Pregnancy

Life Cycle

Pregnancy

I Fetal Growth and Development
A. Embryo
1. 2 – 8 weeks
2. development of vital systems
B. Fetus
1. next 7 months
2. organs grow to maturity
3. from less than 1 ounce to 6.5-9 lbs
4. 20-21”
C. Critical periods: finite period of intense development and rapid cell division
1. neural tube defects
a. critical period is 17-30 days gestation (mother may not be aware of pregnancy at this point)
b. anencephaly affects brain development
c. spina bifida can lead to paralysis or meningitis
II Maternal Weight
A. Recommended weight gains
1. underweight <18.5 BMI: 28-40 lbs
2. healthy weight 18.5 – 24.9 BMI: 25-35 lbs
3. overweight 25 – 29.9 BMI: 15-25 lbs
4. obese > 30 BMI: 15 lbs maximum
5. twins: 35-45 lbs
B. Weight gain patterns:
1. first trimester: 3 ½ lbs
2. 1 lb per week thereafter
3. gain must be gradual, not sporadic (up and down)
C. Components of weight gain
1. increase in breast size = 2lbs
2. increase in mother’s fluid volume = 4lbs (most of the weight gain at the end of pregnancy is fluid)
3. placenta = 1 ½ lbs
4. increased blood supply = 4 lbs
5. amniotic fluid = 2 lbs
6. infant at birth = 7 ½ lbs
7. increase uterus and muscles = 2 lbs
8. mother’s fat stores = 7 lbs (fuel for lactation)
III Energy and Nutrient Needs during pregnancy
A. Energy
1. 2nd trimester increase 340 kcal/day
2. 3rd trimerster increase 450kcal/day


B. Protein
1. increase of 25 gr/day
2. Use food over supplements to avoid strain on the kidneys from vitamins.
C. Essential fatty acids
D. Folate
E. B12
F. Iron
G. Zinc
H. Ca and Vit D for bone development
I. Other nutrients support growth, development and health of mother, and fetus
IV Vegetarian diets during pregnancy and lactation
A. adequate energy is important
B. should include milk and milk products
C. should contain a variety of legumes, cereals, fruits, and vegetables
D. plant-only diets may cause problems during pregnancy
E. Supplements of iron, vitamin B12 (b/c only found in animal products), calcium(best absorbed from dairy products), and Vit D (best absorbed with milk/calcium) may be required
V Common nutrition related concerns of pregnancy
A. Nausea
1. morning (anytime) sickness
2. ranges from mild queasiness to debilitating nausea and vomiting
3. hormonal changes
VI High-Risk Pregnancies
A. Malnutrition
1. fetal growth retardation
2. congenital malformations
3. spontaneous abortion and stillbirth
4. premature birth
5. low infant birth weight
6. food assistance programs
a. supplemental nutrition program for Women, Infants, and Children (WIC)
b. nutrition education
c. food vouchers for nutritious foods only
B. Preexisting Diabetes (maternal)
1. proper management is important
2. risks include:
a. infertility
b. hypoglycemia
c. hyperglycemia
d. spontaneous abortions
e. pregnancy related hypertension
C. Gestational Diabetes
1. routine screening with glucose tolerance test
2. risk factors
a. age 25 or older
b. BMI > 25 or excessive weight gain
c. complications in previous pregnancies
d. symptoms of diabetes
e. family history of diabetes
f. Hispanic, African American, Native American, South or East Asian, Pacific Islander or indigenous Australian
3. consequences
a. complications during labor and delivery
b. high-birth weight infant (Mother’s sugar needs to be metabolized by fetus, but because no room for the fetus to burn it off it gets stored as fat.)
c. chance of mother developing Stage II diabetes later in life
D. Preexisting hypertension
1. heart attack and stroke
2. low birthweight infant
3. separation of placenta from wall of uterus resulting in a stillbirth
E. Transient Hypertension of pregnancy (occurs because of pregnancy)
1. develops during 2nd half of preganancy
2. usually mild
3. returns to normal after birth
F. Pre eclampsia
1. high bp
2. protein in the urine
3. edema all over the body
4. affects all organs
5. retards fetal growth
G. Eclampsia (aka Toxemia…most severe stage)
1. severe stage of pre eclampsia
2. seizures and coma
3. maternal death