Pre-conception

Question 1

Nutrition + reproduction

Answer 1

Conception during food shortage = high mortality rate

Question 2

Weight to gain throughout pregnancy (based BMI)

Answer 2

Underweight = 12.5-18kg
Healthy = 11.5-16kg
Overweight = 7-11.5kg
Obese = 6.8kg

Question 3

Conception at 14.9kg/m2

Increased frequency of…

Answer 3

Spontaneous abortions
Congenital abnormalities
Perinatal mortality
Intra-uterine growth retardation (IUGR)

Question 4

Puberty
Males…
Females…
Hypothesis x2…

Answer 4

Delayed onset in boys due to undernutrition
Menarche influences nutritional status
Critical fat hypothesis
Metabolic signals hypothesis

Question 5

Diminished energy stores after menarche

Answer 5

Irregular or infrequent menstruation

Amenorrhoea in excessive weight loss/anorexia nervosa (protective)

Question 6

Obesity

Answer 6

Decreased sexual activity + function
Psychological handicapping
Gross may alter sex hormone production
Erectile dysfunction + oligospermia
Higher incidence miscarriage
NTDs despite folate supplements

Question 7

Antioxidants

Vit A deficiency + excess

Answer 7

Vit A deficiency - may decrease semen volume, sperm count + motility

Vit A excess - congenital abnormalities

Question 8

Folic acid
Complex...
Protect...
Risk factors...
Supplements...
Fortification...

Answer 8

B vit complex - essential for DNA/RNA synthesis
Protect against NTDs
Risk factors for low status - smoking, pregnancy, no supplements, oral contraceptive use, high parity
Supplements sub-fertile men = increased total sperm count
Fortification - many counties, not UK, masks B12 deficiency + 1mg/d colorectal cancer

Question 9

NTDs stats

Answer 9

4 babies per 10,000 births
Only 70% survive 1st b-day
33 hospital days in 1st year life

Question 10

Vit D

Answer 10

10mg/d
Essential entering pregnancy
Require enough to ensure supply to foetus

Question 11

Zinc
Role…
Co-factor…
Deficiency…

Answer 11

Role DNA + protein synthesis

Co-factor for enzymes involved growth, sexual maturation, fertility + reproduction

Deficiency - adversely affects folate absorption + metabolism. Decrease semen volume + testosterone

Question 12

Selenium
Required…
Deficiency…
Supplements…

Answer 12

Required for sperm maturation
Significant deficiency increases risk miscarriage
Supplements increase sperm motility

Question 13

Copper

Answer 13

Decreased plasma conc may affect fertility

Question 14

Iodine
Deficiency…
Severe deficiency…

Answer 14

Deficiency - decrease libido + andosterone production

Severe deficiency - increased miscarriage

Question 15

Smoking
Lower...
Require more...
Males...
Combined with...

Answer 15

Lower folate
Require more anti-oxidant intakes
Decreases semen quality
Smoking + obesity combined - delay time to conception

Question 16

Alcohol
Interferes...
Increased...
Folate...
Males...
Females...

Answer 16

Interferes Vit A metabolism
Increased zinc loss
Alcoholics - folate deficient
Abnormal sperm, decreased semen vol
Foetal alcohol syndrome, decreased probability conception

Question 17

Drugs

Answer 17

Can cause birth defects
Marijuana - decrease sperm motility
Cocaine + marijuana - affect brain chemistry releasing reproducing hormones
Side effects of prescription drugs

Question 18

Caffeine

Differing viewpoints…

Answer 18

High intake -> abnormal sperm

Stimulatory effect on sperm

Question 19

Recommendations - males

2-3 months before conception

Answer 19

Balanced + varied diet
Moderate alcohol intake
Correct grossly abnormal body weight
BMI upper end of normal range

Question 20

Recommendations - females

Answer 20

Folate supplementation at least 3 months prior conception
Avoid alcohol
Stop smoking
Correct weight
Balanced + varied diet