Nutrition During Pregnancy Part 1

  1. Born in 39-40 weeks
    Full (normal) term
  2. born < 39 weeks
  3. Born in 41 weeks
    Late term
  4. Born in >42 weeks
    post term
  5. Born in < 34 weeks
    very preterm
  6. The status of pregnancy outcomes that reflects the health and socioeconomic status of a population is
    infant mortality
  7. Decreases in _____ are related to improvements in social circumstances, availability of safe and nutritious food supply and infectious disease control
  8. after the introduction of _____ infant morality in the US dramatically declined
  9. Fetal deaths, neonatal mortality and infant mortality in the US are all _____ while maternal mortality is _____
    decreasing, increasing
  10. True/False: low birth weight or preterm infants are at high risk of mortality in the first year than other newborns

    8.2% of births are LBW yet comprise 66% of infant deaths
  11. What three ethnicities have the highest rates of preterm births
    blacks, american indian/Alaskan native, hispanic
  12. infants born with desirable weight are less likely to develop later in life...
    heart and lung diseases, diabetes, hypertension
  13. Desirable birth weight
    3500-4500 g (7 lb. 12 oz- 10 lbs)
  14. Assessed from date of conception and average pregnancy is 38 weeks
    gestational age
  15. assessed first day of last menstrual period and average pregnancy is 40 weeks
    menstrual age
  16. Changes that occur in the mother in the 1st half of pregnancy
    maternal anabolic changes
  17. changes that occur int eh other in the second half of prenancy
    maternal catabolic changes
  18. What occurs during the anabolic phase (0-20 weeks)
    • blood volume expansion, increased cardiac output
    • built up of fat, nutrient and liver glycogen
    • growth of some maternal organs
    • increased appetite, food intake (positive calorie balance)
    • increased levels of anabolic hormones (like insulin)
  19. What occurs during the catabolic phase (20+weeks)
    • mobilization of fat and nutrient stores
    • increase production of serum levels of BG, TG, fatty acids, decreased liver glycogen stores
    • accelerated fating metabolism
    • increased appetite and food intake decline what near term
    • increased catabolic hormones
  20. Body water increases from ~7 L to
    10 L
  21. Body water increase is a result of increased
    intracellular, blood and extracellular volume and amniotic fluid
  22. "dilution effect"
    some vitamins and minerals in blood test will seem lower due to hypervolemia
  23. maintains early pregnancy by stimulating the corpus luteum to produce estrogen and progesteron. Stimulates growth of the endometrium
    human chorionic gonadotropin (hCG)

    *made by the placenta
  24. maintains the implant; stimulated growth of the endometrium and its secretion of nutrients; stimulates breast development; promotes lipid deposition

    *Made by the placenta
  25. increases lipid formation and storage, protein synthesis, and uterine blood flow; promotes uterine and breast duct development

    *made by the placenta
  26. increases maternal insulin resistance to maintain glucose availability for fetus; promotes protein synthesis and lipolysis for energy for maternal use
    human chorionic somatotropin (hCS)

    *made by the placenta
  27. tissue that forms after follicle releases egg
    corpus luteum
  28. metabolic changes in mother can be seen in
    the first few weeks after conception
  29. Preferred source of fuel for fetus
  30. continued supply of glucose to the fetus accomplished through metabolic changes to promote maternal _____ ______
    insulin resistance
  31. causes women to be slightly glucose intolerance in the 3rd trimester so glucose can be used by baby
    "diabetogenic effect of pregnancy"
  32. High levels of estrogen and progesterone in first half of pregnancy stimulate
    insulin production which increases conversion of glucose to glycogen and fat
  33. in second half of pregnancy, increased levels of human chorionic somatotropin and prolactin inhibit conversion of
    glucose to glycogen and fat
  34. goal of second half of pregnancy in CHO metabolism
    ensure that there is a constant supply of glucose to the fetus for fetal growth and development
  35. in the second half of pregnancy there is an increased production of
    glucose by the liver and insulin resistance
  36. With fasts >12 hours, pregnant women more rapidly convert to ____ _____
    fasting metabolism
  37. using gluconeogenic amino acids, fat oxidation and ketone production
    fasting metabolism
  38. What is the purpose of the fasting metabolism?
    to allow the mother to use stored fat for energy and spare glucose and amino acids for fetal use
  39. Prolonged fetal utilization of ketones associated with
    reduced growth and intellectual disability
  40. How is protein conserved during pregnancy?
    By reducing nitrogen excretion
  41. True/False: the mother's body stores protein early in pregnancy to prepare for later needs
    False, no evidence of this
  42. Maternal and fetal needs must be met by....
    mother's intake of protein
  43. When do fat stores accumulate?
    In first half of pregnancy
  44. When does enhanced fat metabolism happen?
    in second half of pregnancy
  45. Increased ____ is used by the placenta for steroid hormone synthesis and by fetus for nerve and cell membrane formation
  46. calcium metabolism occurs in pregnancy because
    there is increased bone turnover and reformation
  47. mineral that accumulates in mother, placenta and fetus

