Physiological Changes during Prego

Question 1

Anabolic Phase and changes

Answer 1

0-20 weeks “Building up”
Fetus grows 10%
Increase anabolic hormones & bigger things (BV, Maternal Organs, Stores, appetite)
Decreased exercise tolerance

Question 2

Catabolic phase and changes

Answer 2

20-birth **Delivering - stored energy and nutrients
Fetus grows 90%
Mobilize, fast metabolism, Increase appetite + intake (decline near term), exercise
Catabolic hormones

Question 3

Best predictor of a baby’s health

Answer 3

Birth weight

Question 4

When is weight gained during pregnancy ?

Answer 4

2nd and 3rd trimester

Question 5

How does the weight you enter pregnancy at affect your gestational weight gain?

Answer 5

Underweight: Should gain more weight
Healthy weight: Should gain ~1/lb a week
Overweight + Obese: Should gain less weight

Question 6

58% of weight gain during pregnancy is due to ?

Answer 6

blood volume, fluids, protein, breast and energy stores

Question 7

When should you not recommend weight gain for pregnancy?

Answer 7

never

Question 8

Fetal weight cause is a cause of maternal weight gain (T/F)

Answer 8

F - Infant bw does not mean maternal gain caused it

Question 9

Overall energy balance during pregnancy?
How is it measured?

Answer 9

positive energy balance of 80,000 kcal
Energy in (diet) - Energy out (BMR, TEF, PA)

Question 10

What is energy needed for?

Answer 10

Maternal tissue
Fetal tissue
Increased BMR
Increased cost of Physical Activity

Question 11

How can we ensure a positive energy balance during pregnancy?

Answer 11

Adaptive responses:
***Increase intake, Decrease Energy expenditure
- Also Metabolic adaptation (less focus b/c cant’ rlly change)

Question 12

How does BMR levels alter for healthy, underweight, and obese women

Answer 12

H: Increased BMR
U: Decreased BMR
O: Greater increase (20%) offset fat accumulation

Question 13

For First trimester how much extra calories are needed and how much weight gain is associated?

Answer 13

No extra calories needed, co change in weight expected

Question 14

For 2nd and 3rd trimester how much calories are needed?

Answer 14

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)

Question 15

Human chorionic gonadotrophin

Answer 15

Maintain the corpus leteum, release hormones (estrogen, progestoge

Question 16

Estrogen during pregnancy does?

Answer 16

Influences reproductive organs, increases binding hormones, influences macro and bone metabolism

Question 17

Progesterone during pregnancy?

Answer 17

Relaxes smooth muscles (Gassy)

Question 18

How does the Placenta lactogen influence the mothers carbohydrate metabolism?

Answer 18

Increase insulin secretion
Increase hepatic glucose production
Decrease Insulin sensitivity
** goes along with the fetus’ needs
Lipid use is increased late into pregnancy

Question 19

Carbs RDA

Answer 19

130g/day
Prego: 175 g/day

Question 20

Fat metabolism during early pregnancy: (storage, levels, hormones, use)

Answer 20

~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

Question 21

Fat metabolism late pregnancy

Answer 21

Placenta lactogen factors maternal lipolysis and mobilize fat
increase FA oxidation = more glucose and AA for fetus
Increase fetal uptake of fat

Question 22

LA and ALA increase AI during pregnancy

Answer 22

LA - 12 to 13g/day
ALA from 1.1 to 1.4g/day

Question 23

Why is ~200mg of DHA necessary during pregnancy

Answer 23

only 5% of linolenic acids gets converted to DHA
AA and DHA are essential in neural and vision

Question 24

Describe protein metabolism during pregnancy

Answer 24

Gradual Increase nitrogen retention which leads to:
Decrease urine output (increase of other N waste) decrease AA oxidation, increase transfer of AA

Question 25

Protein RDA and change

Answer 25

0.8g/kg/day
1.1 g/kg/day (2nd and 3rd trimester)

Question 26

Which micronutrients require the largest increase during pregnancy

Answer 26

> 45%: folate, iron, iodine, B6 (needed for al proteins)
30-39%: zinc (needed for all enzyme rxn)

Question 27

Iron increase during pregnancy is needed for:

Answer 27

RBC mass - 500mg
Fetal/placental use - 315mg
Basal loss - 250 mg
Total: 1065mg needed

Question 28

Hemodilution affect

Answer 28

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)

Question 29

Maternal vs Fetal risk for iron deficiency

Answer 29

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

Question 30

EAR and RDA for Iron

Answer 30

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)

Question 31

RDA for Calcium and Vit D when pregnant

Answer 31

Calcium = 1000mg/d (Same - enhanced absorb )
Vit D = 600 IU/d (same)

Question 32

RDA Vit A

Answer 32

770 mcg/d

Question 33

Vit A deficiency or concern?

Answer 33

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)

Question 34

Vegetarians should pay attention 2?

Answer 34

B12
Protein and Iron intake
adequate energy and weight gain

Question 35

Why is dieting not recommended during pregnancy?

Answer 35

Increase energy expenditure = loss of nutrients, promotes ketones
– lowers glucose blood levels = higher chance of ketone production