Nutrition in Pregnancy Flashcards
1
Q
Determinants for optimal weight gain
A
- BMI
- pre-pregnant nutritional state
- adequate and balanced caloric intake
2
Q
Normal BMI during pregnancy
A
18.5-24.9
3
Q
If a woman is meeting her calories for the day, does this also mean she is meeting her and the baby’s nutritional needs?
A
No!!
Rationale: An adequate caloric intake does no necessarily mean nutritional needs are being met.
4
Q
How many lbs should an UNDERWEIGHT woman gain during pregnancy?
A
28-40lbs
5
Q
How many lbs should a NORMAL weight woman gain during pregnancy?
A
25-35lbs
6
Q
How many lbs should an OVERWEIGHT woman gain during pregnancy?
A
15-25lbs
7
Q
How many lbs should an OBESE woman gain during pregnancy?
A
11-20lbs
8
Q
How many lbs should a woman gain during pregnancy if she is carrying twins?
A
35-45lbs
9
Q
ketonemia
A
losing weight in pregnancy
10
Q
How many lbs does the fetus, placenta, and amniotic fluid add?
A
12+ lbs
11
Q
How many lbs does the uterus add?
A
2lbs
12
Q
How many lbs does increased blood volume add?
A
4+ lbs
13
Q
How much does the blood volume increase throughout pregnancy?
A
40-50%
14
Q
How many lbs do the breasts add?
A
1-4lbs
15
Q
How many lbs do the maternal stores of fluid and ECF fluid add?
A
3-8lbs
16
Q
How many lbs do the increased fat stores add?
A
4-6lbs
17
Q
What is considered the “weight to lose” after birth?
A
the increased fat stores
18
Q
How many lbs/month/overall should be gained in the 1st trimester?
A
1lb/month x3 months = 3lbs
19
Q
How many lbs/week/overall should be gained in the 2nd and 3rd trimesters?
A
1lb/week x26 weeks = 26lbs
20
Q
What amount of weight gain is considered “excessive” and is cause for evaluation?
*likely cause??
A
> 2lbs/week or >6.6lbs/month
*r/t fluid retention
21
Q
Amount of kcalories needed in 1st trimester
A
1800 kcalories
22
Q
Amount of kcalories needed in 2nd trimester
A
2200 kcalories
23
Q
Amount of kcalories needed in 3rd trimester
A
2400 kcalories
24
Q
What can cause excess weight gain in pregnancy?
A
Too much caloric intake in the 1st trimester
25
True or False:
| A majority of women in the United States who give birth are overweight or obese.
TRUE
Rationale: 60% of women in the US who give birth are overweight or obese. They are considered "high-risk" pregnancies and are at risk for developing perinatal/maternal conditions.
26
Risks that coincide with pregnant women who are overweight/obese
- SAB/ miscarriage
- development of gestational DM
- HTN/ pre-eclampsia
- induction of labor
- c-section
- thromboembolism
- abnormal fetal development
- PPH
- depression
27
True or False:
| Pregnant women should eat 3 large meals per day just like normal.
FALSE.
Rationale: Pregnant women should eat 6 small meals per day. This helps to stabilize blood glucose.
28
Why is a small snack of protein recommended at bedtime?
Helps to keep blood glucose consistent through the night (prevents drops)
29
How should a plate look for a pregnant woman?
Variety of colors ie. greens, browns for meat, red berries, etc.
30
Recommended supplements during pregnancy
- folic acid (before pregnancy and during)
- iron (2nd and 3rd trimester)
- daily prenatal vitamin
31
Why do pregnant women need supplemental iron?
A lot of iron goes to the baby so you need to supplement to decrease risk of anemia.
32
Reason for needing folic acid during pregnancy
Folic acid reduces risk of neural tube defects (NTDs)
33
Anemia in pregnancy is associated with...
preterm labor and SGA infants
34
Sources of iron include...
- lean meat (low fat ratio)
- dark leafy greens
- eggs
- whole grain and enriched cereals/ breads
- dried fruits
- legumes
- prune juice
- shell fish
35
Which diet puts women at a higher risk for developing anemia r/t low iron intake?
vegetarian
Rationale: The iron found in veggies is not as readily absorbed as the iron found in red meat.
36
Which juice helps iron absorption?
Orange juice!
Rationale: Vitamin C increases Fe absorption.
37
When is the ideal time to take iron?
with food at bedtime
38
True or False:
It is a sign of iron toxicity if your stools are dark green or black.
FALSE.
Rationale: It is perfectly normal to have dark green or black stools when taking iron supplements.
39
How much iron should be consumed in the 2nd and 3rd trimesters?
27mg
40
What Hct and Hgb levels are considered anemic in a pregnant woman?
Hct <33%
| Hgb <11
41
What lab helps determine anemia?
serum ferritin levels
42
True or False:
Iron that is not bioavailable can increase constipation.
TRUE.
Rationale: Iron found in plants and legumes is not bioavailable and can cause constipation. Vegetarian women should speak to their dietician about this matter.
