1. Life Cycle: Maternal and Infant Nutrition BIOL 103, Chapter 12-1

2. Today’s Topic Pregnancy

3. (Pg. 500)“Energy and nutrient needs both increase, but needs for calories increases by a ___________ percentage than for most vitamins and minerals. As a result, food choices during pregnancy must be ____________-dense.”

4. Pregnancy Nutrition before conception – Goals of preconception care is to provide: 1.Screening for risk 2.Health promotion and education 3.Intervention as needed – Weight Maintain a ___________ weight _____________weight increases risk for poor outcome – If low  preterm delivery – If too high  gestational diabetes, preeclampsia, C-section Not a good time to “diet”

5. Nutrition Before Conception Vitamins (Problem Set 12, Q 1a and 1b) – 400-800 micrograms of synthetic _____________/day Why? – Avoid high doses of __________________________ Why? Substance use – Eliminate alcohol, tobacco, drugs, prior to pregnancy

6. Physiology of Pregnancy Trimesters: 3 time periods of pregnancy, each lasting ~13-14 weeks Stages of human fetal growth 1._________________________________: Weeks 0-2 Cells differentiate into ___________________________ 2._________________________________: Weeks 2-8 Development of _____________ systems Critical period of development – time when _____________ has the greatest impact on the developing embryo. – Birth defects, miscarriages 3._________________________: Weeks 9 to delivery Growth

7. Physiology of Pregnancy Maternal changes: – Growth of maternal tissues  weight gain and lactation. Examples: – Increase in maternal ____________ volume – _________ GI motility  increases __________ absorption.

8. Maternal Weight Gain Recommendations depend on BMI – Table 12.3: Guidelines for weight gain during pregnancy. Underweight  Gain 28-40 pounds Normal weight  Gain ______________ pounds Obese  11-20 pounds – Higher recommended gain for underweight women, _______________________________ – Lower recommended gain for overweight and obese women

9. Maternal Weight Gain Weight gain occurs mostly during 2 nd and 3 rd trimester. 40% of weight gain  fetus, placenta, amniotic fluid 60% of weight gain  maternal tissues (adipose stores, breast/uterine growth, expanded blood and ECF)

10. Energy and Nutrition During Pregnancy Energy – ______ increases to support increased workload on mother’s heart and lungs, and energy requirements of fetus/placenta. – __________________ is the best indicator of adequate calorie intake. Nutrients to support pregnancy – Well-balanced diet – Often, pregnant women have difficulty consuming enough ___________________________

11. Energy and Nutrition During Pregnancy Macronutrients – Moderate-____________, low-_____________, and high _____________________ Protein – Synthesis of new maternal, placental, and fetal tissues – Additional _____ gram/day over non-pregnancy needs Fat – ___________ for mother and development of placenta – Stored fat supports _______________________ Carbohydrates – Main source of ___________________________ – __________________ carbohydrates – ______________-rich

12. Energy and Nutrition During Pregnancy Micronutrients –Increased need for overall _______________ –Increased needs for most vitamins and minerals Support growth and development Highest increase for __________________ Increased needs for vitamins ___________ –Q: How are B vitamins used during pregnancy?

13. Food Choices for Pregnant Women Follow the __________ Daily Food Plan for Moms – Variety – Additional servings of grain, vegetable, fruit, and low- fat milk Supplement with prenatal formula – Herbal supplements are ____________ recommended – Although multi-vitamin supplements are common, generally, supplements are not needed other than for iron and folate.

14. Food Choices for Pregnant Women (PS#12, Q2a) Foods to avoid 1.__________________ 2.__________________ Why? 3.Less than 300 milligrams of ____________ per day

15. Substance Use and Pregnancy Outcome (PS12, Q2b) 1._________________ –Risk for miscarriage, stillbirth, preterm delivery, and low birth weight 2.Alcohol –Risk for __________________________ ___________________ defects ___________________ retardation 3.Drugs –Risks for miscarriage, preterm delivery, low birth weight, ______________, and __________________

16. Strategies to Avoid GI Distress: Slowed GI movement  nausea, heartburn and constipation Smaller/frequent meals, drinking liquids between meals, fiber and fluids are recommended

17. Special Situations During Pregnancy Food cravings and aversions – Food cravings/aversions are _________ based on a nutrient deficiency or a physiological condition. – Pica – consumptions of nonfood items such as dirt, clay, laundry starch, ice, or burnt matches. Hypertension – Preeclampsia: ____________________________ Can progress to eclampsia (seizures)

18. Special Situations During Pregnancy Diabetes – Adjust diet and insulin as needed Gestational diabetes: a condition that results in high blood glucose during pregnancy. –Hormones of pregnancy tend to counteract _________________ Often controlled through ___________ May require insulin

19. Special Situations During Pregnancy HIV/AIDS –______________ to reduce risk of transmission –>90% of childhood HIV infections are from mother-to-child transmission –Many times, women with HIV or AIDS are likely to have multiple nutrition problems __________________ malnutrition __________________ deficiency Inadequate _______________________

20. Special Situations During Pregnancy Adolescence –Extra demands for ____________________ –Risk for preeclampsia, anemia, premature birth, low-birth-weight babies, infant mortality, and sexual transmitted disease –_______________ eating patterns a concern –Weight gain toward _________ recommended –Need for __________________