LU 4.2 Nutrition in Pregnancy

What are the nutrients and behaviour needed by the father for healthy sperm production before conception ?

• avoid smoking, alcohol, drug abuse and obesity (these decreases sperm production and function)

• nutrients : zinc, folate, antioxidants

What are the nutrients and behaviour needed by the mother before conception for a health pregnancy ?

• attain a healthy weight before conception (to decrease the risk of potential birth defects)

• take folate (folic acid) 400micrograms daily (to reduce risk of neural tube defects)

• managing chronic conditions such as DM, hypertension

What is the usual increment of total caloric intake during pregnancy ?

increase of 300 kcal / daily

What are the effects of maternal malnutrition in pregnancy during

• pre conception

• 1st trimester

• 3rd trimester

• pre conception : decreased fertility, increased neural tube defects (eg: spina bifida and anencephaly)

• 1st trimester : increased stillbirths, preterm births, early newborn deaths

• 3rd trimester : low birth weight, preterm birth, small for gestational age

Which vitamin found to be teratogenic to fetus if given in mega doses ?

Vitamin A & D

What is Pica ?

• it is unexplained urge to eat non-nutritive substances

• maybe related to iron deficiency

Nausea and vomiting are usually related to ?

hCG and estrogen

What is the normal weight gain in pregnancy ?

• 11.5 - 16kg (overall)

• weight gain of 1-2 kg by the end of 1st trimester

• weight gain of 500g per week during 2nd and 3rd trimester

When is weight gain usually become excessive and slow?

• excessive weight gain during pre-eclampsia

• slow weight gain during fetal growth retardation

A lack of weight gain may indicate ?

Intrauterine growth retardation (IUGR) of the infant

What are the nutritional needs for pregnancy ?

• protein

• mineral (calcium, iron and iodine, folate)

• vitamin (vitamin D)

What are the function of protein in pregnancy ?

• serves as the building blocks for growth of body tissues

• rapid growth of fetus

• development of placenta

What are the function of these mineral & vitamin in pregnancy ?

• calcium

• iron and iodine

• folate

• vitamin D

• calcium : for fetal development of bones and teeth

• iron : increased hemoglobin synthesis

• iodine : to produce more thyroxine

• folate : build mature red blood cells during pregnancy

• vitamin D : ensure absorption and utilization of calcium and phosphorus for fetal bone growth

What are the nutritional supplementation (prenatal vitamins) for mother during / prior to getting pregnant ?

• folic acid 0.4mg tab daily

• iron (ferrous fumerate or gluconate) 300mg daily

• calcium 1200mg daily

• vitamin C

What are the nutritional advices can be given to a pregnant woman ?

• balanced diet with high proteins during 1st trimester up to 5 months

• consume food high in iron

• take prenatal vitamins and supplements

• avoid alcohol / caffeine

• monitor medication usage during illness

What are the foods to avoid during pregnancy ?

• raw food (high risk of bacteria contamination)

• fish with mercury (may cause brain damage)

• caffeine ( to reduce likelihood of miscarriage during 1st trimester)

• alcohol (can lead fetal alcohol syndrome)

What are the contraindication to do exercises in pregnancy ?

• anemia, asthma, heart disease

• incompetent causes such as bleeding, preterm

• uncontrolled DM, hypertension

What are the benefits of exercise in pregnancy ?

• to help prepare body for the stress of labor and delivery (to gain flexibility and strengthen muscles used during childbirth)

• to help relieve back pain

• to improve posture

• to improve blood circulation

• improve self image (regain pre-pregnancy figure faster)

What are the safe exercises during pregnancy ?

• walking

• swimming

• stationary cycling

• pelvic floor exercises ( Pelvic tilts, Kegels exercise)

What are the recommended exercises guidelines ?

• avoid exercising in supine position after first trimester due to hypotensive effect

• avoid hot and humid environment during exercise

• avoid contact and high risk of falling activities

• heavy weightlifting