    *aldosterone increases and retains Na
  48. Functions of the placenta (3)
    • hormone and enzyme production
    • nutrient and gas exchange between mother and fetus
    • removal of waste from fetus
  49. True/False: placenta is a barrier to all bacteria and viruses

    • Viruses: measles, HIV, rubella 
    • Bacteria: lysteria
    • ^Can pass through
  50. Double lining of cells separating maternal and fetal blood
    structure of placenta
  51. true/false: alcohol, excessive levels of some vitamins and some drugs pass through the fetus
  52. Does insulin cross the placenta?
  53. Which molecules cross the placenta the easiest?
    • small molecules with little to no charge (water)
    • lipids

    Large particles (like insulin and enzymes) are not transferred
  54. water, some AA, glucose, free fatty acids, cotton, vitamins E and K, Na, Cl and gases all use ____ diffusion
  55. iron, vitamins A and D use ____ diffusion
  56. water-soluble vitamins, some minerals (Ca, Zn,Fe, K), amino acids use ____ _____ to cross the placenta
    active transport
  57. immunoglobulins and albumin use ____ to cross the placenta
  58. True/False: the nutrients are first used to meet the fetal needs and then the mothers

    First used to meet maternal needs, then placenta, THEN baby
  59. True/False: the fetus is harmed more than the mother by poor maternal nutrition
  60. the rate of human growth and development is higher during ____ than any other period of life
  61. Genetically pre-programmed time periods during embryonic and fetal development when specific cells, organs and tissues are formed and functional levels are established
    critical periods of growth and development
  62. when is the most intense critical period?
    during the first 2 months when the majority of organs and tissues begin to form
  63. ____ is the primary stimulator of fetal growth
    Insulin-like growth factor (IGF-1)
  64. IGF-1 levels are decreased by
    maternal unernutrition
  65. Newborns whose weight is less than the 10th percentile for gestational age
    Small for gestational age
  66. weight is <10th percentile but have normal length and head circumference)
    Disproportionately small for gestational age (dSGA)
  67. weight, length and head circumference are <10th percentile
    Proportionately small for gestational age (pSGA)
  68. weight is > 90th percentile for gestational age
    Large for gestational age (LGA)
  69. With dSGA babies, utero malnutrition is experienced in
    the 3rd trimester compromising liver glycogen and fat storage
  70. LBW related to short-term episodes of malnutrition such as maternal weight loss or low weight gain late in pregnancy
  71. if a baby is looking skinny and wasted with small abdominal circumference they are...
  72. Risks for dSGA at birth
    • hypoglycemia
    • hypocalcemia
    • hypothermia
  73. if a baby is looking small but well-proportioned they are....
  74. with pSGA babies, utero malnutrition is
  75. Exhibit few health problems at birth than dSGA, but catch-up growth is harder for these infants and they have reduced number of cells in organs and tissues
  76. Birthweight that is >4500 g (10lbs)
  77. birth weight that is related to pre-pregnancy obesity, poorly controlled DM during pregnancy, and excessive weight gain during pregnancy
  78. if infant is ___ there is an risk of delivery complications for mother (C-section, postpartum hemorrhage, shoulder dystocia)
  79. Nutrition risk factors for miscarrages (3)
    • Maternal underweight prior to pregnancy
    • high levels of oxidative stress in 1st half of pregnancy and men prior to conception 
    • vitamin D and E deficiency in 1st trimester
  80. Risk for pre-term babies (5)
    • neurological problem and low IQ scores
    • ADHD
    • congenital malformations
    • cerebral palsy
    • death
  81. Risk for pre-term delivery (4)
    • genital tract infections
    • insufficiency uterine-placental blood flow
    • shorter inter-pregnancy interval (<6 months)
    • high levels of psychological stress
  82. the ability of a fetus to modify gene function when exposed to adverse conditions that threaten its immediate chances of survival leading to increased risk for chronic diseases later in life
    "fetal origins theory"
  83. Possible nutritional protective factors from pre-term delivery
    • use of MVI or folic acid sups
    • consumptions of fish 1-3 times per week
    • exercising during pregnancy
    • healthy diet
  84. Pre-term delivery nutritional risk factors (4)
    • pre-pregnancy underweight
    • low weight gain during pregnancy
    • women who are obese entering pregnancy
    • chronic inflammation and oxidative stress
Card Set
Nutrition During Pregnancy Part 1
LC Exam 1 Material