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Chapter 4

Chapter 4.docx

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Department
Nutrition
Course Code
NUTR 2050
Professor
Simone Holligan

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Chapter 4 Nutrition During Pregnancy Nutritional status stands out as an important factor affecting fetal growth and developmentThe Status of Pregnancy Outcomes Natality Statisticso Summarize important information about the occurrence of pregnancy complications and harmful behaviours along with infant mortality and morbidity ratesRefer to chart 41 pg 88Time breakdowns before during and after pregnancyInfant Mortality Infant mortality rates are highly related to population wide improvements ino Social circumstanceso Infectious disease controlo Availability of safe and nutritious foods Improvements in these above are leading to greater reduction in infant mortality rates more so than improved technology in healthcareSee chart 42 pg 89 th The USA spends more money on healthcare than any other nationyet ranked 29 in international levels of infant mortality Liveborn Infanto Outcome of delivery when a completely expelled fetus breaths or shows any sign of life sto 23 of deaths to livebirth infants occur within 1 month or during neonatal period 3842 weeksLow Birth weight Preterm Delivery and Infant Mortalityo Low birth weight infants82 of all births 66 of all infant deathso Birth rate increases along with the increase in length of the pregnancyo Lowest infant mortality ratesSingapore 2 in 1000 o Highest infant mortality ratesRomania 168 in 1000 Reducing Infant Mortality and Morbidity This can be done through improvements in the birth weight of newborns 7 lb 12oz10 lbsleast likely to die within first year of life as well as least likely to develop heart disease diabetes lung disease etcPhysiology of Pregnancy Pregnancy begins at conception14 days before next scheduled menstrual period Pregnancy lasts 38 weeks or 266 days gestation agemore commonly 40 days this starts at the date of last period LMP menstrual age Maternal Physiologyo The changes in women during pregnancy were once seen as a problem that needed correctiono However attempts to bring pregnant body back to nonpregnant state can do more harm than good to the pregnancy o Order of changes that need to take placesequence of development table 46 pg 92 Maternal plasma volume to be circulate must increase by20 weeksMaternal nutrient stores are accumulated next by20 weeks Placental weight increase to make room for fetal weight increases by31 weeks Blood flow to the uterus by37 weeks Fetal weight by37 weeksNormal Physiological Changes During Pregnancy Changes can be divided into 2 groupso First half of pregnancy Changes here considered maternal anabolicthey build capacity of the mothers body to deliver relatively large quantities of blood oxygen and nutrients10 of fetal growth o Second half of pregnancy Changes here considered maternal catabolicenergy and nutrient stores and the heightened capacity to deliver stored energy and nutrients to fetus predominate 90 of fetal growth Body Water Changeso Increased amount due to increased plasma extracellular fluid and amniotic fluid o Total increase is ranges from 710 liters o 23expansion of blood and body tissue intracellularo 13fluid in spaces between cells extracellularndrdo Increase in plasma accounts for fatigue felt by many pregnant womenincreases in 2 and 3 monthso Edema Swelling usually of legs and feet due to increase in extracellular fluid healthy o Birth weight is strongly related to plasma volumehigh plasma high birth weightHormonal Changeso Placenta is KEY in production of steroid hormones progesterone estrogen and testosterone
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