Nutrition During Pregnancy
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What is the primary use of increased cholesterol supply during pregnancy?

  • Immediate energy for fetal growth
  • Cell division in the mother's tissues
  • Energy production in maternal tissues
  • Steroid hormone synthesis by the placenta (correct)

    • What occurs in the second half of pregnancy regarding fat metabolism?

  • Decreased fat mobilization
  • Increased fat mobilization (correct)
  • Stable blood lipid levels
  • Decreased maternal fat accumulation

    • Why are low-salt diets not recommended during pregnancy?

  • They can lead to dehydration in the mother
  • They may result in sodium overload in the fetus
  • They are linked to high blood pressure in pregnant women
  • They can impair functional and growth development (correct)

    • Which of the following is NOT a function of the placenta?

    <p>Energy storage for the mother</p> Signup and view all the answers

    What is the significance of increased blood lipid levels during pregnancy?

    <p>They serve important roles in fetal development</p> Signup and view all the answers

    Maternal calcium absorption increases during pregnancy primarily to:

    <p>Provide calcium for fetal bone formation</p> Signup and view all the answers

    Which harmful substances can the placenta act as a barrier to?

    <p>Excessive drugs and alcohol</p> Signup and view all the answers

    What is the effect of a cholesterol-lowering diet during pregnancy on maternal cholesterol levels?

    <p>It lowers maternal cholesterol levels</p> Signup and view all the answers

    What is the primary factor influencing nutrient transfer across the placenta?

    <p>Concentration of nutrients in maternal and fetal blood</p> Signup and view all the answers

    Which nutrient transfer mechanism requires energy?

    <p>Active transport</p> Signup and view all the answers

    What percentage of glucose delivered by maternal circulation does the placenta use?

    <p>30–40%</p> Signup and view all the answers

    Which of the following substances is most likely to be transferred across the placenta?

    <p>Water</p> Signup and view all the answers

    What happens when maternal nutrient intakes fall below optimum levels?

    <p>Fetal growth and development are compromised more than maternal health</p> Signup and view all the answers

    Which type of molecules are least likely to be transferred across the placenta?

    <p>Large molecules such as insulin</p> Signup and view all the answers

    Which is NOT a mechanism of nutrient transport across the placenta?

    <p>Osmotic pressure</p> Signup and view all the answers

    What role does the placenta primarily play in nutrient transfer?

    <p>It regulates the transfer rate of nutrients based on concentration gradients.</p> Signup and view all the answers

    What physiological changes occur during the anabolic phase of pregnancy?

    <p>Increased appetite and food intake</p> Signup and view all the answers

    Which pregnancy duration is classified as 'preterm'?

    <p>Before 37 weeks of gestation</p> Signup and view all the answers

    What relationship is observed between maternal nutrition and long-term health outcomes in offspring?

    <p>Improved maternal nutrition can lead to better health in offspring</p> Signup and view all the answers

    What is the preferred fuel source for the fetus during pregnancy?

    <p>Glucose</p> Signup and view all the answers

    Which factor increases maternal reliance on fat for energy in late pregnancy?

    <p>Insulin resistance building up</p> Signup and view all the answers

    What key nutrient is primarily accumulated during pregnancy for tissue synthesis?

    <p>Proteins</p> Signup and view all the answers

    What is the definition of maternal mortality?

    <p>Deaths due to complications of pregnancy or childbirth</p> Signup and view all the answers

    How is edema characterized during pregnancy?

    <p>Swelling in the legs and feet</p> Signup and view all the answers

    What role does progesterone play during pregnancy?

    <p>Promotes lipid deposition</p> Signup and view all the answers

    Which of the following is a cause of infant mortality?

    <p>Congenital malformations</p> Signup and view all the answers

    During which phase of pregnancy does increased lipolysis occur?

    <p>Catabolic phase</p> Signup and view all the answers

    What percentage of fetal growth occurs in the second half of pregnancy?

