Micronutrients During Pregnancy

Question 1

what kind of adaptations occur to accommodate calcium need?

Answer 1

• increased intestinal absorption

- increased bioactive form of Vit D (role unclear)

Question 2

when is calcium requirement especially high?

Answer 2

last trimester when bone accretion primarily occurs

Question 3

calcium requirement (increases/decreases) with pregnancy

Answer 3

neither - there’s no evidence of decreasing bone mass with current Ca intakes

Question 4

what kind of adaptations occur to accommodate phosphorous need?

Answer 4

increased absorption efficiency

Question 5

magnesium requirement (increases/decreases) with pregnancy

Answer 5

increases - increased urination

Question 6

concentration of Mg (increases/decreases) in a pregnant woman’s blood

Answer 6

decreases - bc of hemodilution

Question 7

what is considered in the Fe requirement of a pregnant woman?

Answer 7

• fetal requirements
• expansion of blood volume
• increased storage iron

Question 8

when do iron requirements go down?

Answer 8

first trimester - no menstruation means less Fe loss

Question 9

what kind of adaptation does the body make to accommodate iron need in 2nd and 3rd trimester?

Answer 9

increased bioavailability

Question 10

consequences of anemia?

Answer 10

• severe = perinatal maternal mortality

- moderate = 2x risk of maternal death

Question 11

when is iron supplementation appropriate?

Answer 11

when pre-pregnant Fe stores are inadequate

Question 12

iron requirement (increases/decreases) with pregnancy

Answer 12

increases (from 18 to 27 mg/d)

Question 13

how was the AI for potassium set for pregnant women?

Answer 13

highest median intake

2.9 g/d

Question 14

sodium requirement (increases/decreases) with pregnancy

Answer 14

increases, but slightly - to accommodate higher blood volume over 9 months

Question 15

thiamin requirement (increases/decreases) with pregnancy

Answer 15

increases by 30%

1.4 mg/d

Question 16

riboflavin requirement (increases/decreases) with pregnancy

Answer 16

increases - support growth in maternal and fetal compartments

1.4 mg/d

Question 17

niacin requirement (increases/decreases) with pregnancy

Answer 17

neither - no evidence for change, but because energy requirements go up you eat more

18 mg/d of NE

Question 18

B6 requirement (increases/decreases) with pregnancy

Answer 18

increases (esp last trimester) to accommodate metabolic needs of the mother, fetus, and placenta

1.9 mg/d

Question 19

folate requirement (increases/decreases) with pregnancy

Answer 19

increases by about 200ug/d

rda = 600 ug/d

Question 20

b12 requirement (increases/decreases) with pregnancy

Answer 20

increase due to fetal absorption

2.6 ug/d

Question 21

biotin requirement (increases/decreases) with pregnancy

Answer 21

mixed reviews

AI is kept the same at 30 ug/d

Question 22

choline requirement (increases/decreases) with pregnancy

Answer 22

increases to accommodate need during embryogenesis and perinatal development

450 mg/d

Question 23

what happens with insufficient choline?

Answer 23

liver damage bc lowered phosphatidyl choline tissue concentrations which doesn’t permit TG export through VLDL

Question 24

Pantothenic acid requirement (increases/decreases) with pregnancy

Answer 24

doesn’t change, but AI rounds up

6 mg/d

Question 25

vit c requirement (increases/decreases) with pregnancy

Answer 25

increases due to hemodilution 80-85 mg/d UNLESS u smoke, then 2x vit c need

Question 26

vit A requirement (increases/decreases) with pregnancy

Answer 26

increases (mostly for last trimester) 750-770 ug RAE/d

Question 27

vit D requirement (increases/decreases) with pregnancy

Answer 27

neither - doesn't seem to change status but supplements are viewed as fine 600IU (15 mcg)/d

Question 28

vit E requirement (increases/decreases) with pregnancy

Answer 28

neither - no evidence for deficiency state with current consumption 15 mg/d of a-tocopherol

Question 29

vit K requirement (increases/decreases) with pregnancy

Answer 29

neither - stays the same AI is based on highest median intake 90 ug/d

Question 30

zinc requirement (increases/decreases) with pregnancy

Answer 30

gradually increases as pregnancy progresses based on balance studies EAR = 9.5 mg/d, RDA = 11 mg/d adolescents +1

Question 31

iodine requirement (increases/decreases) with pregnancy

Answer 31

increased; based on radioactive studies ``` EAR = 160 ug/d RDA = 220 ug/d ```

Question 32

what happens with deficient iodine during pregnancy?

Answer 32

miscarriage, stillbirth, birth defects, congenital hypothyroidism

Question 33

selenium requirement (increases/decreases) with pregnancy

Answer 33

increases ``` EAR = 49 ug/d RDA = 60 ug/d ```

Question 34

copper requirement (increases/decreases) with pregnancy

Answer 34

increases; based on platelet concentration ``` EAR = 785-800 ug/d RDA = 1000 ug/d ```

Question 35

Mn requirement (increases/decreases) with pregnancy

Answer 35

increased; based on balance studies. AI based on usual intakes in NA AI = 2 mg/d

Question 36

chromium requirement (increases/decrease) with pregnancy

Answer 36

increases; AI based on average intakes AI = 29-30 ug/d

Question 37

molybdenum requirement (increases/decreases) with pregnancy

Answer 37

increases due to higher body weight ``` EAR = 40 ug/d RDA = 50 ug/d ```

Question 38

Fluoride requirement (increases/decreases) with pregnancy

Answer 38

stays the same; based on prevention of dental cavities AI = 3 mg/d