1. Nutrition: A Lifespan Approach, by Simon Langley-Evans. © 2009 Simon Langley-Evans. 1 Learning objectives

2. Nutrition: A Lifespan Approach, by Simon Langley-Evans. © 2009 Simon Langley-Evans. 2 Table 3.1 Development of the human organs during gestation

3. Nutrition: A Lifespan Approach, by Simon Langley-Evans. © 2009 Simon Langley-Evans. 3 Figure 3.1 The components of maternal weight gain during pregnancy.

4. Nutrition: A Lifespan Approach, by Simon Langley-Evans. © 2009 Simon Langley-Evans. 4 Table 3.2 Optimal weight gain for women in pregnancy is dependent up on their pre-pregnancy BMI

5. Nutrition: A Lifespan Approach, by Simon Langley-Evans. © 2009 Simon Langley-Evans. 5

6. 6 Figure 3.3 The role of GLUT4 in glucose transport. GLUT4 translocation is a key step in movement of glucose across cell membranes. In pregnancy, the formation of IRS-1–PI3-K complexes is inhibited, leading to insulin resistance.

7. Nutrition: A Lifespan Approach, by Simon Langley-Evans. © 2009 Simon Langley-Evans. 7 Figure 3.4 The biosynthesis of long-chain polyunsaturated fatty acids from the essential fatty acids.

8. Nutrition: A Lifespan Approach, by Simon Langley-Evans. © 2009 Simon Langley-Evans. 8 Figure 3.5 The metabolism of vitamin D.

9. Nutrition: A Lifespan Approach, by Simon Langley-Evans. © 2009 Simon Langley-Evans. 9 Table 3.3 Risk factors for preterm delivery

10. Nutrition: A Lifespan Approach, by Simon Langley-Evans. © 2009 Simon Langley-Evans. 10 Research Highlight 3 Advice to reduce caffeine intake in pregnancy

11. Nutrition: A Lifespan Approach, by Simon Langley-Evans. © 2009 Simon Langley-Evans. 11 Figure 3.6 The pathophysiology of PE.

12. Nutrition: A Lifespan Approach, by Simon Langley-Evans. © 2009 Simon Langley-Evans. 12 Figure 3.7 The temporal association between symptoms of nausea and vomiting in pregnancy and concentrations of hCG.

13. Nutrition: A Lifespan Approach, by Simon Langley-Evans. © 2009 Simon Langley-Evans. 13 Figure 3.8 NVP is associated with reduced risk of preterm delivery. Three hundred pregnant women were questioned about symptoms of NVP in the first trimester of pregnancy and the outcome of pregnancy was followed up. Women who reported no NVP symptoms were significantly more likely to give birth prior to 37 weeks gestation. (Source: Langley-Evans and Langley-Evans, unpublished observations.)

14. Nutrition: A Lifespan Approach, by Simon Langley-Evans. © 2009 Simon Langley-Evans. 14 Figure 3.9 GDM is a condition of maternal insulin resistance. Maternal insulin resistance drives glucose across the placenta to the fetal tissues. The ensuing increase in fetal insulin secretion drives excessive fetal growth and leads to LGA.

15. Nutrition: A Lifespan Approach, by Simon Langley-Evans. © 2009 Simon Langley-Evans. 15 Summary Box 3

16. Nutrition: A Lifespan Approach, by Simon Langley-Evans. © 2009 Simon Langley-Evans. 16 Self-Assessment Questions