    <p>90%</p> Signup and view all the answers

    What is the consequence of prolonged fetal utilization of ketones?

    <p>Abnormal growth and impaired development</p> Signup and view all the answers

    What change in blood volume is typical during pregnancy?

    <p>Blood volume increases by 20%</p> Signup and view all the answers

    Study Notes

    Nutrition During Pregnancy

    • General Outcome: Become familiar with physiological changes in pregnancy and how these changes influence nutritional needs.
    • Specific Outcomes:
      • Describe physiological changes during pregnancy.
      • Identify recommended weight gain ranges for various pre-pregnancy weight categories (underweight, normal, overweight, obese).
      • Identify relationships between nutritional status during pregnancy and long-term health outcomes in offspring.
    • Periconceptional: Period before conception, approximately 14 days before the next menstrual period.
    • Trimester 1: Weeks 0-12.
    • Trimester 2: Weeks 13-28.
    • Trimester 3: Weeks 29-40.
    • Preterm: Babies born before 37 weeks.
    • Term: Babies born between 38 and 42 weeks.
    • Postterm: Pregnancy lasting more than 42 weeks.
    • Infancy: Period after birth.
    • LMP: Last menstrual period (used to estimate gestational age).
    • Perinatal: Definition varies from 20 to 24 weeks gestation to 7 to 28 days after birth.
    • Fetal death/Stillbirth: Fetus dies after week 20 of pregnancy.
    • Perinatal mortality: Fetus dies between 20 weeks of gestation or death of an infant who is less than a month old.
    • Neonatal mortality: Death from delivery to 28 days.
    • Post-neonatal mortality: Death from 28 days after birth to 1 year.
    • Infant mortality: Death from birth to age 1 year.

    Infant Mortality

    • Indicator of a country's health level.
    • Number of deaths of infants under one year per 1,000 live births.
    • Decrease in mortality suggests improvements in social circumstances, safe nutrition, and infectious disease control.

    Child Mortality in Malaysia

    • Infant mortality rate declined from 41 to 6.9 deaths per 1,000 live births in Malaysia between 1970 and 2017.
    • Malaysia has experienced significant improvements in health.

    Causes of Infant Mortality

    • Conditions originating in the perinatal period.
    • Meningitis.
    • Pneumonia.
    • Chronic lower respiratory disease.
    • Congenital malformations, deformations, and chromosomal abnormalities.

    Maternal Mortality

    • Deaths due to pregnancy and childbirth complications.
    • Global maternal mortality ratio declined from 2000 to 2020 by 34%.
    • 95% of maternal deaths occur in low and lower middle income countries.
    • More than 80% of pregnancy related deaths are preventable.

    Causes of Maternal Mortality

    • Severe bleeding (mostly after childbirth).
    • Infections (usually after childbirth).
    • High blood pressure (pre-eclampsia).
    • Complications from delivery.
    • Unsafe abortion.

    Maternal Mortality Ratio in Malaysia

    • 1970: 141 deaths per 100,000 live births.
    • 2019: 21 deaths per 100,000 live births.

    Physiology of Pregnancy

    • Pregnancy starts at conception approximately 14 days before the next menstrual period.
    • Pregnancy averages 38 weeks (266 days), but 40 weeks (280 days) is common to relate to LMP.
    • Gestational age: Duration from conception.
    • Menstrual age: Estimated from the LMP.

    Normal Physiology Changes During Pregnancy

    • Anabolic phase (first half): Increased food intake, lipid absorption, and accumulation; increased estrogen and progesterone levels.
    • Catabolic phase (second half): Increased lipolytic activity, decreased lipoprotein lipase activity, decreased insulin sensitivity, increased maternal lipid levels.

    Maternal Anabolic Phase

    • Blood volume & cardiac output increases.
    • Fat, nutrients, and liver glycogen stores are built up.
    • Maternal organs grow.
    • Appetite & food intake increases.
    • Exercise tolerance decreases.

