Pregnancy HP 270 Lacey Zimbro, Mae Van Iderstine, Caleigh Patterson, Emily Bindrim, Angela Bosco

Duration and Trimesters A normal, healthy pregnancy lasts weeks This time period is broken into three trimesters

First Trimester Begins when an ovum and a sperm come together and make a fertilized cell called a zygote The formation of the embryo, cell growth multiplication and differentiation occur Over the next 6 weeks, the tissues start to form into limb buds, organs, and facial features start to show. Alcohol, illegal drugs, prescription, over the counter medications, several herbs, some viruses, cigarette smoking, and radiation can cause birth defects or interfere with development.

First Trimester Continued… An early stage of a skeleton, including fingers and toes has formed within the eighth week. The head starts to develop a mouth, eyes, eyelids and ears. The third month is when the embryo transitions to the fetus. The umbilical cord is an extension of blood vessels connected to the fetus’s navel

Second Trimester 14 to 27 weeks within the pregnancy is when the fetus continues to grow and mature. The fetus is about 3 inches long and weighs about 1.5 pounds At the end of the second trimester the baby will be over a foot long and weigh more than 2 pounds

Third Trimester This is the 28 th week into the pregnancy. The baby is about 18 to 22 inches and weighs about 7.5 pounds. The baby has eyebrows, eyelashes, and hair on their head

WEIGHT GAME How much weight should a pregnant woman gain during pregnancy based on her pre- pregnancy weight? Underweight Woman (BMI<18.5) Normal Pre-Pregnant Woman (BMI ) Overweight Woman (BMI ) Put as many eggs as you think should go in each bag (each egg=5 pounds)

Gaining Weight Results Recommended Weight Gain Underweight Woman ( pounds) Normal Weight (25-35 pounds) Overweight Woman (15-25 pounds)

Variables Influencing Weight Gain Single or Multiple Birth Adolescents Underweight and Obesity Pattern of Weight Gain

Distribution of the Weight Fetus Amniotic Fluid Placenta Increase in the Mother’s Blood Volume

Macronutrient Needs of Pregnant Women During pregnancy there is expansion of mothers blood supply, growth of uterus, breasts, placenta and body fat levels. This all causes a need for an increased level of macronutrients.

Specific Macronutrients Energy: First trimester no caloric intake changes, Second & third trimester calorie intake increases by about Protein & Carbohydrates: Protein is increased, Carbohydrates should be at least 175g/day Fat: Doesn’t change during pregnancy DHA - docosahexaenoic acid - critical for brain growth and eye development (Too much can cause mercury contamination >impairing fetus’s nervous system )

Folate Necessary for cell division, Adequate folate intake is critical during the first 28 days after conception because of the formation and closure of the neural tube If not enough folate is consumed neural tube defects can occur as well as macrocytic anemia Some forms of food containing folate are fortified cereals, grains, spinach & lentils

Vitamins Vitamin B12 (also known as cobalamin): Regenerates active form of folate RDA for pregnant women is 2.1Ug/day Easily obtained from animal food sources: Causing vegans to have deficiencies Vitamin C: Necessary for synthesis of collagen & part of the organic matrix of bones Deficiency causes risk for preterm birth along with other complications Pregnant women require a little more than a 10% intake increase compared to non-pregnant women

More Vitamins Vitamin A: Pregnant women require about 700 Ug/day Excess intake can cause fetal abnormalities Supplementation is not recommended Vitamin D: Important in calcium absorption Intake does not change Prenatal Vitamins Toxicity can cause developmental disability in newborns

Calcium and Iron Calcium: Growth of fetal skeleton, Intake does not change for two reasons Iron: Formation of red blood cells, Demand for red blood cells increases in pregnant women Vitamin C plays a role in iron absorption The fetus builds up maternal iron and is “robbing” it from the mother Maternal iron deficiency anemia

Zinc Intake is increased by about 38% Critical in DNA, RNA and protein synthesis

Sodium and Iodine Sodium intake remains the same and Iodine increases significantly to 220 Ug/day Too much sodium can cause fluid retention, bloating & high blood pressure in the mother Using iodized salt modestly when cooking can help reach RDA

Supplements Pregnant women do not necessarily need prenatal multivitamins or mineral supplements, but many doctors suggest them

Fluids Beneficial in preventing constipation, fluid retention, Urinary Tract Infections, and dehydration from vomiting

ACOG There is information available for pregnant women from her doctor about nutrition, exercise, and weight management This information is distributed by the ACOG They have specific guidelines to promote optimal health and strive to promote healthy pregnancies in all women

Morning Sickness Consists of vomiting, or nausea and is potentially a serious medical condition. Symptoms can vary from constant nausea and vomiting or just occasionally feeling nauseous. Usually begins at the 8 to 12 week period and ends around the 12 to 16 weeks. Morning sickness can possibly lead to the mother having to be hospitalized. There is no cure

Cravings and Aversions Woman tend to have major cravings for one particular food when they are pregnant. Most people tend to believe that woman crave what they need. Not all woman crave foods, a good amount of woman crave nonfoods. This craving is known as Pica. Food aversions are common during pregnancy as well, this may come from cultural and religious beliefs.

