Term
| Define infertility and the chances of a healthy couple at conception |
|
Definition
-lack of conception after 1 year of unprotected intercourse
-healthy couples have a 23-30% chance of conception within 1 cycle |
|
|
Term
| Define miscarriage and possible causes |
|
Definition
-loss of conceptus in 1st 20 weeks of pregnancy
-causes: defect in fetus, maternal infection, structural abnormalities in uterus, endocrine or immunological disturbances |
|
|
Term
| Define subfertility, examples, how to overcome |
|
Definition
-reduced lvl of fertility characterized by unusually long time for conception
-ex: multiple miscarriages (2+), sperm abnormalities, infrequent ovulation
-one partner can make up for the other, can be diminished by improvements to diet and lifestyle |
|
|
Term
| Describe Healthy Ppl 2020 nutrition objectives for the nation related to preconception |
|
Definition
-increase proportion of women of childbearing potential with intake of at least 400 micrograms of folic acid
-decrease proportion of those women who have low RBC folate concentrations
-increase the proportion of women delivering a live birth who recieved prec. care and practiced key rec. prec. health behaviors (multivit./folate supp., no smoke/drink, healthy wt.) |
|
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Term
|
Definition
| period in which humans become biologically capable of reproduction |
|
|
Term
|
Definition
| eggs females produce and store within the ovaries |
|
|
Term
|
Definition
| approx. 4 week interval in which hormones direct buildup of blood and nutrient stores within uterus, ovum matures and is released |
|
|
Term
|
Definition
| chamber where embryo develops |
|
|
Term
|
Definition
| inner lining of uterus, site of implantation of blastocyst- gives rise to maternal portion of placenta |
|
|
Term
| explain the possible causes of damage to the ova |
|
Definition
| oxidation, radioactive particle exposure, aging |
|
|
Term
| explain when ova and sperm develop |
|
Definition
sperm-begins at puberty, decreases at 35
ova-born with them, >35 more likely to have chrom. damage |
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|
Term
steps of follicular stage
1st hormone secreted and what it stimulates |
|
Definition
| gonadotropin-releaseing hormone (GnRH), stimulates pituitary to release FSH and LH |
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|
Term
steps in the follicular stage
what FSH stimulates |
|
Definition
-maturation of ovum and sperm
-the production of E
-vascularity and storage of glycogen and other nutrients within uterus
-E + FSH stim. growth/mat. of follicles |
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|
Term
steps in the follicular stage
what LH stimulates |
|
Definition
-secretion of E, progesterone, and testosterone
-causes cells within follicles to secrete progesterone
-prepares uterus for fertilized ovum, increases vascularity of endometrium, stim. cell division of fertilized ova |
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|
Term
steps in the follicular stage
effects of E and progesterone on uterus |
|
Definition
| -prompt uterine wall to store glycogen and other nutrients to increase growth of BV and connective tissues |
|
|
Term
steps in the follicular stage
ending step |
|
Definition
-blood lvls of FSH and LH peak.
-surge in LH-ovum released from follicle=ovulation |
|
|
Term
steps of luteal stage
beginning step |
|
Definition
| -begins with formation of corpus luteum from follicle, which secretes E and progesterone |
|
|
Term
steps of luteal stage
effects of E and progesterone |
|
Definition
-inhibit prod. of FSH and LH
-stim. dev. of endometrium |
|
|
Term
steps of luteal stage
steps if ovum not fertilized |
|
Definition
-the production of hormones from the corpus luteum decreases, E and progesterone decrease
-this removes the inhibition of GnRH for the next cycle
-this stimulates menstrual flow
-prostaglandins aid in the constriction/dilation of BV ->cramps |
|
|
Term
steps of luteal stage
steps if ovum is fertilized |
|
Definition
-implantation occurs in 8-10 days
-fertilized egg secretes hormones
-this signals corpus luteum to increase in size and to continue to produce E and progesterone
-corpus luteum fxns only for 1st few months of pregnancy |
|
|
Term
| The effect of androgens on the male reproductive system |
|
Definition
| (testosterone)-stim. maturation of sperm, transferred to epididymus for storage |
|
|
Term
| sources of disruptions in fertility |
|
Definition
-adverse ntr exposure
-contraceptives
-severe stress
-infection (STDs may lead to PID-scarring/blockage of fallopian tube)
-structural damage
-chrom. damage
-endometriosis-portions of endometrium becomes embedded with other tissue |
|
|
Term
| two biggest diagnoses of infertility |
|
Definition
1. endocrine abnormalities
2. "unknown" cause |
|
|
Term
| how undernutrition affects fertility |
|
Definition
| -acute-dramatic decrease in fertility, increases with increased intake |
|
|
Term
| how body fat affects fertility |
|
Definition
-decreased with low or high body fat.
