Nutrition During Pregnancy NTR 450 Chapter 4 Pregnancy • Rapid growth and development • Susceptibility to effects of many factors – Diet/nutritional status – Physical activity – Medical conditions – Medications – Substance use – Stress Time-related Terms Before, During, and After Pregnancy • Review Illustration 4.1 Infant Mortality • Deaths from birth to 1 year of age “Infant mortality is a mirror of a population’s physical health and socioeconomic status.” Decreases in mortality related to improvements in social circumstances, safe & nutritious food availability, & infectious disease control Infant Mortality Risk Factors • Low birth weight – 8.2% of births – 66% of infant deaths • Preterm delivery – 12% of births – 25% of neonatal deaths Reducing Infant Mortality and Morbidity • Improve birth weight of newborns – Desirable birth weight = 3500-4500 g (7 lb. 12 oz.-10 lb.)
• Infants born with desirable weight are less likely to develop: • Heart and Lung diseases • Diabetes • Hypertension 2020 Health Objectives for the Nation Related to Pregnant Women and Infants • Review Tab le 4.5 or link to Healthy People 2020 (on Blackboard) Physiology of Pregnancy • Watch online video on BB – Week 3 Physiological Changes • Increased plasma volume • Increased maternal nutrient stores • Placental development • Increased uterine blood flow • Fetal growth Normal Physiological Changes • Review Table 4.8 Maternal Nutrient Metabolism • Changes can be seen in the first few weeks after conception. • Ensures that nutrients will be available to the fetus when needed. • Changes occur to metabolism of carbohydrates, protein, fat, minerals and fasting metabolism Carbohydrate Metabolism • Glucose is preferred fuel for fetus – changes ensure continuous supply • “Diabetogenic effect of pregnancy” results from maternal insulin resistance • Estrogen and progesterone increase insulin production • Human chorionic somatotropin and prolactin inhibit conversion of glucose to glycogen/fat
Fasting Metabolism • Rapid conversion to glucogenic amino acid utilization, fat oxidation, and increased ketone production in fasting states • Allows maternal utilization of fat for energy, sparing glucose for fetal use Protein Metabolism • Greater need for N and protein to support growth • Protein accumulation (about 925 g overall) • Reduced N excretion and amino acid conservation (recycling) • Needs must be met by mother’s intake of protein rather than stored protein Fat Metabolism • Fat stores – Accumulate in first half of pregnancy – Enhanced fat mobilization in second half • Increase in blood lipids and cholesterol-containing lipoproteins – Triglycerides: fat mobilization – Cholesterol: sex hormones and fetal cell membranes – Increase in lipids carried by lipoproteins: carotenoids, fat-soluble vitamins
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