Physiological Changes during Prego Flashcards
Anabolic Phase and changes
0-20 weeks “Building up”
Fetus grows 10%
Increase anabolic hormones & bigger things (BV, Maternal Organs, Stores, appetite)
Decreased exercise tolerance
Catabolic phase and changes
20-birth **Delivering - stored energy and nutrients
Fetus grows 90%
Mobilize, fast metabolism, Increase appetite + intake (decline near term), exercise
Catabolic hormones
Best predictor of a baby’s health
Birth weight
When is weight gained during pregnancy ?
2nd and 3rd trimester
How does the weight you enter pregnancy at affect your gestational weight gain?
Underweight: Should gain more weight
Healthy weight: Should gain ~1/lb a week
Overweight + Obese: Should gain less weight
58% of weight gain during pregnancy is due to ?
blood volume, fluids, protein, breast and energy stores
When should you not recommend weight gain for pregnancy?
never
Fetal weight cause is a cause of maternal weight gain (T/F)
F - Infant bw does not mean maternal gain caused it
Overall energy balance during pregnancy?
How is it measured?
positive energy balance of 80,000 kcal
Energy in (diet) - Energy out (BMR, TEF, PA)
What is energy needed for?
Maternal tissue
Fetal tissue
Increased BMR
Increased cost of Physical Activity
How can we ensure a positive energy balance during pregnancy?
Adaptive responses:
***Increase intake, Decrease Energy expenditure
- Also Metabolic adaptation (less focus b/c cant’ rlly change)
How does BMR levels alter for healthy, underweight, and obese women
H: Increased BMR
U: Decreased BMR
O: Greater increase (20%) offset fat accumulation
For First trimester how much extra calories are needed and how much weight gain is associated?
No extra calories needed, co change in weight expected
For 2nd and 3rd trimester how much calories are needed?
2nd: 340kcal/d
3rd: 424kcal/d
*about 2-3 extra servings a day of healthy food (3/4 yougurt, 1/2 pasta w/ tomato sauce, banana)
Human chorionic gonadotrophin
Maintain the corpus leteum, release hormones (estrogen, progestoge
Estrogen during pregnancy does?
Influences reproductive organs, increases binding hormones, influences macro and bone metabolism
Progesterone during pregnancy?
Relaxes smooth muscles (Gassy)
How does the Placenta lactogen influence the mothers carbohydrate metabolism?
Increase insulin secretion
Increase hepatic glucose production
Decrease Insulin sensitivity
** goes along with the fetus’ needs
Lipid use is increased late into pregnancy
Carbs RDA
130g/day
Prego: 175 g/day
Fat metabolism during early pregnancy: (storage, levels, hormones, use)
~35,00 kcal stored up to the 20 weeks
Estrogen, progesterone, and insulin favor fat deposition - inhibit lipolysis
increased TG, cholesterol, phospholipids, FA
** Some cholesterol used by placenta for steroid syn and fetus for nerves and membrane
Fat metabolism late pregnancy
Placenta lactogen factors maternal lipolysis and mobilize fat
increase FA oxidation = more glucose and AA for fetus
Increase fetal uptake of fat
LA and ALA increase AI during pregnancy
LA - 12 to 13g/day
ALA from 1.1 to 1.4g/day
Why is ~200mg of DHA necessary during pregnancy
only 5% of linolenic acids gets converted to DHA
AA and DHA are essential in neural and vision
Describe protein metabolism during pregnancy
Gradual Increase nitrogen retention which leads to:
Decrease urine output (increase of other N waste) decrease AA oxidation, increase transfer of AA
Protein RDA and change
0.8g/kg/day
1.1 g/kg/day (2nd and 3rd trimester)
Which micronutrients require the largest increase during pregnancy
> 45%: folate, iron, iodine, B6 (needed for al proteins)
30-39%: zinc (needed for all enzyme rxn)
Iron increase during pregnancy is needed for:
RBC mass - 500mg
Fetal/placental use - 315mg
Basal loss - 250 mg
Total: 1065mg needed
Hemodilution affect
increased in plasma volume and a decrease in Hb because of the babies blood included
-Primarily 10-20 weeks (2nd trimester = max volume, Hb >105g/l)
Maternal vs Fetal risk for iron deficiency
Mom: work slow, can’t do blood loss,
Fetus: 2-3x increase risk of preterm baby, lower intelligence, language, gross motor, risk of iron deficiency anemia
EAR and RDA for Iron
EAR = 22mg/day = 5.5mg absorbed
RDA = 27 mg/day = 6.75mg absorbed
Health Canada = 16-20mg of iron throughout pregnancy (unless entered iron deficient)
RDA for Calcium and Vit D when pregnant
Calcium = 1000mg/d (Same - enhanced absorb )
Vit D = 600 IU/d (same)
RDA Vit A
770 mcg/d
Vit A deficiency or concern?
deficiency in developing countries: (malformations of lungs, heart, urinary tract)
toxicity concern in developed countries: “retonic acid syndrome - small or no ears, brain malformations, heart defects)
Vegetarians should pay attention 2?
B12
Protein and Iron intake
adequate energy and weight gain
Why is dieting not recommended during pregnancy?
Increase energy expenditure = loss of nutrients, promotes ketones
– lowers glucose blood levels = higher chance of ketone production
