Pregnancy-Lactation-Lecture-2010

Pregnancy-Lactation-Lecture-2010 - Pregnancy Lactation NST...

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1 1 NST 160 April 23, 2010 Kasuen Mauldin 2 Nutrition before conception Why important? 3 Women: pre-pregnancy nutritional status Healthy weight (BMI = 18.5 to 24.9) Underweight BMI < 18.5 If < 17% body fat - amenorrhea, < 22% - no ovulation Risk of miscarriage Baby with low birth weight (IQ, stature, CVD/DM) Obese BMI > 30 Fertility issues (ratio of testosterone to estrogen altered) Pregnancy complications Large baby - preterm/difficult labor/C-section 4 Women: nutrients Meet DRI: folic acid, calcium, iron (prenatal) Vitamin A in high doses = teratogen *miscarriage 5 Other pre-conception concerns Alcohol - Fetal Alcohol Syndrome Subclinical: behavior, learning, coordination problems Excessive caffeine Smoking Drugs Men: nutrition/alcohol/drugs Low sperm count, motility Sperm abnormalities 6 Pregnancy
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2 7 Pregnancy timeline Gestation period ~ 40 weeks Due date calculation: FDLMC Full term 38 - 42 weeks Age of fetus calculated 1st Trimester = 0 - 13 weeks 2nd Trimester = 14 - 27 weeks 3rd Trimester = 28 - 40 weeks A week after first missed period: 5 weeks along! 8 Pregnancy anatomy basics Uterus Amniotic sac - amniotic fluid (protect, temp. reg.) Placenta - only way nutrients reach developing fetus (umbilical cord) Fetal and maternal blood do not mix 9 1st Trimester: embryo/fetal development Zygote to fetus: most susceptible to teratogens Most dramatic changes occur Organogenesis Photo 8 weeks = fetus By 13 weeks = ~ 1 oz, 4 inches 10 Organogenesis * Dark blue = period most susceptible to teratogens 11 1st Trimester: nutritional needs No increase in kcal Lack of teratogens Foods to avoid Why? Key nutrient: folic acid 5, 10-Methyl-THF required for DNA synthesis 5-Methyl-THF (Vitamin B12) required for DNA methylation Necessary for rapid cell division and growth 12 Folic acid and neural tube defects Both brain and spinal cord develop from the neural tube Defects result in CNS disorders Spina bifida = incomplete closure of the bony casing around the spinal cord [mild to severe] An-encephaly = partially or completely missing brain Formation complete by 6 weeks
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3 13 Folic acid and neural tube defects 400 µ g/day supplementation + dietary intake Neural tube defects (1st 3 weeks!) 1998 American fortification of food supply Prenatal vitamin 4 weeks 14 1st Trimester: maternal changes Uterus grows (increase urination frequency) Placenta forms
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Pregnancy-Lactation-Lecture-2010 - Pregnancy Lactation NST...

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