Gastro esophageal Reflux When the esophageal sphincter is overly relaxed or damaged or there is damage to the esophagus itself. Gastro esophageal reflux is highly common during pregnancy. Pregnancy-related hormones make the smooth muscles of the lower esophagus lower. The uterus tends to expand during the last two trimesters and pushes up the stomach.

Constipation During pregnancy hormonal production can cause the smooth muscles to relax, this includes muscles of the large intestines. This can slow the colonic movement of food residue. There are some helpful tips that can help pregnant woman avoid constipation.

Gestational Diabetes Approximately 7% of pregnant woman in the U.S. are diagnosed with gestational diabetes. This is when a pregnant woman is unable to produce sufficient insulin or becomes insulin resistant. Gestational Diabetes has no ill effects on either the mother or the fetus. If not controlled, can result in a baby who is too large. Large infants are at risk for early delivery or trauma during vaginal birth. Women who are obese, over the age of 35, native American, African American or Hispanic, have a greater risk of gestational diabetes.

Hypertensive Disorders of Pregnancy Gestational hypertension Preeclampsia Eclampsia Unsure of what causes these various hypertensive disorders. In the end, childbirth is the only thing that will cure this problem. Today, hypertensive disorder is usually caught in a very early stage, and the outcomes for the mother and fetus are usually very good.

Adolescent Pregnancy Through the adolescent years, a woman’s body is not fully developed. Most adolescent women do not establish a nutritional pattern. This can lead to problems such as: preterm births, low birth weight babies and other problems.

Vegetarianism Well-planned vegetarian diets are appropriate for pregnant women Vegetarian women who consume dairy products and/or eggs have no nutritional concerns Vegan women must be more careful, and make sure they take the right supplements that provide nutrients that only come from animal products

Caffeine Consumption Caffeine can cross the placenta and reach the fetus Suggested intake of caffeine is <300 mg a day High consumption of caffeine shows increase risk of miscarriage and low birth weight

Alcohol Consumption Drinking during pregnancy increases risk of miscarriage, delivery complications, preterm birth, birth defects, and sudden infant death syndrome FASD (fetal alcohol spectrum disorders) are a range of conditions that are caused by consumption of alcohol during pregnancy FAS (fetal alcohol syndrome)

Smoking More than 10 % of pregnant women smoke Smoking exposes fetus to toxins Impaired fetal growth and development caused by reduction of fetal blood flow Maternal smoking increase risk of miscarriage, still birth, placental abnormalities, preterm birth, & low birth weight

Food Safety U.S. Departments of Health & Human Services and of Agriculture recommend pregnant women to avoid unpasteurized milk, raw or partially cooked eggs, raw or undercooked meat/fish/poultry, unpasteurized juice and raw sprouts Pregnant and breastfeeding mothers should avoid consuming foods that contain high mercury content Foods contaminated with dioxins should also be avoided Dioxins can affect the development of fetal organs Soft cheese should also be avoided due the contamination of bacterium Listeria monocytogenes

Exercise Physical activity during pregnancy is beneficial and recommended for healthy women with normal pregnancies Inactive women prior to pregnancy should begin an exercise program slowly and progress gradually during pregnancy Studies have proven that many of the concerns discussed earlier can be avoided simply by participating in 30 minutes of moderate exercise daily

Exercise continued… If a woman is physically active prior to pregnancy then she can continue physical activity during pregnancy Walking is a great low- impact choice of physical activity

Pregnancy Tips Prepare your body if you are thinking about becoming pregnant and/or consult a physician Change unhealthy eating habits right away Educate yourself!! Get plenty of rest! Write a pregnancy journal to track your thoughts throughout the process Carry out all of the practices that we’ve discussed to maintain a successful pregnancy

References dangerous-for.htmlhttp://pi-bill-articles.blogspot.com/2012/03/research-alert-statins- dangerous-for.html unborn-child.htmlhttp://healthassistant.blogspot.com/2008/12/brain-food-for-your- unborn-child.html Thompson, J., & Manore, M. (2012). Nutrition an applied approach. (third ed., pp ). San Francisco, CA: Pearson Education Inc. Jones, J., Housman, J., & McAleese, W. (2010). EXERCISE, NUTRITION, AND WEIGHT MANAGEMENT DURING PREGNANCY. American Journal Of Health Studies, 25(3), n_drinking_milkhttp:// n_drinking_milk pregnant-women-eat-influences-baby.html

References Continued… kids/ kids/ part-of.htmlhttp://vitaminsandherbs101.blogspot.com/2012/01/prenatal-vitamins-should-be- part-of.html to-be-miss-america/ to-be-miss-america/ coffee-cup/ coffee-cup/ Weiss, R. E. (n.d.). 50 tips for a healthy pregnancy. Retrieved from pregnancy.about.com/cs/preconceptionalhe/a/50tips.htm