Final Exam- Chapter 14

What is the average birthweight/height of a newborn baby?

18-22 inches long and weighing 7.5 pounds.

What is the recommended weight gain for women of normal pre-pregnancy weight?

25-35 pounds; underweight women should gain a little more than this amount (28-40 pounds) and overweight women should gain a little less than this amount (15-25 pounds).

What is the AI for total fluid intake?

3 liters/day; this recommendation includes approximately 2.3 liters of fluid as total beverages, including water.

Hypertensive disorders of pregnancy

7-8% of U.S pregnancies complicated by some for of hypertension (high blood pressure); can be caused by deficiencies in dietary protein, vitamin c, vitamin e, calcium, and magnesium.

What is the estimated percentage of neural tube defects that could have been prevented if the mother consumed enough folate/folic acid?

70%; folate deficiency cal also result in macrocytic anemia (red blood cells do not mature properly) and is associated with low birthweight, preterm delivery, and failure of fetus to grow properly.

What newborn birthweight is considered to be a marker of a successful pregnancy?

A birthweight of at least 5.5 pounds.

After week 8, what is the developing baby called?

A fetus.

How long does a full-term pregnancy last and in what stages is it broken up?

A full-term pregnancy lasts for 38-42 weeks; this length of time is broken up into trimesters lasting about 13-14 weeks each.

What happens by the 4th week of pregnancy?

A primitive placenta has formed in the uterus from both embryonic and maternal tissue. The placenta is a pregnancy-specific organ.

Describe Vitamin D

AI does not increase during pregnancy; excess can cause developmental disabilities in newborns, supplementation is only advised if exposure to sunlight is limited or milk consumption is low. Prenatal vitamins contain 10 ug/dose

other birth defects associated with maternal alcohol consumption

Alcohol related birth defects (heart, skeletal, kidney, ear, and eye malformations), alcohol related neurodevelopmental disorder (range of lifelong developmental, disorders like ADD) and fetal alcohol effects (used as diagnosis when child does not meet all traits of FAS)

What correlates with the increased need for energy during pregnancy?

An increased need for the micronutrients involved in energy metabolism.

What polyunsaturated fatty acid has been found to be uniquely critical for both brain growth and eye development?

An omega-3 polyunsaturated fatty acid known as docosahexaenoic acid (DHA). Good sources are oily fish such as salmon, sardines, anchovies, and mackerel.

Describe the neural tube defects associated with Folate deficiency

Anencephaly: a fatal defect in which brain tissue is partially or fully absent Spina bifida: a defect in which a portion of the spinal cord portrudes through the spinal vertebrae, causing varying degrees of paralysis

When does the zygote arrive in the uterus?

At about day 4 after conception.

Why is Vitamin B12 (Cobalamin) vital during pregnancy?

Because it regenerates the active form of folate. During pregnancy is absorbed more efficiently which is why you do not increase your intake by much; the required amount can easily be obtained from animal food sources.

Why is the man's/father's nutrition important prior to pregnancy as well?

Because malnutrition contributes to abnormalities in sperm. Both sperm number and motility are reduced by alcohol consumption, use of certain prescriptions and illegal drugs.

Why is DHA especially important in the maternal diet?

Because of the dramatic fetal brain growth during the third trimester as well as the rapid brain growth that occurs during the first three months of life.

Why does it continue to be critical that the mother eat an adequate and balanced diet through the third trimester?

Because of the intense growth and maturation of the fetus during the third trimester. A balanced diet is one of the most important variables under a mothers control for increasing the chance for birth of a mature newborn (newborn born at 38-42 weeks).

What is the first substance to be released from the breast after birth?

Colostrum: pre-milk that is thick, yellowish in color and rich in protein and micronutrients; also includes antibodies that help protect newborn from infection. Also fosters growth of good bacteria in the infants gastrointestinal tract and has laxative effect on infant helping them to expel meconium (sticky first stool)

Define umbilical cord

Connects the placenta to the fetal circulatory system; is an extension of fetal blood vessels emerging from the fetus's navel.

Describe different deficiencies in Vitamin B12

Deficiency can cause macrocytic anemia; even though is found in many food products pregnant women can still become deficient, such as mothers who are also vegan. If vegan, fortified foods or supplementation provide needed B12.

What are developmental features of the second trimester?

Develops ability to suck its thumb, to hear, and to open and close eyes in response to light.

Which stage of life is nutrition the most crucial?

During fetal development and infancy.

What are the Macronutrient needs of Pregnant Women?

