Ch 9: Maternal & Fetal Nutrition

Why is nutrition before conception important?

then first trimester is critical for organ development; a healthy preconception diet ensures adequate nutrition for the developing fetus

What is the difference between folate and folic acid?

Folate = natural form in foods

Folic acid = synthetic form in supplements and fortified foods.

What defects are linked to poor folic acid intake?

neural tube defects: spina bifida, anencephaly

When does the neural tube begin to close?

within the first month of gestation, often before a woman realizes she is pregnant

How much folic acid should all women of childbearing age take daily?

0.4 mg (400mcg) + dietary folate

What folic acid dose is recommended for women with a history of neural tube defects pregnancy?

4 mg daily, starting longer than 1 month before conception through the first trimester

what maternal weight factors increase pregnancy risks?

being underweight or overweight at conception

How does weight loss before pregnancy affect overweight/obese women?

it may lead to a healthier pregnancy

What should ideally be achieved before conception regarding weight?

desirable body weight

What food provides ≥500 mcg folate per serving?

chicken, turkey, goose liver

What foods provide ≥200 mcg folate per serving?

lamb, beef, veal liver

What foods provide ≥100 mcg folate per serving?

Legumes (½ cup), lentils, chickpeas, kidney beans, spinach (cooked), asparagus, papaya, fortified cereal, wheat germ.

What factors increase nutrient needs during pregnancy?

uterine-placental-fetal growth, ↑ total blood volume (40–50%), mammary development, ↑ metabolic rate (20%).

When do energy needs increase during pregnancy?

no change in 1st trimester; +340 kcal/day in 2nd trimester; +452 kcal/day in 3rd trimester.

What is expected weight gain for a normal-weight woman?

2-4 lbs in the first trimester then 1 lbs per week in 2nd/3rd trimesters

What risks are linked to low pre-pregnancy weight or inadequate weight gain?

↑ risk of preterm birth and SGA infant.

What does excessive weight gain in pregnancy suggest?

possible complication such as fluid accumulation

Should women try to lose weight during pregnancy?

No — weight gain should at least equal the products of conception

Why are weights checked at every prenatal visit?

To monitor maternal and fetal health, and because weight impacts medication dosing.

Why is protein important in pregnancy?

Supports fetal growth, uterine/placental/mammary development, blood volume expansion, and amniotic fluid formation.

What are the best sources of high-quality protein in pregnancy?

milk, meat, eggs, cheese (high biological volume)

Why are high-protein supplements not recommended in pregnancy?

they can be harmful to the fetus

Why are DHA and AA important in pregnancy?

support fetal brain and eye development, and neurologic function

what are good sources of DHA and AA?

fish oil, seafood

Which fish should pregnant women avoid due to mercury risk?

shark, swordfish, king mackerel, tilefish. Limit albacore tuna to less than 6 oz/week

Why is dietary fiber important in pregnancy, and how much is recommended?

prevents constipation

How much folate is needed daily in pregnancy, and why?

600 mcg/day; prevents neural tube defects and supports RBC/cell growth.

what is a benefit of vitamin B6?

supports metabolism and may reduce nausea/vomiting.

Which vitamin deficiency is common in vegans and why?

Vitamin B12; found mainly in animal products.

Why should pregnant women avoid excess vitamin A?

Can cause teratogenic effects (e.g., with isotretinoin or high-dose supplements).

What is the role of vitamin D in pregnancy?

promotes calcium reabsorption and supports immune function

Which vitamin needs increase if the woman smokes?

vitamin C

What enhances vs. inhibits iron absorption?

Enhances: vitamin C, meats.
Inhibits: bran, tea, coffee, milk, spinach, egg yolk

Good calcium sources for lactose-intolerant women?

yogurt, hard cheese, lactase-treated milk, fortified juice

What mineral is needed for CNS development and enzyme function?

zinc

Which mineral may need supplementation if taking high doses of iron or folic acid?

zinc

What nutrient is essential for neural development and cell signaling, and how much is needed?

choline

Why is alcohol contraindicated in pregnancy?

causes fetal alcohol syndrome (growth restriction, CNS defects, facial anomalies)

What is the recommended caffeine limit during pregnancy?

less than 200 mg/day

Which artificial sweetener is unsafe in PKU?

aspartame

What is pica, and what is it associated with?

craving non-food items; linked to iron deficiency and heavy metal risks

Why are vegans at risk for nutritional deficiencies in pregnancy?

Risk of low iron, zinc, vitamins D/E/B12, calcium, choline, and essential fatty acids.

What is the main risk of gluten-free diets in pregnancy?

deficient in folate, B vitamins, and iron