Pregnancy Flashcards
Human gestation
40 weeks
3 trimesters
Placenta
Supplies nutrients + removes waste Barrier to potentially harmful agents Key endocrine organ Barred - water-soluble, active transport Cross - fat-soluble, toxins, teratogens
Second trimester
Growth
Mass: 25-900g
By end - foetus viable, many organ systems immature
Third trimester
Growth rapid
Maturation of all organ systems
28-40wks
Foetus quadruples weight
- truncal growth
- fat stores
- other nutrients
Weight gain
Average = 12.5kg
Most in second half
Important predictor of pregnancy outcome
Insufficient or excessive -> poor outcomes
In range that optimises maternal survival
Energy requirements
Needed for…
Decrease of…
Recommend…
Needed for
- increase mass uterus
- formation foetus
- formation placenta
- expanded blood volume
- deposition extra adipose tissue (lactation)
Decrease
- food intake
- BMR
- physical activity
Recommend
- 200kcal/d more EAR only 3rd trimester (exceptions: underweight + high P.A)
Protein requirements
For growth of foetus + maternal tissue
Excess -> health risks
6g more than DRV - current UK intake excess
LCPs
Pro + anti-inflammatory eicosenoids + module cell signalling pathways
Involved in gene expression
Heavily concentrated brain + retina
Transfer to foetus : rate correlated with maternal intake (meat, eggs, fish)
DHA depletion
Decreased visual function
Learning defects
Intervention - cod liver oil supplements from 2nd trimester
Lipids
Adequate supply critical to neurodevelopment
Foetal + neonatal brain has high demand for arachidonic acid + DHA
Vit C
Foetal demand especially 3rd trimester
Increase RNI by 10mg/d
Vit D
10ug/d supplements
Deficiency can be passed to baby
Calcium
No additional requirement - mobilisation stores + increased absorption
Supplements for adolescent pregnancy
Medical conditions can influence, e.g. celiac
Zinc
No additional requirements
Adaptive response
Magnesium
Adaptive response
Release from maternal stores
Iron
No additional requirements
- menstruation stops
- mobilisation of stores
- increased intestinal absorption
Supplements can contribute to constipation
Aversions
Early pregnancy…
Late pregnancy…
Early - tea, coffee, alcohol, fried foods, eggs
Late - sweet foods
Cravings
Random + variable
Compulsive urge for food not previously desired (in excess)
Rarely adversely affects overall nutrition
Pica
Desire for non-food substances - dirt, clay, starch
High prevalence in rural areas or family history
Consequences - toxicity, malnutrition, obesity, intestinal obstruction, interference with mineral absorption
Nausea + vomiting
Mostly 1st trimester
Recommend - stay hydrated, small frequent meals, crackers, avoid: tea, coffee, spicy + fatty foods
Hyperemesis gravidarum
Definition…
Complications…
Management…
Persistent vomiting before 20th week
Complications
- weight loss
- dehydration
- acidosis
- poor micro + macro nutrients
Management
- anti-emetics
- nutrition support
- fluid + electrolyte replacement
Pre-eclampsia
Characteristics
Risk factors
Prevention
Inc seizures or coma
Characteristics - hypertension, proteinuria, oedema
Risk factors - 20-40yrs, high BMI, family history, num children had
Prevention - possibly antioxidants
Heartburn Increased... Progesterone... Exacerbated by... Common... Recommendations...
Increased abdominal pressure from enlarged uterus pushing up against stomach
Progesterone decreases integrity sphincter muscle
Exacerbated by - spicy, fizzy, fatty, acidic foods, lying down
Common in 3rd trimester
Recommendations - milk, antacids, eat slowly, small/frequent meals
Constipation
Caused by… (2)
Increase…
Enlarging uterus displaces internal organs
Progesterone slows peristaltic action SM in bowel
Increase fluid, fibre + P.A
Gestational diabetes
Pregnant women with no prior history
Mostly resolves after birth
Associated with - high prematurity incidences, peri-natal mortality
Treatment - low sugar/high fibre diet, occasionally insulin injections req.
Smoking
34% all mothers UK smoke before/during pregnancy
Higher % in lower social class
Has decreased 1/3 last 15yrs
Alcohol can cause
Spontaneous abortion Birth defects Foetal alcohol syndrome Attachment disorders Suicide + depression Difficulties in social situations
Food safety: Toxoplasmosis
Parasite infection
Foetal abnormalities, blindness + mental retardation
Avoid - raw/uncooked meat, unwashed F+V, unpasteurised goats milk, cat faeces
Food safety: Listerosis
Results in brain damage
Food poisoning monocyte
Sources - raw/uncooked meat, unpasteurised milk/cheese
Developmental origins of health + disease
Events in foetal + early life may contribute to occurrence of diseases in adulthood
E.g. circulatory, respiratory, diabetes
1st trimester
embryo vulnerable
establish supporting placenta