-fertility lower with BMI <20 or >30 |
|
|
Term
| how weight loss affects fertility |
|
Definition
->10-15% of usual weight decreases E, LH, and FSH
-amenorrhea
-anovulatory cycles
-short/absent luteal phase
-clomid ineffective in underweight women |
|
|
Term
| how exercise affects fertility |
|
Definition
-delayed puberty
-lack of cycles
-decreased E and bone density |
|
|
Term
| how diet affects fertility |
|
Definition
-vegetarian, low fat/high fiber, soy, may impact hormones
-caffeine-increases time to conception
-alcohol may decrease E or testosterone
- Zn decreases sperm count |
|
|
Term
| how iron status affects fertility |
|
Definition
| -female infertility decreases with iron supplements |
|
|
Term
| Define oxidative stress and effects on sperm and egg |
|
Definition
-production of reactive oxygen molecules exceed the body's antioxidant defenses
-female-harms egg/follicle development, interferes with corpus luteum and implantation
-male-decreases sperm motility and ability of sperm to fuse with egg |
|
|
Term
| how antioxidants decrease oxidative stress |
|
Definition
-vit. E, C, selenium, B-carotene
-protects cells |
|
|
Term
| How high fiber, isoflavones, and soy impact fertility |
|
Definition
-high fiber low fat- decreased E and irregular periods
-isoflavones (from soy)-decreased gonadotropins, E, and progesterone
-regular soy intake decreases sperm in men and 1-day increase in cycle for women |
|
|
Term
| nutrition related side effects of contraceptives |
|
Definition
-oral-increased blood HDL, LDL, triglycerides, risk of blood clots, cervical cancer, CVD, blood Cu levels. decreased blood B12 and B6 levels.
-injections- wt gain, increased blood LDL and HDL, decreased bone density
-implants- wt. gain |
|
|
Term
| how folate status effects the development of NTDs |
|
Definition
| -inadequate folate prior to conception may cause NTDs |
|
|
Term
| Food group servings for preconceptional women |
|
Definition
-grains- (6-8oz)
-veg- (2.5-3c)
-fruit- (1.5-2c)
-milk- (3c)
-meat/beans- (5-6.5oz)
-oil- (5-7tsp) |
|
|
Term
| explain 2 model preconceptional nutrition programs and their health benefits |
|
Definition
WIC-better Fe status, higher birth wt.
