fnh 371- lesson 2- pregnancy 1

what are the key goals of nutrition in pregnancy?

to provide nutrients needed to support fetal growth and development while supporting the pregnant person with the nutrients they need to maintain their own health

why is nutrition important during pregnancy?

• inadequate or excess nutrients (malnutrition) or exposure to toxins can impact the development of the embryo/fetus and cause short/long term health problems

• the fetus depends on the pregnant person for all its nutrient needs

• proper nutrition reduces risk of maternal/infant mortality, and low birth weight

• sets the stage for a health baby and parent

what are the trends of births in Canada?

every year the number of lives births have been decreasing since the introduction to birth control, Canada reported 351,679 live births in 2022

what is maternal mortality?

(#) of maternal deaths/ 100000 live births

• includes death related to pregnancy (up to 42 days postpartum)

• key performance indicator of the strength and quality if healthcare

• causes: geriatric pregnancy, medical co-morbidities, growing refugee and immigrant population

what is infant mortality?

(#) of infant deaths/ 100 live births

• babies that do not live past 1 year

• more common than maternal mortality

• increased deaths in less developed areas

• causes: immaturity, structural/functional defects, lack of oxygen, infection, SIDS

• factors: low maternal education, inadequate housing, poverty, lack of healthcare, food insecurity, parental unemployment

• most vulnerable: Canadians living in deprived areas and indigenous peoples

what are the consequences of low birthweight?

causes higher risk of health complications

what is the developmental origins of adult disease hypothesis?

risk for chronic conditions may depend on the environment that fetus experiences in utero

why is maternal nutrition important in the hypothesis?

key determinant of the fetal environment and can affect the likelihood that offspring will experience health challenges decades later

• low birthweight suggest malnutrition during pregnancy which causes a higher risk for the baby

what is the foundations of david barker’s hypothesis?

chronic disease in adults was strongly related to their placental and birth weight

what are the differences between infants experiencing malnutrition in late, mid and early pregnancy?

the earlier the fetus experienced malnutrition in pregnancy the more chronic health problems in their later childhood/adult life

when are the critical periods of development in pregnancy?

first 2 months of pregnancy the organs begin to develop

what are epigenetics?

heritable changes in gene expression that do not change the DNA code

what is DNA methylation?

the adding of a methyl group to turn on/off gene expression

what is a histone code?

dna wraps around histone to dictate gene expression

what are RNA-based mechanisms?

involves RNA to silence or express genes

what happens to DNA methylation patters when established in utero?

• as fertilization occurs, methyls on DNA begin to fall off and start a new

• as cells divide the genes remethylate and build a pattern

• malnutrition and stress can break remethylation patters and cause health defects

• DNA can be over/under methylated and cause unwanted outcomes

how does early nutrition effect dna methylation?

• perinatal material consumption of nutrients with epigenetic effect (preconception, pregnancy, breast-feeding; altered nutrients)

• altered dna methylation of genes playing a role in obesity and metabolic health development

• development of obesity and metabolic syndrome

what are the the important nutrients that impact dna methylation?

folate, vitamin B12, choline

what are transgenerational events?

the eggs that may someday become the grandchild are developed inside the daughter while she is still in the womb with the mother

what is fetal age?

period of intrauterine development from conception to birth (approx 38 weeks)

what is gestational age?

period of intrauterine development from the first day of the last menstrual cycle to birth (approx 40 weeks)

how to calculate estimated due date using Naegele’s Rule?

LMP (last menstrual period)- 3 months+7 days

how many weeks are considered full term, preterm and post-term births?

• full term=37-42 weeks

• preterm <37

• post-term >42

what is considered a high risk pregnancy?

increased risk of health problems for pregnant person or baby

• pre-existing conditions (chronic health disease)

• multiples

• substance use

• complication in pregnancy (placenta not forming properly)