Macro nutrients for pregnancy

Question 1

Ca for pregnancy

Answer 1

no change
increase in intestinal absorption – increase 1,25(OH)2D conc. in blood
not related to vitamin D for maternal bone remodeling

Question 2

P for pregnancy

Answer 2

no change

increased absorption by 10% in intestine

Question 3

Mg for pregnancy

Answer 3

increased
higher in adolescent
decresed blood conc. due to hemodilution and weight gain –> parallel decrease in plasma serum protein

Question 4

Fe for pregnancy

Answer 4

requirement = decrease for 1st trimester but increase at 2nd and 3rd
increased RDA, EAR
factors = 1. basal loss and mestrual loss
2. fe on expansion of Hb
3. fetal and relative tissue deposition
lower Hb in maternal –> increase maternal heart work load –> to make enough O2 for fetus
supplement unnecessary

Question 5

K for pregnancy

Answer 5

no changes

very somall accretion

Question 6

Na & Cl fore pregnancy

Answer 6

so minimal increase – no change to req.
used to 1. maintain blood pressure while increase blood volume
2. provide products for conception
no benefit to reduce HTN

Question 7

Thiamin B1 pregnancy

Answer 7

increased

increase in growth of maternal and fetal compartment + small increase in E utilization

Question 8

ribofalvin B2 pregnancy

Answer 8

increased
lower urinary excretion
increase growth in maternal + fetal + small increase in E utilization
low intake –> increase risk of ariboflavinosis

Question 9

Niacin B3 preganacy

Answer 9

increased

same reason as B1, B2 – no direct evidence

Question 10

Vitamin B6 pregnancy

Answer 10

increase 
no accumulation 
to maintain pyridoxal phosphate at non pregnancy level 
75% bioavailability 
especially required in 3rd trimester

Question 11

folate B9 pregnancy

Answer 11

increased
DFE = dietary folate equivalence = 50% (ingect with food increased to 60%)
usages
1. actively transported in fetus
2. increased single C transfer reaction – homocysteine synthesis
3. nucleotide synthesis – cell divition (various growth)
EAR and RDA defined by
[folate] blood maintenance
inadequate –> maternal serum [folate] decrease –> megaloblastic marrow decreased growth in fetus –> NTD risk

Question 12

Vitamin B12 pregnancy

Answer 12

increased
increased intrinsic receptor absorbed B12 –> increase absorption
only newly absorped B12 transfered to fetus
liver store maternally –> no related to fetus
vega mother – may have B12 deficiency in infant

Question 13

biotin in pregnancy

Answer 13

no change
increase metabolites (3-hydroxyisovaleric acid) and decrease urinary exretion
factors effect biotin absorp
1. raw egg white avidin
2. biotindase deficiency – gentic disorder
3. anticonvulsant – increase biotin catabolism
4. pregnancy – higher metabolits conc. vs. [biotin]

Question 14

choline in pregnancy

Answer 14

increased
increase delivery to fetus as phosphatidylcholine
used to decrease fetus cortisol production – effect methylation status
deficiency in maternal –> decrease in [HMC] –> NTD risk in fetus
Choline can be denovo synthesis – related to B12 B6 B9
normal people with low choline and phsophatidylcholine –> liver damage

Question 15

B5 pantothenic acid pregnancy

Answer 15

increased

by average median intake

Question 16

Vitamin C pregnancy

Answer 16

increased
maternal plasma [C] decreased – by hemodilution and transfer to fetus to prevent fetal scruvy + other stress factos
cigarettes alcohol and aspirin intake – interferen with C –> need more consume

Question 17

Vitamin A Pregnancy

Answer 17

increased
RAE retinal activity equivalent 1:12:24
absorption in 70%
RDA used for all childbearing age women – prevent pregnancy deficient

Question 18

Vitamin D pregnancy

Answer 18

no change

too minimal transferred to fetus

Question 19

Vitmain K

Answer 19

no change

based on highest median intake