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43 Cards in this Set
- Front
- Back
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Pregnancy duration |
38-42 weeks to deliverfull term infant |
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Ovum |
egg cell |
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Zygote |
fertilized ovum – term for cells as they divide until 14 days |
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Embryo |
term for cells from 14 days to 8weeks |
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Fetus |
embryo is termed fetus at 8 weeksthrough the end of pregnancy |
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What is the role of theplacenta? |
supplies nutrients and oxygen from maternal circulation |
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What are best practices to improve fertility nutritionally? |
fats, carbohydrates, antioxidantnutrients, B vitamins, zinc, and iron |
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How is body fat related to fertility? |
Low and body fat decreases fertility in both men andwomen Women: lower estrogen production Men: decrease sex drive, sperm count High body fat decreases fertility in both men andwomen |
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What is polycystic ovary syndrome? |
Tiny cysts that surround the ovaries |
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How do hormonal changes involved inPCOS affect fertility? |
Two hormonal alterations: increased testosterone and increased insulin levels – All women secrete some testosterone; high levelscause symptoms (excess hair growth on the face,acne, and a tendency to deposit fat around the waist) – Insulin resistance (body cannot use its insulin well)and chance of type 2 diabetes |
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What are best practices to improve fertility nutritionally? |
Folate important for women and men – Role in DNA synthesis (significant for egg andsperm), metabolism of homocysteine – Natural sources: Leafy green vegetables,strawberries, orange juice, – Synthetic form: supplement or fortified foods(ready-to-eat breakfast cereals) • Diets rich in antioxidant nutrients can limitactivity of free radicals and damage to DNAand cell membranes: – Vitamin E, vitamin C, selenium, zinc, beta- carotene,some plant pigments linked to improved fertility forboth men and women – Brightly colored fruitsand vegetables, wholegrains, and plant oils,rich sources • Iron and zinc linked to fertility – Zinc linked to male fertility: protects sperm fromoxidative damage and required for normal sexualmaturation – In women, iron and zinc needed for normalovulation • Limit sources of saturated and trans fats • Choose plant oils and fish oils • Women: promotes insulin resistance, impairs ovulation • Men: high intakes linked to poor sperm quality • Men: omega-3 fatty acids in fish oil, walnuts improve sperm quality • Avoid alcohol when trying to conceive |
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In which trimester does the mother’s nutritional status and intake have the greatestimpact on fetal development? |
First Trimester |
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Which nutrients are transferred to infant in third trimester |
fat, calcium, iron |
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What is defined as successful pregnancy for mother and infant? |
Mother’s physical and emotional healthprotected so she can return to pre-pregnancy health Infant success:– Greater than 37 weeks gestation – Birth weight greater than 5.5 pounds – Sufficient lungdevelopment also important – The longer the gestation,the less the health risk |
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Preterm birth |
born < 37 weeks |
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LBW |
Low birth weight: less than 5.5 pounds |
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SGA |
Small for Gestational Age: – Full-term and preterm infants weighing less than the expected weight for gestation – More likely to have medical complications |
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How is maternal age related to the outcome of a pregnancy? |
• Ideal age for pregnancy,between 20 and 35years • Teen pregnancy increases risk for negative outcomesboth mother and child |
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What are food safety recommendations during pregnancy to reduce risk of Listeriaexposure |
• Recommend pasteurized milk, thoroughlycooked meats (including deli meats), fish, andpoultry |
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How does pre-pregnancy BMI affect pregnancy outcome? |
• Infants born to over/underweight women more likely to have problems • Obese women: infants more likely for birth defects, death early in life, obesity in childhood • BMI under 18.5: infants more likely low birth weight, premature – Lower nutrients stores, specifically iron – Improve by gaining weight before, during pregnancy |