Fe in Indonesia (Ministry of Health)
-couples applying for marriage license had to be advised of Fe status
-improved Fe status |
|
|
Term
| Explain the CDC's preconception health initiative and 2006 CDC recommendations |
|
Definition
recommended that primary health care visits include:
-preconception health and pregnancy outcome education
-screening for vaccines, wt., Fe and folate status
-alcohol use assessed
-mgmt of diabetes and celiac disease |
|
|
Term
| Define preconception care and goals |
|
Definition
-a set of interventions used to ID and modify BCH, behavioral and social risks to a woman's health
-goal-for every woman to receive services that will enable her to achieve optimal health before pregnancy |
|
|
Term
| why preconception care is important |
|
Definition
| the risk of adverse health effects to mom and baby decrease if interventions are applied preconceptionally |
|
|
Term
| ID the cluster of indicators of metabolic syndrome (5) |
|
Definition
1. waist circumference: women >35, men >40
2. blood triglycerides: >/= 150 mg/dL
3. HDL: women <40mg/dL, men <50mg/dL
4. BP: >130/85 mm Hg
5. fasting BG: >/= 110 mg/dL |
|
|
Term
|
Definition
| intolerance to carbohydrates with fasting glucose >/= 126mg/dL |
|
|
Term
|
Definition
Type 1-results from deconstruction of insulin producing cells
Type 2-body can't use insulin normally, can't produce enough or both
Gestational-onset during pregnancy |
|
|
Term
| importance of control of diabetes before coneption |
|
Definition
| -b/c they're at increased risk of: retinopathy, neuropathy, nephropathy, CVD, stillbirth, miscarriage |
|
|
Term
| NTR management of type 1 diabetes |
|
Definition
-carb control (insulin/carb ratios)
-use of artificial sweeteners
-low GI foods, high fiber (sol)
-F+V, low fat |
|
|
Term
| NTR management of type 2 diabetes |
|
Definition
-diet/exercise/meds
-wt. loss
-kcal: 15-20% pro, <30% fat, 50% carb
-low GI |
|
|
Term
| Goal of NTR therapy for diabetes |
|
Definition
| -achieve and maintain BG levels in normal range through dietary and lifestyle modifications to decrease risk of perinatal complications |
|
|
Term
| Health consequences of obesity for general population and mom/baby |
|
Definition
-gen pop- CVD/diabetes, increased risk of morbidity from HBP, coronary artery disease, and cancer
-mom- increased GDM, HBP, thromboembolism, preeclampsia, sleep apnea, C-section, preterm delivery, wt. retention
-baby-macrosomia, congenital abnormalities, shoulder dystocia, childhood obesity |
|
|
Term
|
Definition
under- <18.5
normal- 18.5-24.99
over-25-29.99
obese->30 |
|
|
Term
| Goals of medical nutritional therapy for the obese |
|
Definition
-decrease weight
-maintain lower weight
-prevent weight gain |
|
|
Term
| why should a woman's BP be evaluated before pregnancy? |
|
Definition
-leading cause of maternal mortality
-associated with increased risk of preterm birth and intrauterine growth restriction |
|
|
Term
| ADA's hypertension intervention guidelines |
|
Definition
| -MNT (Dash) -decrease weight -physical activity |
|
|
Term
| Metabolic dysfunctions associated with PCOS and the chronic diseases associated |
|
Definition
-metabolic: menstrual irregularities, infertility, hyperandrogenism, HBP, insulin resistance, hyperinsulinemia
-chronic: CVD, type 2 diabetes, metabolic syndrome |
|
|
Term
| Nutritional treatment and primary goal of PCOS treatment |
|
Definition
-dietary/lifestyle changes- omega 3s, F+V+WG, LF dairy, low GI
-weight management
-meds
-goal: increase insulin sensitivity |
|
|
Term
|
Definition
| autoimmune disease in ppl with genetic susceptibility to protein gliadin found in gluten, causes malA and flattening of intestinal lining |
|
|
Term
| General types of gluten-containing foods |
|
Definition
|
|
Term
| Reproductive effects of untreated celiac disease |
|
Definition
men-alterations in androgen action, delayed sexual maturation, hypogonadism
women-amenorrhea, increased miscarriages, fetal growth restriction, LBW deliveries, short lactation |
|
|
Term
| Risk of alcohol to unborn baby |
|
Definition
| Spontaneous abortion, intrauterine growth restriction, CNS/facial malformations, mental retardation |
|
|
Term
| Risk of folate deficiency to baby |
|
Definition
| NTDs (spina bifida/anencephaly) |
|
|
Term
|
Definition
| a metabolic disorder characterized by mental retardation, microcephaly, LBW, and congenital heart defects. Elevated blood phenylalanine due to lack of phe. hydroxylase) |
|
|
Term
| Effects of smoking on mom and child |
|
Definition
-increased risk of heart disease, some cancers, lung disease
-spont. abortion, premature rupture of the membranes, placenta previa/abruption, preterm delivery
-infant-intrauterine growth restriction, LBW, sudden infant death syndrome |
|
|
Term
| ID and describe changes in mothers CV system |
|
Definition
-increase blood volume, cardiac output and RBC mass
-decrease in systemic vascular resistance and BP
-lung capacity (tidal volume) increases by 40% |
|
|
Term
|
Definition
-human chorionic gonadotropin.
