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Pregnancy, (Iron 14.5mg/d, Zinc 7mg/d, Calcium) - Coggle Diagram
Pregnancy
Essential fatty acids 450mg/d
Neurological & retina development
Cell membranes and new tissue
Positive assiciation between mothers intake and child’s cognitive and visual function
DHA, EPA, AA
Limit tuna (4cans) due to mercury which can cause fetal nerve damage
No fish oil supplement as high in vit A teratogenic
2 servings of fish (140g) 1 oily due to dioxins and PCBs
Deficiency in foetal alcohol syndrome
Decreases maternal DHA status
Reduces transfer through placenta
Decreases intake
Energy requirements +200kcal 3rd trimester only
Adaptations
⬇️physical activity
⬆️metabolic efficiency
Maternal stores to prioritise foetus
⬆️ BMR
2nd - 10.8%
3rd - 24%
1st - 4.5%
Recommendations
SACN (2011) +200kcal/d in 3rd trimester
WHO (2004) 1st +85kcal/d, 2nd +285kcal/d, 3rd +475kcal/d
Weight gain average in UK 12.5kg
If normal 11-15kg
If obese 5-9kg
If overweight 7-11kg
weight loss not recommended during pregnancy - loss weight before then maintain
adverse effect on foetal development
adverse effect on maternal nutrient stores
poor micro nutrient intake
adverse effect on breast milk composition
Physiological changes :
Renal
30% ⬆️ renal blood flow
GFR ⬆️
⬆️ size & weight
⬆️ BMR
More metabolically active tissue
Placenta
Amniotic fluid
Foetus (new lean & fat tissues)
Maternal tissues
Blood
Extracellular fluid
Breasts
Extravascular fluid
Uterus
Storage of nutrients🧳
Maternal fat reserves
Cardiovascular
20-30% more RBC mass
30-50% increase cardiac output
45% increase blood volume
40% increase in tidal volume
Increase amount of air inspired per breath
Prone to hyperventilation
Increased oxygen consumption
Protein requirements +6g/d (COMA)
Increased requirement due to
Maternal tissue
Growth of fetal tissue
Antibodies
Muscle
Enzymes
Collagen
Placenta
Body conserves protein
Rises to 51g/d - no concern as UK intake much higher
Vitamins
Water soluble
Riboflavin (1.1mg) +0.3mg/d
Vitamin C (40mg/d) +10mg/d
Enhances iron absorption
Reduces oxidative stress
Thiamin (0.8mg/d) +0.1mg/d final trimester
Fat soluble
Vitamin D (10mcg/d)
Stimulates calcium absorption
Deficiency can lead to
Neonatal hypocalcaemia
Rickets
LBW
Gestational diabetes
Preeclampsia
Vitamin A (600mg/d) +100mg
use beta carotene rich foods
risk of toxicity with retinol
important for immunity and retinal development
Minerals
Iron 14.5mg/d
Increased demand 800-900mg due to
Fetal and placental development 300-400mg
Maternal RBC mass 500mg
Losses at delivery 100-250mg
Adaptations
Mobilisation of maternal stores
Increased intestinal absorption
Cessation of menstruation
Many mothers go into pregnancy with low levels
Zinc 7mg/d
Required for
DNA & RNA synthesis
Metabolism
Calcium
No increase as absorption increases via placental hormones
Compensatory release of PTH
Maintains serum Calcium level
Enhances intestinal absorption
Decreases urinary excretion
NDNS (2020) most UK women meet requirements
Inhibit reabsorpton for mothers bones