lecture 2 outline- pregnancy

lecture 2 outline- pregnancy - Lecture 2 Pregnancy Prelude...

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Lecture 2 - Pregnancy Prelude to Pregnancy *Body Weight *Diet *Physical Activity *Environmental Factors 2010 Nutrition Objectives Related to Pre-Conception *Healthy weight adults (42-60%) * obesity (23 to 15%) * Iron deficiency in children and females of childbearing age (1-7%) *Spina Bifida & other neural tube defects (7-3 per 10,000 live births) *Preconceptual counseling (risk assessment) Fertility Concerns *Weight loss >15% *Excessive body fat (body fat- hormonal rein, see table 3.2 in text) *Extreme exercise *R-OH *Endocrine disorders e.g. hypothyroidism, Diabetes *Metabolic disorders eg. Celiac disease, PKU *Contraceptives (females) & steroids (males) * Carotenemia *Age Normal Pregnancy *Institute of Medicine, 1990 * 1
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*Normal Weight Gain in Mom *Normal Hematologic Values for Mom & Baby (e.g. Hb & Hct) *Prompt Onset of Lactation Weight Gain In Pregnancy *Mom: *IBW (BMI 18.5 - 24.9) - ______________________ *UBW (BMI < 18.5) - _________________________ *OBW (BMI > 25.1 ) - ________________________ *2 - 8 lb during Trimester 1 & average of 0.8 lb/wk thereafter. Total at least 15 lb *Baby * * *> 8.8 lb, high birth weight Proportional to baby’s weight and mother’s physiological changes & reserves for lactation: *maternal stores * * *breasts and muscle tissue *amniotic fluid Development Wt. Gain (lb) Infant at Birth 7.5 Placenta 1.5 Mother’s Blood Vol. 4 Mother’s Fluid Vol. 4 Size of Uterus & muscles 2 Mother’s breasts 2 2
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Amniotic Fluid 2 Mother’s Fat Stores 7 Total 30 Risk Factors * *Hx of poor pregnancy outcome *Close pregnancies * *Lack of Family Support * * *Smoking, Alcohol or Drug Addiction *> 15% underweight or overweight. BMI < 20 or > 27.0 *Chronic Disease *1st pregnancy * Ecological Factors * *Infectious diseases - sexual & non * *Avail. & Access to Health Care *Socio-demographics * * Adverse Outcomes *Miscarriages/ spontaneous abortions * 3
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*Infant mortality & morbidity * *Premature birth * *Low birthweight *Respiratory Distress Maternal Physiology See Tables 4.6 and 4.7 Maternal Tissue and organs (Uterus, Breasts, heart, thyroid, liver, kidneys) Food and GIT changes (appetite, taste, odor, thirst, N&V, constipation, etc.) Blood volume & hemodilution (20% blood vol. incr., 50% plasma vol.inc., and edema in 60-75% of women Lipids Glucose BMR and temperature Placenta and umbilical cord Hormones (hCG, hCS, PL, Progest., Estrogen, etc) respiration, absorption, excretion, immunity Placenta Derived from Latin word “cake” Larger than fetus for most of pregnancy Functions: Hormone and enzyme production Nutrient and gas exchange (passive & facilitated diffusion, active transprt; endocytosis) Removal of waste products Barrier to harmful compds– mat. RBC, bacteria, large proteins 4
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Placental Hormones (table 4.8 & illustration 4.3 p 90)
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