Preconception Ch 2-3 Flashcards
What is a miscarriage?
What are the common causes of miscarriage?
MISCARRIAGE: Spontaneous abortion in 1st 20 weeks of pregnancy
Defect in fetus
Maternal infection
Structural abnormalities of uterus
Endocrine or immunological disturbances
What hormones are involved in the reproductive physiology of females
LH: stimulates secretion of progesterone & testosterone
FSH: stimulates maturation of ovum, sperm, & production of estrogen
FOLLICULAR PHASE:
- Follicle growth & maturation -
Main hormones: GnRH, FSH, estrogen, & progesterone
Luteal Phase
- After ovulation
- Formation of corpus luteum
- estrogen & progesterone
stimulate menstrual flow
- Prostaglandins & cramps
What hormones are involved in the reproductive physiology of males
Interactions among hypothalamus, pituitary gland, and testes
-fluctuating levels of GnRH
-Signal the release of FSH and LH
Trigger production of Androgens ( Testosterone )
What are the nutrition-related disruptions in fertility? (5)
Undernutrition Weight loss Obesity High exercise levels Intake of specific foods & food components
NOT ON SG: what are the sources of disruptions in fertility? (6)
Adverse nutritional exposure Contraceptive use Severe stress Infection Tubal damage or other structural damage Chromosomal damage
Describe nutrition-related disruptions in fertility: UNDERNUTRITION
UNDERNUTRITION in women previously well-nourished
-Asso w/ dramatic ↓ in fertility (recovers
when food intake is re-est)
-Food shortages => dramatic ↓ in birth rates
Describe nutrition-related disruptions in fertility: BODY FAT
↓ fertility w/ low or high body fat bc of alterations in hormones
Estrogen and leptin
-Levels increased w/ high body fat & reduced with low
body fat
-Both extremes lower fertility
Infertility lower w/ BMI 30 (∴ fertility: 20-30 BMI)
Describe nutrition-related disruptions in fertility:
WEIGHT LOSS in W (3)
Weight loss >10-15% of usual weight ↓ estrogen, LH, FSH
Results in amenorrhea, anovulatory cycles, & short or absent luteal phases
*Treatment with fertility drug Clomid not effective in underweight women
Describe nutrition-related disruptions in fertility:
WEIGHT LOSS in M (2)
- studies fm WWII: 50% ↓ in male fertility during starvation
- sperm viability & motility ↓ w/ wt. 10-15% below normal & cease at wt. loss exceeding 25% of normal
Describe nutrition-related disruptions in fertility:
OXIDATIVE STRESS in M (2)
↓ sperm motility
↓ ability of sperm to fuse w/ an egg
Describe nutrition-related disruptions in fertility:
OXIDATIVE STRESS in F (3)
exercise, iron status, and alcohol intake
- Harm egg and follicular development
- Interfere with corpus luteum function
- Interfere with implantation of the egg
Describe nutrition-related disruptions in fertility: IRON STATUS (3) exercise, and alcohol intake
- Poor iron status = ↓ fertility
- Rate of infertility ↓er in W (who use iron
supplements/consumed iron from plant sources)
* 14% of U.S. women of childbearing age have inadequate iron stores
Describe nutrition-related disruptions in fertility:
EXERCISE
Adverse effects of intense physical activity ↑ deficits: from hormonal and metabolic changes -Delayed age at puberty -Lack of menstrual cycles Related to : -Caloric deficits -Low levels of body fat -↓ levels of estrogen -↓ bone density
Describe nutrition-related disruptions in fertility:
ALCOHOL INTAKE
Alcohol may ↓ estrogen & testosterone levels or disrupt menstrual cycles
Studies on weekly drinks consumed by women show:
1-5 drinks/week -> 39% ↓ in conception
>10 drinks/week -> 66% ↓ in conception
What is metabolic syndrome?
What are the components of metabolic syndrome?
Cluster of abnormal metabolic & health indicators
Diagnosed if 3/ 5 conditions exist:
1. Waist circumference: >40” in men & >35” in women
2. Blood triglyceride: ≥ 150mg/dL
3. HDL-cholesterol: < 40mg/dL M &130/85mmHg
5. Fasting blood glucose: ≥100mg/dL
Describe consequences*, prevalence, & therapy of MS.
CONSEQUENCES Increases risk of CVD & type 2 diabetes Characterize by chronic inflammation and oxidative stress PREVALENCE 32% in U.S. adults THERAPY -Dietary modifica/on -Exercise -Weight reduction
What is hypothalamic amenorrhea?
aka “functional hypothalamic amenorrhea” / “weight- related amenorrhea” : ending of menstruation related to changes in hypothalamic signals that maintain ovulation
- Reduced produc/on of GnRH (FSH and LH) (affects next steps)
- Caused by deficits in energy & nutrients (@L: 30% caloric deficit)
What is the relationship between body fat and hormones?
body fat ↑ = hormones ↑ (esp estrogen)
-can suppress hormones & affect ovulation
Describe the relationship between eating disorder & fertility
Anorexia nervosa & bulimia nervosa linked to hypothalamic amenorrhea in some women
- > likely to miscarry, have preterm delivery, have low birthweight infants
-Menses typically resumes w/ wt gain
Care - involves evidence based practice
-interdisciplinary group of experienced health professionals
What is female athlete triad? How it affects fertility?
Triad consists of: Amenorrhea, Disordered eating, Osteoporosis
Triggered when energy intake is ~30% less than requirement
∴ ↓ in LH, FSH & lack of estrogen
Low hormone levels -> ↓ in bone density
Differentiate between type 1 diabetes, type 2 diabetes, and gestational diabetes
Diabetes Mellitus: intolerance to carbs w/ fasting glucose ≥126 mg/dL (high glucose)
Type 1: results fm destruction of insulin-producing cells
(10% of cases)
-beta cells in pancreas can’t produce insulin
Type 2: body unable to use insulin normally, to produce enough insulin or both (90%)
-highly related to lifestyle
Gestational: onset during pregnancy (3-7%)
What are the key components of the nutritional management of PCOS? (4)
Primary goal is to ↑ insulin sensitivity
- Insulin-sensizing drugs
Diet recommendations:
-Lean proteins, whole grains, fruits & vegetables, regular
meals, non-fat dairy, & low-GI foods
-Weight loss & exercise improve prognosis
What is PCOS? (7)
POLYCYSTIC OVARY SYNDROME
*5-10% of women of childbearing age
leading cause of female infertility: absence of
ovulation
many are obese / have ↑ levels of intra-abdominal fat
Cause is uncertain
-Insulin resistance a possible factor
-Appears to have strong genetic component
What is PKU? How do you manage PKU?
PHENYLKETONURIA : Elevated blood phenylalanine (protein in milk) due to lack of phenylalanine hydroxylase (enzyme)
-Preventable cause of intellectual disability
Low-phenylalanine diet for life
What is celiac disease? (3)
*prevalence in U.S. is ~1 in 133
:autoimmune disease characterized by chronic
inflammation of small intestine
Inherited sensitivity to gluten in wheat, rye, barley, which causes malabsorption & flattening of intestinal lining
How do you manage celiac disease?
Eliminate gluten in diet
-Look for “gluten free” labels
Gluten found in many non-grain foods like hot dogs, deli meats, supplements, chips, bouillon, salad dressing, etc.
-Correction of vitamin & mineral deficiencies
What are the consequences of untreated celiac disease? (3)
multiple vitamin and mineral deficiencies
impaired fertility
fetal growth disruption
