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by: Ian Spath

NHM201Ch5Notes.pdf NHM 201

Marketplace > NHM 201 > NHM201Ch5Notes pdf
Ian Spath
GPA 3.25
Nutrition 201 Midterm ( Chapters 1-9)
Karin Pennington

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Nutrition 201 Midterm ( Chapters 1-9)
Karin Pennington
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This 4 page Study Guide was uploaded by Ian Spath on Monday January 19, 2015. The Study Guide belongs to NHM 201 at a university taught by Karin Pennington in Fall. Since its upload, it has received 179 views.


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Date Created: 01/19/15
Chapter 5 FACTORS RELATED TO PREGNANCY COMPLICATIONS Obesity Hypertension Diabetes Preexisting and gestational Eating Disorders Multifetal Pregnancies Adolescent Pregnancy OBESITY AND PREGNANCY Obesity associated with higher rates of gestational diabetes and hypertensive disorders Associated with unfavorable metabolic changes blood glucose levels Creactive protein levels blood levels of insulin amp insulin resistance blood pressure High TotalLDL cholesterol amp Triglycerides Low HDL cholesterol Dumping Syndrome a condition characterized by weakness dizziness flushing nausea and palpitation immediately or shortly after eating and produced by abnormally rapid emptying of the stomach especially in individuals who have had part of the stomach removed Gestational Diabetes Carbohydrate intolerance with onset of or first recognition of pregnancy OBESITY AND INFANT OUTCOMES Obesity associated with higher rates of Stillbirth Large for gestational age newborns Cesareansection delivery May increase child s risk of becoming ovenNeight or having Type 2 diabetes later in life NUTRITIONAL RECOMMENDATIONS AND INTERVENTIONS FOR OBESITY IN PREGNANCY Meet nutrient needs Consume a variety of basic foods Participate in physical activity Maintain appropriate rates of weight gain PREGNANCY AFTER BARIATRIC SURGERY Bariatric surgery for weight loss has increased Weight rapidly lost due to Limited food intake Fat malabsorption Dumping syndrome Deficiencies of many nutrient stores Thiamine Vitamins D B12 and Folate Iron and calcium HYPERTENSIVE DISORDERS OF PREGNANCY Hypertension HTN is defined as blood pressure 2140 mm Hg systolic or 290 mm Hg diastolic blood pressure Affects 6 to 10 of pregnancies Contributes to stillbirths fetal amp newborn deaths amp other adverse conditions Pregnancyinduced hypertension is being replaced with hypertensive disorders of pregnancy Oxidative Stress a condition that occurs when cells are exposed to more oxidizing molecules such as free radicals than to antioxidant molecules that neutralize them and help repair cell damage Over time oxidative stress causes damage to lipids DNa cells and tissues Endothelium the layer of cells lining the inside of blood vessels HYPERTENSIVE DISORDERS OF PREGNANCY Chronic Hypertension Present before pregnancy or before 20 weeks of pregnancy Defined as BP greater than or equal to140 systolic or 90 diastolic th that does not resolve after pregnancy A BP greater than or equal to 160 systolic or 110 diastolic increases risk of fetal death preterm delivery and fetal growth retardation Treatment Low sodium diet if salt sensitive Gestational Hypertension Elevated blood pressure levels that begin after 20 weeks No proteinuria BP must return to normal 12 weeks after delivery Lower risk for poor pregnancy outcomes than those with preeclampsia Placenta Abruption the separation of the placenta from its attachment to the uterus wall before the baby is delivered Also called abruption placenta Prostacyclin a potent inhibitor of platelet aggregation and a powerful vasodilator and blood pressure reducer derived from n3 fatty acids Thromboxane the parent of a group of thromboxanes derived from the n6 fatty acid arachidonic acid thromboxane increases platelet aggregation and constricts blood vessels causing blood pressure to increase HYPERTENSIVE DISORDERS OF PREGNANCY Preeclampsia High blood pressure and proteinuria Symptoms Hypertension increased urinary protein low urine output persistent and severe headaches eyes sensitive to bright light blurred vision abdominal pain nausea Related to oxidative stress reduced antioxidant defenses and insulin resistance 2 Pregnancy specific diagnosed after 20 weeks Only cure is delivery Eclampsia Life threatening seizures still may occur within 12 days of delivery although normal preeclampsia symptoms disappear after delivery DIETARY IMPLICATIONS FOR THOSE AT RISK OF PREECLAMPSIA Calcium 10002000 mg per day Adequate Vitamin D status MVI supplement 5 or more servings of fruits and vegetables daily Moderate exercise Generally no sodium restriction Stay within weight gain recommendations GESTATIONAL DIABETES Adverse outcomes levels of Hgb A1c over 8 Mom C section increased risk of preeclampsia increased risk of type 2 diabetes HTN and obesity later and increased risk of GD in later pregnancy Child stillbirth spontaneous abortion neonatal death hypoglycemia increased risk of type 2 diabetes HTN and obesity later Congenital Anomalies Structural functional or metabolic abnormalities present at birth also called congenital abnormalities RISK FACTORS FOR GD Obesity Hx of delivery of newborn gt10 lbs Weight gain between Chronic hypertension pregnancies Mom SGA at birth UndenNeight Hx of gestational diabetes previously gt35 Grandmother diabetic and mom was LGA Ethnicity Family History TREATMENT FOR GD Normalize blood glucose levels with diet and exercise lnsulin injections may be added if postprandial levels remain high two weeks after diet Type 2 diabetics do not use their normal oral meds during pregnancy at this time PREVENTION OF GESTATIONAL DIABETES Weight loss before pregnancy if ovenNeight or obese Increase physical activity Decrease insulin resistance TYPE 1 DIABETES Risk to newborns increased mortality SGA or LGA hypoglycemia occurs in half of newborns born over 10 lbs fetal abnormalities Blood glucose control throughout pregnancy is key Other treatment adequate nutrition and appropriate weight gain monitoring urinary ketones MULTIFETAL PREGNANCIES Twin births have increased due primarily to assisted reproductive technology 1 in 56 births in 1980 1 in 32 births in 2006 Rate is also higher in obese women Multifecal pregnancies account for 3 of all births 21 of all lowbirthweight newborns 14 of preterm births 13 of infant deaths Assisted Reproductive Technology ART an umbrella term for fertility treatments such as in vitro fertilization NE a technique in which egg cells are fertilized by sperm outside the woman s body artificial insemination and hormone treatments DIETARY IMPLICATIONS Increased calorie needs Essential fatty acids Linoleic and alphalinoleic acid lron Calcium EATING DISORDERS IN PREGNANCY Pregnancy weight gain generally below recommendations Associated with spontaneous abortion HTN difficult deliveries lnfants tend to be smaller with more complications Nutrition Intervention Behavioral Changes Good Nutrition ADOLESCENT PREGNANCY How do you support growth of mother and fetus Prevent multiple pregnancies during adolescence Dietary quality and weight status are important components of the health status of adolescents and influence the course and outcome of their pregnancies


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