placenta

Question 12

abnormalities in the development of any of these physiological systems cannot subsequent fetal growth and development

Answer 12

false

*it can

Question 13

placenta

Answer 13

a disc-shaped organ of nutrient and gas interchange between mother and fetus

Question 14

a woman’s body gains a good deal of water during pregnancy, primarily due to increased

Answer 14

• volumes of plasma
• extracellular fluid
• amniotic fluid

Question 15

the primary purpose of increased body water composition is to

Answer 15

expand blood flow and nutrient transfer to the placenta and fetus

Question 16

fatigue associated with plasma-volume increases in which months of pregnancy declines as other compensatory physiological adjustments are made

Answer 16

second and third months or pregnancy

Question 17

early pregnancy surges in plasma volume appear to be the primary reason that pregnant women feel tired and become exhausted easily when undertaking exercise performed routinely prior to pregnancy

Question 18

if not acomapnied by hypertension, edema generally reflects a healthy expansion of plasma volume

Question 19

high gains are associated with increasing degrees of edema and weight gain

Question 20

what is strongly related to plasma volume

Answer 20

birthweight

*the greater the expansion the greater the newborn size

Question 21

which vitamins increase and decrease during pregnancy

Answer 21

increase - fat-soluble
decrease - water-soluble

Question 22

the placenta serves many roles, but a key one is the production of

Answer 22

steroid hormones like progesterone and estrogen

Question 23

what is the main supplier of many other hormones needed to support the physiological changes of pregnancy

Answer 23

placenta

Question 24

the amount and types of nutrients required depend on what is needed for specific metabolic pathways to function and for fetal structures to develop. because normal fetal tissue growth and development are genetically timed, nutrients must be available at the same time that genes controlling fetal growth and development are expressed.

Question 25

diabetogenic effect of pregnancy

Answer 25

normal pregnant women slightly carbohydrate intolerant in the third trimester of pregnancy *since glucose is the preferred fuel for the fetus, continued availability of a fetal supply of glucose is accomplished primarily through metabolic changes that promote maternal insulin resistance

Question 26

carbohydrate metabolism in the first half of pregnancy is characterized by

Answer 26

estrogen and progesterone stimulated increases in insulin production and conversion of glucose to glycogen and fat

Question 27

in the self half of pregnancy rising levels of ____ and ____ from the mother's pituitary gland inhibit the conversion of glucose to glycogen and fat

Answer 27

hCS prolactin

Question 28

insulin resistance builds, increasing the reliance on ___ for energy

Answer 28

fats

Question 29

decreased conversion of glucose to glycogen and fat, lowered maternal utilization of glucose, and increased liver production of glucose help to ensure that

Answer 29

a constant supply of glucose for fetal growth and development is available in the second half of pregnancy

Question 30

fasting maternal blood glucose levels decline in the third trimester due to increased utilization of glucose by the rapidly growing fetus. however! post-meal blood glucose concentrations are elevated and remain higher longer than before prenancy

Question 31

maternal metabolism is rapidly converted toward

Answer 31

- glucogenic amino acid ulization - fat oxidation - increased production of ketones with fasts that last longer than 12 hrs.

Question 32

fasting metabolism allows pregnant women to use primarily _____ for energy while sparing ___ and ____ for fetal use

Answer 32

fat glucose amino acids

Question 33

fasting eventually increases the dependence of the fetus on ketone bodies for energy. prolonged fetal utilization of ketones, such as occurs in women with poorly controlled diabetes or in those who lose weight during part or all of pregnancy is associated with abnormal growth and impaired intellectual development of the offspring.

Question 34

nitrogen and protein are needed in increased amounts during pregnancy for

Answer 34

synthesis of new maternal and fetal tissues

Question 35

the increased need for protein is met through reduced levels of nitrogen excretion and the conservation of amino acids for protein tissue synthesis

Question 36

there is evidence that the mother's body stores protein early in pregnancy in order to meet fetal needs for protein later in pregnancy

Answer 36

false, there is no evidece

Question 37

maternal and fetal needs for protein are primarily fulfilled by

Answer 37

the mother's intake of protein during pregnancy

Question 38

changes in lipid metabolism promote

Answer 38

- accumulation of maternal fat stores in the first half of pregnancy - enhance fat mobilization in the second half

Question 39

increased fat mobilization causes

Answer 39

blood lipid levels to increase dramatically * plasma triglyceride levels increase first, more than doubling nonpregnant levels by term.

Question 40

cholesterol containing lipoproteins, phospholipids, and fatty acids also increase, but to a lesser extent than do triglycerides.

Question 41

the increased cholesterol supply is used by the placenta for

Answer 41

steroid hormone synthesis by the fetus for nerve and cell membrane formation

Question 42

high concentrations of cholesterol and triglycerides observed during normal pregnancy have not been found to promote the development of atherosclerosis

Answer 42

however evidence suggests that abnormally high levels of cholesterol and triglycerides may indicate the prepregnancy existence of insulin resistance or another disorder

Question 43

insulin resistance before conception increases the risk that ____ and ____ will develop during pregnancy

Answer 43

diabetes and hypertension

Question 44

although a cholesterol lowering diet during pregnancy has been found to lower maternal cholesterol levels somewhat, it does not appear to alter cord and neonatal cholesterol levels

Question 45

increases in HDL cholesterol in pregnancy as well as other changes in serum lipids appear to revert to prepregnancy levels postpartum.