43
True or False:
Vitamin B9 and folic acid are synonymous.
TRUE.
44
How much folic acid should a pregnant woman take in (low risk PG)?
0.4mg
45
How much folic acid should a pregnant woman take in (high risk PG)?
4mg
46
Sources of folic acid include...
- liver
- chicken
- turkey
- beef
- lamb
- green veggies
- peanuts
- oranges
- pasta
- corn
- eggs
47
Examples of neural tube defects
- spina bifida
- meningomyelocele
- anencephaly
48
What vitamin to vegetarians need to supplement?
- vitamin b12
- vitamin D
- calcium
49
What is phenylketonuria (PKU)?
An inability to covert phenylalanine to tyrosine, which leads to increased phenylalanine level, leading to toxicity in the blood.
50
True or False:
Women will PKU will complain of musty smelling urine.
TRUE.
51
Who is at highest risk for developing PKU?
Caucasians
52
What food should women with PKU avoid at all cost during pregnancy? Why?
food containing aspartame (artificial sweeteners)
the body breaks this down into phenylalanine
53
True or False:
Women can pass PKU onto their babies if not careful.
TRUE.
Rationale: Women with PKU should be on a PKU diet to decrease risk of passing condition to baby.
54
True or False:
Babies with PKU can be completely breastfed.
FALSE.
Rationale: Babies with PKU need to be fed either completely with phenylalanine-free formula or given a mixture of breastmilk and PAF formula.
55
What is the only FDA approved drug to help with PKU?
Kuvan (sapropterin)
Rationale: Increases tolerance to phenylalanine.
56
How much fluid should pregnant women drink daily? How much of this should be water?
3 liters
8-10 (2.3L) glasses
57
True or False:
Dehydration increases the risk of cramping, uterine contractions, and PTL.
TRUE.
*also decreases amniotic fluid volume
58
Why should pregnant women limit coffee, tea, soft drinks, and energy drinks?
These drinks contain caffeine, which causes vasoconstriction of blood vessels and also acts as a diuretic.
59
Why is mercury dangerous in pregnancy?
The developing fetal brain is susceptible to the effects of mercury neurotoxicity.
60
Which fish carry high levels of mercury? Limit to...
- shark
- swordfish
- king mackerel
- albacore tuna
Limit to 6oz/week
61
Low levels of mercury are found in which fish? Limit to...
- canned light tuna
- shrimp
- salmon
- catfish
- pollock
- sardines
- trout
Limit to 12oz/week
62
Why is seafood important in pregnancy?
Provides a source of omega 3 fatty acids, which improve neurologic/visual development and reduce risk for PTB.
63
If wanting to avoid listeriosis and E. coli, which foods should be restricted?
- cookie dough
- unpasteurized dairy or juice
- uncooked seafood
- store prepped salads with eggs, ham, chicken, or seafood
64
True or False:
Pregnant women do not need to be cautious of hotdogs, lunch meats or prepackages foods.
FALSE.
Rationale: It is possible that these foods contain listeriosis and E. coli. These foods should be avoided and hot dogs should be cooked to 160 degrees.
65
If wanting to avoid toxoplasmosis, which foods should be restricted?
unpasteurized eggs and undercooked meats
66
True or False:
A pregnant woman should not handle cat feces or the litter box.
TRUE.
Rationale: Cat feces can carry toxoplasmosis. The woman should have a friend or family member dispose of the litter.
67
What do listeriosis, E. coli, and toxoplasmosis cause if contracted during pregnancy?
Causes maternal and fetal sepsis. Can also cause SAB, PTB, or still birth.
68
How does listeriosis, E. coli, and toxoplasmosis travel to baby?
Transplacentally or during birth.
69
True or False:
If a laboring or postpartum mother presents with brown stained amniotic fluid or with an abnormal placenta, this is not cause for concern.
FALSE.
Rationale: These two signs are signs of infection (listeriosis, E. coli, toxoplasmosis) and the mother and baby should be tested immediately.
70
Why is PICA severely underreported?
embarrassment
71
Which groups are at a higher risk for developing PICA?
- low socioeconomic status
- African Americans
- Hispanics
- rural dwelling
- family hx of PICA
- LOW IRON during pregnancy
72
What do African American women with PICA usually crave?
cornstarch
73
What do Hispanic women with PICA usually crave?
Tierra - eating soil and pulverized pottery
74
Women with PICA are at a higher risk for which two conditions?
Anemia and constipation
75
Do adolescents need to gain more or less weight during pregnancy?
MORE
76
How many calories should a breast feeding woman eat per day?
approx. 500+ kcalories than normal
2500-2700 kcalories
77
How many grams of protein should a breastfeeding mom eat per day?
62-65 grams/day
78
What are some foods that make babies colicky?
garlic, onions, cabbage, chocolate
79
Should moms continue to take iron postpartum?
YES!!! For 2-3 months postpartum
80
How comprehensive should a diet analysis be?
very comprehensive - helps get a true evaluation of eating patterns
