Nutrition in Pregnancy Flashcards
What supplements should be taken pre-conception?
400mcg folic acid
What supplement should be taken through pregnancy and continued if breast feeding and why?
Vit D 10mcg/day, List
helps with fatigue, weight problems, mood problems, digestive problems and immune impairment
smoking during pregnancy is associated with lower levels of DHA. What is this?
omega-3 fatty acid that is an important structural component of human Brian, skin and retina
What patients should take 5mg of folic acid?
obese women,
diabetic patients,
history of abby with NTD or FH,
on anti-epileptics
Where are folates found naturally in diet?
green leafy veg,
oranges,
cereals
Why is iron intake very important in pregnant women?
anaemia v common and iron is involved in numerous enzymatic processes, increased risk of still-birth in severe deficiency
Who is at most risk of low iron in pregnancy? (3)
young age at first pregnancy,
repeated pregnancies,
multiple pregnancies
How much should calorie intake be increased in first trimester, second trimester and first 6 months of breastfeeding?
first trimester: 70kcal.day,
second trimester: 260-500kcal.day,
third: 250-500kcal/day,
breastfeeding: 500kcal/day
How much should protein intake be increased in first trimester, second trimester and third trimester?
first trimester: 1g/day,
second trimester: 8g/day,
third trimester: 26g/day
How much fish is recommended during pregnancy per week?
2-3 servings
maternal risks of low vitamin D? (5)
osteomalacia, pre-eclampsia, gestational diabetes, c-section, bacteria vaginosis
Fetal risks of low vit D? (4)
SGA,
neonatal hypocalcaemia,
asthma/resp infection,
rickets
List 7 foods that should be avoided in pregnancy?
soft cheese, undercooked meats, tuna, raw eggs, pate, liver, vitamin & fish oil supplements
50% of women of child-bearing age in UK are overweight or obese. T/F?
The
Why are women with low BMI <18.5kg/m 2 times more likely to take more than 1 year to get pregnant?
Due to hormonal imbalances
Low BMI risks in pregnancy? (4)
maternal nutritional depletion,
fetal intrauterine growth restriction,
preterm labour,
LBW
Antenatal management for woman with low BMI? (2)
exclude and manage ED,
USS for growth at 28, 32 and 36 weeks
Labour management for woman with low BMI? (3)
Usually normal,
beware of blood loss as “normal” may be more for them,
may need to adjust drugs
List 6 maternal risks of obesity
Basically everything increased!! miscarriage, gestational diabetes, pre-eclampsia, infection, labour dystocia, PPH
List 5 fetal risks of obesity
increased risk of: fetal anomalies, macrosomia, miscarriage, still birth, less likely to be breastfed
Management of obesity in pregnancy? (7)
folic acid 5mg till 12 weeks,
vit D10mg,
low dose aspirin (150mg daily from 12wks to delivery),
VTE score (fragmin from booking/12wks if needed),
OGTT 24-28wks,
USS growth from 28wks,
anaesthetic review 3rd semester if BMI >40
Postpartum management in terms of thromboprophylaxis for obese women
Fragmine dose weight dependent and give for 6 weeks postnatal
What are 4 common deficiencies in bariatric surgery?
vitamin D,
B12,
folate,
Fe
What test may not be possible when checking for gestational diabetes mellitus in pregnant women who have had bariatric surgery? What should you do instead?
OGTT may be impossible,
do HBA1c, BG monitoring, fasting blood sugar
Muslim women who are pregnant should avoid fasting and islamic law permits this. T/F?
T
Food sources of Vit B12 (4)
milk,
cheese,
eggs,
fortified unsweetened soya drinks
Sources of vita (4)
direct sunlight,
egg yolk,
some cereals,
most plant based spreads
Majority of GDM needs to be managed by medication. T/F?
False! 80% can be managed by diet alone
Why is exercise so important in GDM?
More glucose used by muscles for energy so BGs lower and insulin used more efficiently so BGs are maintained/lower