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How does nutrition during pregnancy affect pregnancy outcome? |
• Supports fetal growth • Supports maternal changes: – To support pregnancy and lactation • Inadequate calories: – Can retard fetal growth (especially if <1000 kcal per day) – Higher risk for maternal and fetal death in famine areas • The poorer the nutritional status of themother, the poorer the pregnancy outcome |
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What are energy demands during pregnancy? What is the bestpredictor of pregnancy outcome? |
• 1st trimester: – Balanced and adequate diet – no increase in kcal • 2nd and 3rd Trimester: – 350-450 extra kcal per day • Choose nutrient-dense foods (why?) • Adequate maternal weight gain – The best predictor of pregnancy outcome |
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What is the activity recommendation for a healthy woman during pregnancy?What types of activities should be avoided? What are benefits of exercise during pregnancy? |
• Healthy women should get 150 minutes/weekof moderate-intensity aerobic activity • High risk pregnancies– May need to restrict activities • Consult physician about possible limitations |
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What is optimal weight gain during pregnancy for a woman who begins pregnancy at ahealthy BMI? How does this differ for a woman who begins pregnancy underweight?Overweight? Obese? |
Low BMI (<18.5): 28-40 pounds Normal BMI (18.5-24.9): 25-35 pounds High BMI (25-29.9): 15-25 pounds Obese (>30): 11-20 pounds |
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What is the RDA for Protein and Carbohydrate during pregnancy? Compare to non-pregnant recommendations |
• RDA for protein– Additional 25 g/day beyond 0.8g/kg – Many (non-pregnant) women already consume recommended amount of protein for pregnancy• RDA for carbohydrate – Prevent ketosis – 175 gm/day – Most women exceed this amount |
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What is the Lipid intake recommendations during pregnancy? Compare to non-pregnant recommendations. |
– Maintain 20-30% of total calories from fat (avoidlow fat diet) – 7% or less from saturated fat – 1% or less from trans fat – Omega-6 and omega-3 • Required for fetal growth, brain and eye development • 13 g/day Omega-6 • 1.4 g/day Omega-3 |
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What are general recommendations for vitamins during pregnancy? Can needs be metby diet mostly? |
• Increase during pregnancy • RDAs/AIs up 30% for most B vitamins and even greater for vitamin B-6 (45%) folate(50%) • Vitamin needs increase by 10% • Most needs easily met through diet, except for folate • Vitamin D intake osen insufficient |
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What is recommendation regarding folate and Vitamin D and Why? |
• Vitamin D (RDA = 15 mcg/day; 600 IU) – Many experts recommend increasing to 25 mcg/day; 1000 IU) • Folate (600 mcg/day) – Synthesis of DNA (egg and sperm house geneticmaterial) – Fetal and maternal growth – Increased red blood cell formation – Prevent neural tube defects |
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What arerecommendations for Ironduring pregnancy? Why? |
• Iron (27 mg/day) – Increased hemoglobin – Iron stores for the fetus (remember when themother will transfer iron?) – Many women need a supplement • Iron supplement between meals – Be aware of nutrient-nutrient interaction – Maximize bioavailability • Possible effects of iron-deficiency anemia – Preterm delivery – Low birth weight – Fetal deaths |
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What vitamin and mineral supplements are routinely prescribed for pregnancy?Forwhich vitamin is the UL especially important during pregnancy and why? |
• Other than folate, iron, and vitamin D intakesof pregnant women are generally adequate • Prenatal supplements routinely prescribed – Higher iron needs (27 mg/day) – Higher folate needs (600 mcg/day) – Easier than changing diet (morning sickness too!) • Recommended especially for women withpoor eating habits • Vitamin A– Should not exceed 3000 μg RAE/day |
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What nutrients are of special concern for a pregnant woman who practices a veganlifestyle. |
Vegan must plan diet carefully – Requires sufficient protein – Focus on vitamins D, B-6, and B-12; iron, calcium, and zinc |
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What diet and lifestyle strategies would you suggest to a pregnant woman whocomplains of frequent heartburn, constipation, or morning sickness? |
Heartburn: • Avoid lying down after eating • Avoid spicy foods • Check with physician regarding use ofantacids – Antacids can prevent absorption of somenutrients Constipation: – Regular exercise – Fluid (10 C/day) and fiber (28 gm/day) Morning Sickness: – Avoid nauseating foods or smells – Eat small, frequent bland meals – Consider changing prenatal supplement – Megadose of vitamin B-6 |
