Nutrition During Pregnancy

infant mortality

• most occur in the first month of life from inter-uterine issues

• include all deaths in the first year after birth

11th leading cause of death

• infant mortality

low birth weight

• LBW

• < 2500g (2.5kg) or 5.5lb

• 30% of cases occur from malnutrtion during pregnancy, 70% occur from preterm delivery

preterm delivery

• <37 weeks

• 11.8% of newborns

desirable birthweight

3500-4500g (3.5-4.5kg), 7lb 12oz-10lb

• less likely to die within a year

• less likely to develop birth defects

conception

• occurs 14 days before the next menstrual period

gestational age

• 40 weeks: includes 2 non-pregnant weeks, covers uncertainty period

• do not know exact fertilization date

menstrual age

• 38 weeks, age from fertilization

very preterm

< 34 weeks

stages of fetal growth

• blastogenesis stage: conception - 2 weeks

• embryonic stage: 2 weeks - 2 months

• fetal stage: 3 months - birth

blastogenesis stage

• starts with fertilization

• morula forms (3-4 days): solid mass of cells, cells divide

• forms blastocyst (4-5 days): hollow ball from morula

• implantation: by 10 days

blastocyst

• formed from morula

• inner cell mass becomes embryo

• outer coat becomes placenta, which is absorbed into endometrium

embryonic stage

• most critical period

• hyperplasia: increase in cell number, differentiation

• critical for organogenesis, organ formation

• by the 60th day, most organs are formed

• deficiency or excess in specific nutrients causes irreversible damage to the fetus

  • ex) NTD with folate deficiency

• quality of nutrients is more important

fetal stage

• hypertrophy: increase in cell size, making the embryo larger

• period when most rapid growth occurs

• can cause growth retardation if energy and nutrients are not sufficient

• quantity/size is more important

what are normal weight and development interrupted by?

• pregnancy underweight

• low weight gain

• poor diet

• clinical complications

• smoking, drug abuse

dSGA

• disproportionately small for gestational age

• caused by malnutrition in 3rd trimester

• low birth weight: < 10th percentile (quantitiative)

• normal length, head circumference

• risk for chronic disease later in life, fetal organ hypothesis

pSGA