Energy requirements increase only modestly during pregnancy. Instead of eating more, the pregnant woman should attempt to maximize the nutrient density of what she eats. During last two trimesters of pregnancy, caloric needs increase by about 350-450 kcal/day.

What are your fat intake needs while pregnant?

Fat intake should not change during pregnancy but be aware that some fat in diet is essential for proper fetal development. consumption of right kinds of fats are important; limit intake of saturated and avoid trans fat.

What happens to the fat used by the developing fetus?

Fetus stores most of its own body fat during the third trimester; these fat stores serve as critical source of fuel during the newborn period and allow newborns to regulate their body temperature.

What is the height/weight of the fetus at the beginning of the second trimester and then at the end of the second trimester?

Fetus will go from being 3 inches long and about 1.5 pounds at the beginning of the second trimester to over 1 foot long and over 2 pounds at the end of the second trimester.

What weeks are each trimester associated with during pregnancy?

First trimester: conception-week 13 Second trimester: week 14-week 27 Third trimester: week 28-week 40

Which micronutrients are involved in energy metabolism and are needed in excess during pregnancy?

Folate, Vitamin B12, Vitamin C, Vitamin A, Iron, Zinc and Iodine.

In the first weeks of pregnancy where does the embryo obtain its nutrients?

From cells lining the uterus.

What nutrition-related disorders can the mother avoid if she follows a healthful diet before conception?

Gestational Diabetes and Hypertensive Disorders.

Describe functions of Calcium

Growth of fetal skeletal system requires a significant amount of calcium but recommended amount stays same because pregnant women absorb calcium from their diet more efficiently than non-pregnant

What does a healthful diet before conception include?

Having a pre-pregnancy BMI between 19.8 and 26.0 and an appropriate level of physical activity.

How does drinking adequate fluid help?

Helps combat discomforts of pregnancy such as fluid retention and constipation. May also lower risk for UTI, which are common in pregnancy, and can combat dehydration.

What deficiency-related problems develop early in pregnancy or typically before the mother even realizes she is pregnant?

Inadequate levels of folate during the first few weeks following conception can result in brain and spinal cord (neural tube) defects. Can reduce risk by taking 400 ug of folate (folic acid) daily before conception.

What happens to the zygote as it travels through the fallopian tube?

It divides into a ball of 12 to 16 cells.

When and where is the zyogte created?

It is created when the ovum and sperm unite; this uniting of egg and sperm happens in the uterine tube after ovulation.

What is the embryonic stage?

It is the developmental stage lasting from the third week (where further cell growth, multiplication, and differentiation occurred resulting in the formation of the embryo) to the end of the 8th week after conception.

What happens to the blastocyst by Day 10 after conception?

It will have implanted into the uterine lining, with the outer portion of the zygote becoming part of the placenta.

How does lactation occur?

Lactation, the production of breast milk, is a process set in motion during pregnancy in response to several hormones. One established can be sustained as long as mammary glands continue to receive the proper stimuli.

Define preterm and gestational age

Many low and very low birth weight babies are born either preterm or are born at term but are small for gestational age. preterm: before 38 weeks' gestation.

What specific developmental features of the embryo happen by the end of the embryonic stage?

Primitive skeleton (including fingers and toes), muscle development in trunk and limbs with some movement possible, primitive heart beat and digestive organs are becoming distinct. Differentiation of brain and vague features of face.

What are your Protein needs while pregnant?

Protein needs increase to 1.1 g/day/kg body weight ( about 25 additional grams of protein per day). find in dairy products, meats, eggs and soy products, as well as legumes, nuts and seeds.

Rates of initiation of breast feeding by country

Rates of initiation of breast feeding are extremely low in Eastern Europe and Central Asia whereas highest rates are in Latin America, the Caribbean, and Eastern and Northern Africa.

What are things to avoid pre-pregnancy?

Teratogens (substances that cause birth defects which includes alcohol and illegal drugs) and other possible hazards like smoking, caffeine, medications, some herbs and supplements.

During the Embryonic stage, what are the developing embryos extremely vulnerable too?

Teratogens, not only alcohol and illegal drugs but also some prescription and over-the-counter medications and megadoeses of supplements, several herbs, some viruses, cigarette smoking, and radiation. All of these can interfere with embryonic development and cause birth defects.

As a fully functioning organ, what does the placenta do?

The placenta is responsible for oxygen, nutrient, and waste exchange between mother and fetus.

In some cases, what happens to the pregnancy when the damage from teratogens to the developing embryo during the first trimester is too severe?

The pregnancy is naturally terminated in a spontaneous abortion (miscarriage), most of which occur in the first trimester.