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What is morning sickness? When do you get it? How can you treat it? |
• “Morning Sickness” – 70-80% will experience in 1st trimester – May be due to heightened sense of smell – Can occur any @me of day – Avoid nauseating foods or smells – Eat small, frequent bland meals – Consider changing prenatal supplement – Megadose of vitamin B-6 |
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Define gestational diabetes. What causes gestational diabetes? When are womenscreened for it? How can it be treated? What are complications of unmanaged gestationaldiabetes |
: is a condition that develops during pregnancy when the body is not able to make enough insulin. – Main contributor: hormones synthesized byplacenta decrease action of insulin – 4% of pregnancies – Routine screening at 24 - 28 weeks gestation – Controlling carbohydrates in diet may be recommended – Insulin may be needed in some cases – Risks: increased birth weight, low infant bloodglucose after birth, trauma, malformations – Usually disappears after birth but is linked to Pregnancy Complications |
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Define Pregnancy induced hypertension (PIH). What are complications of PIH? |
– High-risk disorder – 3-5% pregnancies – Preeclampsia (mild form) – Eclampsia (severe form) • Signs: – Elevated blood pressure, protein in the urine, edema, change in blood clotting – Convulsions in third trimester – Liver and kidney damage, leading to death diabetes later in life for mother |
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What are the AAND and AAP recommendations regarding breastfeeding? |
• First 6 months of life breastfeed solely • Solid foods and breast milk until 1 year – Recommended by Academy of Nutrition andDietetics and American Academy of Pediatrics • The World Health Organization – Breastfeed for at least 2 years • 70% of all mothers breastfeed in thehospital – Number decreases as infants get older |
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How does a mother know if her baby is well – nourished? |
• Infant has 6 + wet diapers a day • Shows normal weight gain • Passes 1+ stool per day • Sosening of breast @ssue • May take 2-3 weeks to establish breast feedingroutine • Introduce bottle-feeding only after breast feeding iswell established |
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What is colostrum? Why is it important for infant? |
- Think, yellow fluid produced during late pregnancy and few days after birth • Contains antibodies, immune-system cellsand Lactobacillus bifidus factor • Provides protection to infant againstinfections • Facilitates the passage of 1st stool(meconium) |
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Does an infant need additional fluid beyond breastmilk? |
• Human milk: – Provides adequate hydra@on for baby • Addi@onal fluids needed: – Hot climate, diarrhea, vomiting • Too much water: – Leads to brain disorders – Causes low blood sodium |
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How many extra kcal does a breast feeding mother need? What dietshould she follow and why? |
• Milk production requires ~800 kcal/day • Energy RDA is addi@onal 400-500 kcal/day • kcal difference will contribute to mother’sgradual weight loss • Increased need for vitamins A, E, C, riboflavin,copper, chromium, iodide, magnanese,selenium, and zinc • Follow the diet plan for pregnancy |
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What are general guidelines for nutrition for lactating mother? |
• Balanced variety of foods • Moderate fat intake • Adequate fluids • Reduction of milk supply caused by: – Restricting kcal – Ingestion of alcohol – Smoking • Limit high mercury fish and intake of peanuts(allergens) |
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Understand how these factors affect the fetus |
• Folic Acid(400mcg/day)– prevent neural tube defects • Iodide– prevent cretinism (congenital hypothyroidism) • Antioxidants–combat free radicals • Vitamin A–prevent toxicity of this vitamin to avoid birth defects • Caffeine– moderate use to avoid decreased iron absorption and harm to fetus • Aspartame– control intake • Obesity and chronic health conditions – manage healthand pre-existing condtions • Alcohol– Avoid to prevent birth defects and fetal alcoholspectrum disorders and Alcohol Related Birth Defects • Environmental Contaminants– mercury (avoid swordfish,shark, king mackerel and tile fish and consume < 6oz tunaper week |
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What is fetal alcohol syndrome? |
• Large amounts of alcohol during pregnancy • Excess alcohol reaches the embryo/fetus • Embryo/fetus cannot metabolize alcohol • Poor fetal and infant growth • Physical deformities • Mental retardation • Irritability and hyperactivity |