-earliest BCH indicator of pregnancy.
-embryo produces
-role-to rescue corpus luteum and maintain progesterone and relaxin production.
-synthesized from cholesterol |
|
|
Term
|
Definition
(aka hSC) human placental lactogen/human chorionic somatomammotropin
-modifies metabolic states of mom to facilitate energy supply to fetus |
|
|
Term
| explain the effects of relaxin and LH on the renal system |
|
Definition
-LH stimulates relaxin secretion from CL
-creates an increase in glomerular filtration rate (flow rate of fluid filtered through kidneys) |
|
|
Term
| describe the role of syncytiotropoblast |
|
Definition
-synthesizes hormones to ensure fetal growth and survival
-directs maternal metabolism/fetal growth/development
-increases surface area |
|
|
Term
| hormones secreted by syncytiotropoblast |
|
Definition
| HPL (hSC), hCG, progesterone |
|
|
Term
| describe the effects of estrogen on a healthy pregnancy |
|
Definition
-increases uterine blood flow
-helps supply nutrients to the fetus
-prepares breasts for lactation, affects the renin-angiotensin system |
|
|
Term
| ID and describe changes in renal system |
|
Definition
-renal size, wt and volume increase
-renal blood flow increases
-glomular filtration rate increases |
|
|
Term
| ID and describe changes to immune system |
|
Definition
| not suppressed, but modified. responds to things differently |
|
|
Term
|
Definition
| a mass of cells that forms the embryo |
|
|
Term
|
Definition
| cells forming the outer layer of the blastocyst, which provide nutrients to the embryo and develop into a large part of the placenta |
|
|
Term
| Predict the effect of excess BS on placental/fetal growth |
|
Definition
| -development of blastocyst and implantation potential are decreased |
|
|
Term
| predict the effect of adequacy of AAs on placental/fetal growth |
|
Definition
| adequacy of AAs detected by mTOR pathway. When adequate, mTOR pathway stimulates blastocyst growth and invasion |
|
|
Term
| Describe the effect of insufficient nutrition on placental/fetal growth |
|
Definition
| lack of invasiveness, implantation window may be lost |
|
|
Term
| Predict the effect of nutrient restriction early and late in pregnancy |
|
Definition
early: baby normal size, increased risk of CVD later in life, hyperemesis-sm. decrease in birth wt.
