Pregnancy Flashcards
3 m before preg what should u do
- stop smoking
- stop drinking
- stop narcotics and unessery drugs
- periconception nutrition
folic acid recommendations for preg
minimal dose is 0.2mg daily in preconception and post
(.8mg recommended supplementally)
-use at least 1 m before trying to get preg
oral contraceptive complience
42%
accidental contraception in up to 2%
what is folate used for in body (2)
- used in conversion of homocysteine to methionine and involved in DNA methylation pathways via SAM (important for fetal devel)
- Also need to secrete tetrahydrofolate to up regulate the thymidylate DNA synthesis
how is folic acid made into folate in the body
ingested in form of mono glutamate folate
- converted to dihydrofolate via reductase
- DHF converted to tetrahydrofolate
- then finally made into 5,10 methylene THF
What is the significant of methylene tetrahyrofolate reductase in development
mutation in this gene leads to increased risk of neural tube defects
why does lower enzyme of 5methyl THF lead to neural tube defects
lower enzyme activity increases homocysteine as it cannot be converted back to methane
homocysteine are responsible for the delay in closure of neural tube
if mother has mutation in THF what is the risk (homozygous)
2x increase
-if fetus does too it goes up to 6x
what is the benefit of supplementing with 6S-6-MTHF
- aleady active form so don’t need gene for conversion
- doesnt mask signs of anemia + B12 def (folate usually masks signs)
- shows similar bioavailability/absorbtion etc
what are other benefits of good nutrition before conception
- high quality diet before and during preg may reduce the risk of gestational hypertension for the mother
- reduces risk of delivering a low birth weight infant
Vit D and pregnancy
Decreased odds of low birth weight infants
when does pregnancy typically occur in gestational period
2 weeks
What happens in the follicular phase+ how long
14 days
- FSH causes several follicles to rise to the surface of ovary
- maturing follicle releases estrogen that increases over time and peaks a day/two before ovulation
- estrogen increases GRH which increases LH and test
When does ovulation happen and hormones
around day 14
- surge in LF and FSH causes the release of the follicle
- mature egg is released and enters fallopian tube where fertilization may take place if sperm is present
What occurs in the luteal phase
the empty follicle will degenerate into the corpus lute
-levels of FSH + LH decrease and corpus luteum start producing progesterone
what is the middelschmerz pain
pinching sensation lateralized to the side of ovulation in lower abdomen can correlate w ovulation
cervical mucus w ovulation
- when fertile, the mucus changes consistency and structure to allow for sperm to travel to egg (clear and stretch)
- when not fertile the mucus is more sticky/cloudy
basal body temp during ovulation
temp increases .5c the day after ovulation and stays that way until menstruation
metabolic signalers in ability to get preg
leptin, insulin, glucose
epinephrine and neuroppeptide Y connect to the forebrain and influence GNRH
what do girls with REDS have lower levels of
have lower levels of leptin, LH, estradiol
Overnutrition + preg
- overeating in 1st few weeks increases embryonic mortality associated w lower levels of progesterone
- 4x increase in risk of offspring being obese
Obesity and preg can lead to what (4)
Syndrome ‘O’
- Over nourishment
- overprod of insulin
- ovarian confusion
- ovulation disruption
possibility of preg after single episode of unprotected sex intercourse
20-30%
home preg test- when should it be done + HCG level for neg/preg
4-5 w after
-Anything <5 is neg
>25 is considered pos
-# doubles every 3 days during preg
normal weight gain over full gestational period (+ for overweight women)
11.3-15.9 kg
overweight= 6.8-11.4kg
what is preclampsia
multisystem disease
- characterized by elevated blood pressure and proteinuria
- can lead to substantial fetal morbitity/mortality
omega 3 and preg
Omega 3s have anti-inflammatory actions that may influence hypertension and preclamsia
-low risk preg show statistical dif in omega 3 supplementation in terms of disease prevention
activity guildlines in preg: type, intensity, duration, frequency
tyep: low impact, sets of 12 major mm groups
intensity- light to mod
duration: 150 m/w
frequeny: 5x week
how is choline available to fetus and when is it purge
- dietary delivered strait to fetus
- choline in liver can make PC and thru CDP-choline pathway or be oxidized to betaine then PC through the PEMT-PC pathway
- upreg in 3rd tri
adequate intake of choline
425mg/day
decreased iron status in the mother can lead to
- increased maternal illness
- low birthweight
- prematurity
- intrauterine growth restriction
- autism
- schizo
newborns w iron def have
compromised recognition memort
slower speed of processing
poorer bonding
prevelence of iron def
- 3%
49. 4% were sev def
DHA/EPA supplementation + cognitive parameters and birth weight
no impact