    Maternal Catabolic Phase

    • Mobilization of fat & nutrient stores.
    • Blood glucose, triglycerides, and fatty acids increase.
    • Fasting metabolism accelerates.
    • Catabolic hormones increase.

    Fetal Growth

    • Approximately 10% of fetal growth occurs in the first half of pregnancy, with the remaining 90% in the second half.

    Body Water Changes

    • Increased blood volume, extracellular fluid, and amniotic fluid are associated with pregnancy.
    • High fluid gains are associated with edema and weight gain.

    Hormonal Changes

    • Placenta produces hormones (hCG, hCS, Estrogen, Leptin, Progesterone).

    Hormones in more detail

    • hCG: Stimulates estrogen and progesterone production, and endometrial growth.
    • hCS: Increases insulin resistance, promotes maternal protein synthesis, and mobilizes fat.
    • Estrogen: Increases lipid formation and storage, promotes uterine and breast development, improves ligament flexibility.
    • Leptin: Regulates appetite, lipid metabolism, and weight gain.
    • Progesterone: Maintains the implantation, relaxes uterine muscles, and stimulates breast development.

    Carbohydrate Metabolism

    • Glucose is the fetus' preferred fuel.
    • Early pregnancy: Increased insulin production, conversion of glucose to glycogen and fat.
    • Late pregnancy: Increased hCS and prolactin inhibit the conversion of glucose to glycogen, and insulin resistance increases in the mother, relying more on fats for energy.

    Accelerated Fasting Metabolism

    • Increased utilization of glucogenic amino acids for fat oxidation.
    • Increased production of ketones to support fetal use in the absence of glucose.
    • Prolonged use of ketones may lead to impaired fetal development.

    Protein Metabolism

    • Protein is needed for maternal and fetal tissue synthesis.
    • About 925 grams of protein are accumulated during pregnancy.
    • Maternal protein intake supports fetal and maternal needs.
    • Protein needs are met through reduced nitrogen excretion and amino acid conservation.

    Fat Metabolism

    • Maternal fat accumulation in the first half of pregnancy.
    • Increased fat mobilization in the second half of pregnancy for fetal needs.
    • Blood lipid levels rise dramatically during pregnancy.

    Placenta

    • Derived from the Latin word for "cake".
    • Round and disk-like shape.

    Placenta Functions

    • Hormone and enzyme production.
    • Nutrient and gas exchange between mother and fetus.
    • Waste product removal from the fetus.
    • Acts as a barrier to harmful compounds.

    Nutrient Transfer in Placenta

    • The placenta uses 30-40% of the glucose from maternal circulation.
    • Fetus also receives small amounts of water and other nutrients from amniotic fluid.
    • Factors influencing nutrient transfer include molecule size, solubility, and concentration gradients. Smaller, more lipid-soluble molecules transfer more easily than larger ones.

    Mechanisms of Nutrient Transport

    • Passive diffusion: Nutrients move from high to low concentration.
    • Facilitated diffusion: Receptors on cell membranes speed up nutrient transfer.
    • Active transport: Energy (ATP) is used to move nutrients against a concentration gradient.
    • Endocytosis: Large molecules are engulfed and transported into cells.

    Fetus Not a Parasite

    • The fetus depends on the mother for nutrients.
    • Maternal nutrient intake affects fetal growth and development more than maternal health.
    • Nutrients first support maternal needs then placental development.

    Mineral Metabolism

    • Maternal calcium absorption and mobilization from bones increase.
    • Increased needs for sodium and other minerals.
    • Restricted sodium intake can impact growth.

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    Related Documents

    Nutrition During Pregnancy GTN218/3 PDF

    Description

    This quiz explores the key physiological changes during pregnancy and their impact on nutritional requirements. Participants will learn about recommended weight gain for various pre-pregnancy categories and the long-term health implications for offspring based on maternal nutrition. Test your knowledge about essential terms and guidelines related to pregnancy nutrition.

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