late: growth restriction, increased risk of metabolic diseases later in life |
|
|
Term
| Predict/describe the effect of repeat exposure to glucocorticoids on fetal growth and the mechanism that protects baby |
|
Definition
-growth restriction
-protected by placental enzyme 11-BHSD |
|
|
Term
|
Definition
-maternal metabolism indicators that may be involved in fetal intrauterine growth adaptation and longterm health
-regulates placental nutrition transport functions, providing a direct link btw maternal nutritional status and delivery to fetus |
|
|
Term
| Explain how nutrient mediated alteration in epigenetic regulation during gestation may lead to alterations in placental function |
|
Definition
-IUGR
-placental villous surface area. increases to compensate for insufficient delivery from mother |
|
|
Term
| Function/structure of placenta |
|
Definition
Function: hormone/enzyme production, nutrient/gas exchange, remove waste from fetus
Structure: double lining of cells separating maternal and fetal blood |
|
|
Term
| Describe 3 potential mechanisms by which underntr may affect blastocyst development or implantation |
|
Definition
-increased with AA supply
-decreased with restricted protein diet and ghrelin treatment |
|
|
Term
| Explain how tropo. cells in placenta attempt to compensate for protein restriction and how IUGR may occur anyways |
|
Definition
-tropo. enhance villous development
-placenta surgace A increased by 15%
-doesn't always decrease IUGR, may be inadequate, uptake efficiency of placenta may be inadequate |
|
|
Term
| Role of placenta in regulating maternal metabolism and fetal growth |
|
Definition
-hCS(hPL) produced by syncytiotropoblast
-decreased maternal fasting glucose
-increased maternal plasma FFA
-increased insulin secretion |
|
|
Term
| IGF purpose and effect of maternal nutrition on them |
|
Definition
-act as growth regulators of fetal and placental tissues
-IUGR with inadequate IGR-1
-concentration influenced by level of nutrients/O
-insulin and IGF-1 lveles are positively correlated |
|
|
Term
| Factors that affect nutrient transfer across placenta |
|
Definition
size and charge of molecule
small pass easily
lipid solubility of particles
concentration of nutrients in maternal and fetal blood |
|
|
Term
| How glucose, AAs, and ketones are passed through placenta |
|
Definition
glu-lower in fetus, changes parallel to mother lvls. Facilitated diffusion
AAs-higher in fetal plasma. actively transported
ketones-lower in fetal plasma. preferential transfer of LCPUFAs |
|
|
Term
| Explain why pregnant women are at increased risk of developing diabetes |
|
Definition
| insulin production and resistance increases |
|
|
Term
| How carb metabolism changes from early to late pregnancy |
|
Definition
early-high E and progesterone stimulate insulin which increases glu>glycogen+fat
late: hCS and prolactin inhibit glu>glycogen+fat |
|
|
Term
| how lipid metabolism changes from early to late pregnancy |
|
Definition
early-accumulation
late-enhanced fat mobilization |
|
|
Term
| Benefits of maternal TGs to fetus |
|
Definition
-represent a floating energy deposit
-used by mother, spares glucose for fetus
-increases milk synthesis |
|
|
Term
| Use of FFAs and cholesterol |
|
Definition
FFA-used by liver to synthesize VLDL, glucose, ketones for fetus
chol- steroid hormone synthesis |
|
|
Term
| Explain the increased rate of multiple births in the US |
|
Definition
| increased use of assisted reproductive technologies (ART) |
|
|
Term
| Risks of ART and multifetal pregnancies |
|
Definition
-prematurity, LBW, perinatal mortality
-preeclampsia, gestational diabetes, preterm birth |
|
|
Term
| define preterm birth, LBW, VLBW |
|
Definition
perterm birth- <32 weeks
LBW- <2500g
VLBW-<1500g |
|
|
Term
| weight gain recommendations for twins |
|
Definition
normal-37-54
overweight-31-50
obese25-40
1.5lb/week in 2nd and 3rd trimesters |
|
|
Term
| ways to manage nausea and vomitting |
|
Definition
-small, frequent meals and bev.