When does the embryo transition from being an embryo to a fetus?

The third month of pregnancy; to supplement its dramatic growth, the fetus requires abundant nutrients from the placenta.

What enhances iron absorption?

Vitamin C as do dietary sources of heme iron. Substances in coffee, tea, milk, bran and oxalates decrease iron absorption.

Which micronutrients does a pregnant woman NOT have an increased need for?

Vitamin D, Calcium, and Sodium.

What is the most common activity of pregnant women?

Walking because it is an excellent low-impact choice; women who were avid runners before can continue to run although distance and intensity may need to be limited.

When does the first trimester of pregnancy begin?

When the ovum and sperm unite to form a single, fertilized cell called a zygote. (AFTER the woman ovulates/releases an ovum or egg cell from the ovary, which leads to the ovum being drawn into the uterine tube).

Do most drugs pass through the placenta into fetal blood?

Yes; newborns will also suffer withdrawal symptoms including tremors, excessive crying, sleeplessness, and poor feeding.

Gestational hypertension

a woman who develops high blood pressure with no other symptoms is said to have this.

Fluid Needs for Pregnant women

allows for necessary increase in the mother's blood volume, aids in regulating body temperature and helps maintain the amniotic fluid (surrounds and protects fetus in the uterus).

What happens to prolactin and these hormones after childbirth?

at full term level of prolactin is 10 times higher than at beginning of pregnancy; at birth, suppressive effects of hormones end and prolactin is free to stimulate milk production.

Food safety while pregnant

avoid unpasteurized milk, raw or partially cooked eggs, raw or undercooked meat/fish/poultry, unpasteurized juices, and raw sprouts. Also avoid eating large fish and canned albacore tuna because of their high mercury content.

Describe Fetal Alcohol Syndrome (FAS)

babies born with FAS have characteristic malformations, particularly of face, limbs, heart and nervous system. have high mortality rate and typically have emotional, behavioral, social, learning and developmental problems thru life.

Why does the fetal demand for iron increase even further during the last triemester?

because the fetus stores iron in the liver for use during the first few months of life.

What is the inner portion of the zygote called?

blastocyst.

Consumption of caffeine in relation to pregnancy

caffeine is a stimulant that crosses the placenta and reaches the fetus; 1-2 cups of coffee per day will most likely cause no harm. more than that can increase risk of miscarriage and low birth weight.

Benefits of Exercise during Pregnancy

can help keep a woman physically fit during pregnancy, enhance mood and help women feel more in control over their changing bodies; will also improve cardiovascular fitness and help keep blood pressure low.

What is the key for getting adequate nutrients while not consuming too many extra calories?

choosing nutrient dense foods instead of eating more.

Aversions related to pregnancy

common during pregnancy and may originate from social, cultural, or religious beliefs.

Gastroesophageal Reflux in relation to pregnancy

common during pregnancy because pregnancy-related hormones relax the smooth muscle of the lower esophagus.

Why do pregnant women need adequate intake of Macronutrients?

during pregnancy they provide necessary energy for building tissue and are the building blocks for the physical form and structure of the fetus.

What happens during the Embryonic stage?

embryonic tissues continue to differentiate and fold into primitive, tubelike structure with limbs, bud and organs, and facial features recognizable as human.

Describe Vitamin A

excess can cause abnormalities in fetal kidneys and nervous system; supplementation is not recommended due to toxicity risk. Beta carotene (provitamin A) is not associated with birth defects.

What are good sources of Folate?

fortified cereals and grains, spinach, and lentils.

Constipation in relation to pregnancy

hormone production during pregnancy causes smooth muscles to relax, including the muscles of the large intestine slowing colonic movement of food residue.

Why is more iron needed during pregnancy?

important in formation of red blood cells; demand for RBC's increases to accommodate the needs of the mothers expanded blood volume, growing uterus, the placenta and the fetus.

What does severe inadequate intake of iron have the potential to do?

increase risk for low birth weight, preterm birth, and death of the newborn in the first few weeks after birth. In most cases however, the fetus steals maternal iron, prompting iron-deficiency anemia in the mother.

What is associated with a deficiency in Vitamin C during pregnancy?

increased risk for preterm birth and other complications such as preclampsia

What are the risks associated with an infant and low birth weight?

increased risk of infections, learning disabilities, impaired physical development, and death in the first year.

What are your carbohydrate needs while pregnant?

intake should be at least 175 g/day and majority of intake should come from whole grain breads and cereals, brown rice, fruits, vegetables and legumes.

