NU321 Exam 1 Lecture 6 Maternal and Fetal Nutrition

what trimester is crucial for embryonic and fetal organ development

first

what prevents neural tube defects

folate and folic acid

why is proper closure of the neural tube essential

normal formation of the spinal cord

begins to close in the first month of pregnancy (before women knows)

how much folic acid do women of childbearing age need

0.4 mg

what puts the fetus at increased risk of neural tube defects

if the mother is significantly overweight or underweight

energy needs during pregnancy

met by carbs, fat and protein

no specific recommendations, based on recommended weight gain

if you have 'normal' weight how many more calories are needed/day

300-500

severly underweight mom during pregnancy can lead to

preterm labor, LBW infant

issues when the mom has inadequate weight gain during pregnancy

infant has IUGR

obesity (prepregnancy or during) can lead to

macrosomnia, fetopelvic disproportion, operative birth, emergency C section, postpartum hemorrhage, wound, genital tracr or urinary tract infection, birth trauma, later fetal death

obese women are more likely to have (TRIANGLE)

preeclamsia and gestational diabetes

pattern of weight gain during pregnancy

gain should be throughout, not all at once

poor weight gain in beginning of pregnancy can lead to

SGA (small for gestational age )

adolescents and weight gain

higher end of recommendation due to competeing with baby for growth

poor weight gain at the end of pregnancy can lead to

preterm birth

gain of 3 or more kg in a month after the 20th week of pregnancy may indicate

preeclampsia

dieting and pregnancy

just no

change eating habits to healthier foods for appropriate weight gain; quality is important

nutritional element basic to growth; adequate intake is essential to meet increasing demands of pregnancy

protein

foods high in protein

milk, meat, eggs, cheese

why is use of high protein supplements not recommended

increase incidence of preterm births

why should big old fish (tuna, macrol, swordfish) not be consumed

mercury

recommended daily fluid intake

8-10 glasses

what can dehydration increase the risk for in pregnancy

cramping, contractions, preterm labor

caffeine and pregnancy

moderate ammounts, no more than 200 mg; more can contribute to miscarriage and IUGR

aspartame and pregnancy

moms with PKU avoid

needed to allow for transfer of adequate iron to the fetus and to permit expansion of the maternal RBC mass

iron

occurs when the relative excess of plasma causes a modest decrease in the hemoglobin concenration and hematocrit; normal adaption during pregnancy

pysiologic anemia

anemia and giving birth

anemic women are poorly prepared to tolerate hemorrhage at the time of birth

iron deficiency anemia and pregnancy

risk for preterm birth

recommended iron supplement for pregnancy

30 mg ferrous sulfate daily starting at 12 weeks (in prenatals, take with vitamin C)

non pregnent teen iron intake

15 mg

non pregnant women iron intake

18 mg

good sources of iron

liver, meats, deep green leafy veg, legumes

calcium and pregnancy

some intake recommended

calcium intake for women 19 and younger

1300

calcium intake for women 19-50

1000

good sources of calcium

milk, cheese, yogurt, sardines, some leafy green veg, baked beans, tortillas

Vitamins A, D, E, K and pregnancy

supplements not recommended, dietary intake instead

Pregnancy and vit A

can cause congenital malformations when mothers take excessive ammounts from supplements

higher for pregnancy and lactating

pregnancy and vitamin d

increased while pregnant and lactating, found in fortified milk, fortified cereal, salmon, tuna, liver

vitamin E and pregnancy

increased when lactating, veg oil, green leafy veg, whole grains, liver, cheese, fish

folate/folic acid supplements and pregnancy

600 mg

pyridoxine/vit B6 and vit C in pregnancy

increased

adolescent pregnancy needs

may need to increase calories as they are still growing

foods to avoid while pregnant

deli meat (steam!!)

raw mear

fish with mercury (mackeral, tuna, shark/swordfish)

raw shellfish

raw effs

soft cheese (feta/bre)

unpasteurized milk

pate

caffeine

etoh

wash fruit/veg

physical activity during pregnancy

moderate exercise is beneficial; keep doing what you did prepregnancy don't add; caution with positioning (no back abs)

nutritional needs during lactation

similar to pregnancy

increase fluids (use thirst as guide)

continue prenatal vitamins