-avoid spicy, fried, and high fat foods
-high CHO easier to tolerate
-avoid cooking odors
-get out of bed slowly
-vit, supp. of B6, eat ginger |
|
|
Term
| define hyperemesis gravidarum (HG) and complications |
|
Definition
-severe nausea and vomitting
-hospitalization, gallbladder and liver disfunction |
|
|
Term
|
Definition
| elevated, sm/frequent meals, avoid chocolate, caffeine and seasonings |
|
|
Term
| ways to manage ptyalism (excessive saliva) |
|
Definition
| chew gum, restrict fluids |
|
|
Term
| ways to manage constipation |
|
Definition
| increase liquids, fiber, and physical activity |
|
|
Term
| characteristic behaviors of EDs and how clinically present |
|
Definition
-restrict intake, laxative use, self-induced vomitting, increased exercise, weight/body shape concerns high in pregnancy
clinically-menstrual dysfunction, low bone density, sexual dysfunction, preterm delivery, LBW |
|
|
Term
| Consequences of EDs in pregnancy |
|
Definition
| spontaneous abortion, HBP, difficult deliveries, smaller newborns, high rates of neonatal complications |
|
|
Term
| Goals of nutrition interventions for women with eating disorders |
|
Definition
-behavioral changes
-improve nutrient status
-appropriate weight gain |
|
|
Term
| list the unfavorable metabolic changes and complications with obesity |
|
Definition
-higher rates of gestational D and hypertensive disorders
-higher BG levels, C-reactive protein, blood insulin/resistance, BP, LDL and lower HDL |
|
|
Term
| Recommendations for obese pregnant women |
|
Definition
-meet nutrient needs
-consume a variety of basic foods
-physical activity
-maintain appropriate weight gain |
|
|
Term
| diagnosis criteria for gestational diabetes |
|
Definition
must exceed >/= 2:
-overnight fast 95
-1-hr after glucose load 180
-2-hr after glucose load 155
-3-hr after glucose load 140 |
|
|
Term
| treatment of gestational diabetes |
|
Definition
-normalize BG with diet and exercise
-insulin injections added if no improvement in 2 weeks |
|
|
Term
| diagnosis criteria for chronic and gestational hypertension |
|
Definition
chronic-present before pregnancy/before 20 weeks. BP>140/90
gestational-present at or after 20 weeks |
|
|
Term
| outcomes/criteria for preeclampsia-eclampsia |
|
Definition
-increased BP >140-90
-proteinuria-excretion of >.3g pro. in a day
-manifestation of kidney damage |
|
|
Term
| hypertension and preeclampsia |
|
Definition
-common in overweight/obese
-risk factors-previous preeclampsia, maternal age <20 or >40, diabetes and genetics |
|
|
Term
| possible causes, associated complications and characteristics of hypertension and preeclampsia |
|
Definition
-unknown cause
-could be related to inadequate placental blood supply
-associated with preterm delivery, LBW, neonatal death, increased risk of CVD later in life |
|
|
Term
| Nutritional interventions for chronic hypertension |
|
Definition
-adequate and balanced diet
-if salt-sensitive, Na restriction |
|
|
Term
| Goals of nutritional management of HIV |
|
Definition
-maintain positive nitrogen balance and preservation of lean muscle and bone mass
-adequate intake of energy and nutrients
-adopt safe food-handling practices
-healthy newborn |
|
|
Term
| Why pregnant women must be cautious with seafood and list safety recommendations |
|
Definition
-mercury exposure
-eat up to 12 oz. of a variety of M-low fish (shrimp, canned light tuna, salmon, pollock, catfish) |
|
|
Term
| why listerosis is a concern |
|
Definition
-infection caused by consuming food contaminated with Listeria monocytogenes
-flu-like symptoms
-menengitis, encephalitis, infections, miscarriage, stillbirth |
|
|
Term
|
Definition
-avoid hotdogs/deli meats unless VERY hot
-avoid soft cheeses, refrigerated meat pates/spreads, refrigerated smoked seafood (unless cooked), unpasteurized milk, eggs, or juice |
|
|
Term
|
Definition
1. Tumor necrosis factor-alpha- produced by placenta, increases insulin resistance
2. adiponectin- synth in adipocytes, secreation decreases with increased gestation, acts as an insulin sensitizing hormone
3. leptin- moderates satiety and energy homeostasis, synth. in adipocytes and placenta, increase with gestation |
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