Describe Zinc

is critical in DNA, RNA, and protein synthesis; inadequate intake can lead to malformations in the fetus, premature labor, and extended labor. Absorption of Zinc is inhibited by high intakes of non-heme iron.

Describe functions of Vitamin C

is necessary for the synthesis of collagen, which is a component of connective tissue and part of organic matrix of bones. Found in many food sources such as citrus fruits and juices and numerous other fruits and vegetables.

Describe the functions of Folate

is required for cell division; is critical in the first 28 days for the development of the neural tube, which comes the brain and spinal cord.

Risks associated with having a low pre-pregnancy BMI versus risks associated with having a high pre-pregnancy BMI.

low BMI: increase risk of having a preterm or low birth weight baby and of depleting their own nutrient reserves to dangerous levels. high BMI: increase risk of fetus being large for gestational age which increases chance of trauma during vaginal delivery and c-section births.

Define low-birth weight and very low-birthweight

low birthweight is an infant weighing less than 2,500 g (about 5.5 pounds) at birth. very low birthweight in an infant weighing less than 1,500 g (about 3.3 pounds).

Describe Gestational Diabetes

make up 7% of U.S pregnancies; temporary condition in which a pregnant woman is unable to produce sufficient insulin or becomes insulin resistant, resulting in elevated levels of blood glucose; elevated levels can result in a baby that is too large

Why should you avoid unpasteurized milk and cheeses while pregnant?

may be contaminated with the bacterium Listeria monocytogenes, which triggers miscarriage, premature birth or fetal infection.

Sources of Calcium

milk, yogurt and cheese as well as nondairy foods such as kale, collard greens, and brocolli

Effects of maternal smoking

more than 10% of pregnant women smoke; exposes fetus to toxins such as lead, cyanide, nicotine and carbon monoxide. Reduces fetus blood flow resulting in impaired fetal development; rates of sudden infant death syndrome, respiratory illness, and allergies higher in smoking mothers

Cravings related to pregnancy

most women crave general type of food (something "sweet" or "salty") Pica: women who crave nonfoods like laundry starch or clay or chalk; can result in nutritional/health problems for the mother and fetus.

Describe morning sickness

nausea and vomiting of pregnancy; symptoms vary is severity from mild queasiness to constant nausea with bouts of vomiting. usually peaks between weeks 8 and 12; can be dangerous if mother is so sick that they are unable to nourish or hydrate themselves. no cure.

Describe Sodium

necessary to maintain fluid balance but intake does not increase from pre-pregnancy to pregnancy.

Describe Iodine

needs increase significantly during pregnancy but is easy to achieve by using a modest amount of iodized salt (sodium chloride) during cooking.

Define dioxins

persistent organic pollutants associated with a variety of health problems; found in fish, shellfish and a variety of meats. Effects developing fetal organs, including the nervous system.

Hypertensive disorders

preeclampsia: characterized by sudden increase in maternal blood pressure with swelling, excessive and rapid weight gain unrelated to food intake and protein in urine. if left untreated, can lead to eclampsia, characterized by seizures, kidney failure, and potential death.

Define fetal alcohol spectrum disorders and fetal alcohol syndrome

refers to a range of conditions that result from maternal intake of alcohol; the most severe form of FASD is fetal alcohol syndrome, where the mother drinks heavily (more than 3-4 drinks per day) throughout pregnancy.

Which hormones increase the breasts physically for lactation?

the estrogen and progesterone produced by the placenta throughout pregnancy; breasts increase in size and milk producing glands (alveoli) and milk ducts are formed.

What happens during the third trimester?

the fetus gains nearly half of its body length and 3/4 of its body weight, extensive brain growth, lungs fully mature, and the fetus acquires eyebrows, eyelashes and hair on its head.

Define gestation

the period of intrauterine development from conception to birth.

Define Conception

the point at which a woman's ovum (egg) is fertilized with a man's sperm.

How do Fiber rich foods contribute during pregnancy?

they contribute to ones sense of fullness which helps to avoid excess weight gain and may lower risk of constipation.

Nutrition for breast feeding mothers

throughout most of history, infants thrived on only breast milk. During 1st half of 20th century: infant formulas began to replace breast milk as mother's preferred feeding method 1970's: renewed appreciation for breast feeding; in 2005 almost 75% of new mothers initiated breas feeding in the hospital and over 43% still breast fed their babies at 6 months of age.

When does the production of the hormone Prolactin increase?

toward the end of pregnancy; is released by the anterior pituitary gland and is responsible for milk synthesis. estrogen and progesterone suppress the effects of prolactin during pregnancy.