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NUTR 337 > placental metabolism > Flashcards

placental metabolism Flashcards

1
Q

what is a placenta?

A

circular shaped organ that is important for sharing the circulatory system between mom and kid so that nutrients, gases, hormones, and waste products can be exchanged. portion from embryo and portion from mom’s uterus

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2
Q

true or false: an embryo and mom share blood

A

false; the fetus and mother have separate systems but there are villi where the exchange can happen

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3
Q

when is the development of the placenta fastest? implications?

A

first half of pregnancy

any complications during this time can have

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4
Q

maternal venule

A

site where waste products and co2 are sent out from the fetus

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5
Q

maternal arteriole

A

site where oxygenated blood

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6
Q

placental functions (2):

A
  • metabolism (synth of glycogen, lactate, cholesterol)
  • transport
  • endocrine
  • hormone metabolism
  • nutrient storage
  • protection against xenobiotics
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7
Q

what percentage of oxygen and glucose uptaken by the placenta is used by the placenta?

A

65% glucose

up to 50% oxygen

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8
Q

what substances can be transported by the placenta?

A
  • nutrients
  • immunoglobulins (passive immunity)
  • harmful substances
  • waste products
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9
Q

mechanisms of transport in the placenta?

A
  • passive (gases, electrolytes, fat-solubles)
  • facilitated (sugars, long chain PUFAs)
  • active (AAs, cations)
  • solvent drag (electrolytes)
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10
Q

the placental carriers for PUFAs are (uni/bi - directional)

A

uni

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11
Q

if the mom has diabetes, will the fetus be protected from excess blood sugars?

A

yes - the glucose transporters will be saturated, blocking sugars from reaching the same concentrations in the fetus

that said, hyperglycemia is still considered teratogenic. late in the pregnancy it is also associated with excessive growth of the fetus.

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12
Q

what happens if the mom is malnourished

A

reduces blood volume

  • -> cardiac output decreased
  • -> decreased placental blood flow
  • -> decreased placenta size and decreased nutrient transfer
  • -> retardation of fetal growth
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13
Q

what happens to the placenta in the 3rd trimester?

A
  • fetus grows fast so placenta increases blood flow to compensate. placental growth is increased by 50%
  • progressive decline in quantity of nutrients transferred, contributing to decelerated growth rate
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14
Q

why is having a pregnancy that is too long dangerous?

A

placenta can no longer compensate optimal nutrient and oxygen needs of the fetus

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15
Q

what kind of maternal conditions can lead to placental failure?

A
  • severe hypotension
  • renal disease
  • EFA deficiencies
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16
Q

what’s a placental infarction?

A

death of placental tissue

can be due to exposure to harmful substances like cigarette smoke

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17
Q

main role of eicosanoids in pregnancy?

A

maintaining blood flow between mom and placenta

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18
Q

what is glycation?

A

enzymatic covalent bonding between protein and glucose; closely linked to the pathogenesis of diabetes

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19
Q

what is biomagnification as it pertains to DHAs?

A

there’s selected transfer DHAs from maternal system ultimately to the fetal brain so that concentrations go up so that the brain can accumulate these DHAs

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20
Q

what makes PUFAs relevant?

A
  • contribution to membrane fluidity –> better transmission of nerve signals
  • brain is made of this
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21
Q

what is the relevance of ketone bodies?

A
  • natural state of pregnancy is to induce some insulin resistance so that lipids sources of energy can be delivered to the placenta
  • this can also increase the ketones that make it to the placenta which is fine during the 3rd trimester to some extent, but risky in earlier pregnancy
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22
Q

what kind of adjustments are seen during pregnancy?

A
  • increased blood volume
  • altered stomach, cardiac, renal, and pulmonary functions
  • hemodilution
  • altered plasma lipid profiles
  • altered appetite and thirst
  • altered digestion and assimilation of food
23
Q

in early pregnancy, the mother undergoes the (anabolic/catabolic) phase and the fetus undergoes the (catabolic/anabolic) phase

A

mother: anabolic
fetus: anabolic

24
Q

in late pregnancy, the mother undergoes the (anabolic/catabolic) phase and the fetus undergoes the (catabolic/anabolic) phase

A

mother: catabolic
fetus: anabolic

25
Q

weight gain required for those with BMI under 20?

A

12.5 to 18 kg

26
Q

weight gain required for those with a BMI between 20-27?

A

11.5 to 16 kg

27
Q

weight gain required for those with a BMI over 27?

A

7 to 11.5 kg

28
Q

when does most of the weight gain happen?

A

second half of pregnancy; really takes off in the last trimester

29
Q

why are the mom’s fat stores important?

A
  • protect from energy deficits

- important during lactation

30
Q

how much weight gain do we see in the first trimester?

A

minimal

31
Q

most important determinants of birth weight

A
  • gestational age
  • maternal weight gain
  • preconception weight
32
Q

in what weight range is infant mortality rate lowest?

A

2.5 to 4 kg

33
Q

what are some abnormal growth patterns linked to adult diseases?

A
  • lbw, symmetrical babies
  • lbw but catch-up later (disproportionally large head, narrow waist)
  • normal bw that grow slowly during infancy
34
Q

long-term health risks associated with lbw

A
  1. decreased lung capacity during childhood
  2. x2 risk of cvd
  3. x6 risk of diabetes/impaired glucose metabolism
  4. increased bp risk, abnormal high TG, insulin and low HDL
35
Q

long-term health risks for excessive bw?

A
  • risk of hormonally related cancers

- obesity

36
Q

why is heart disease risk increased w/LBW?

A

liver cholesterol metabolism is hampered

37
Q

why the risks for LBW infants?

A

undernourished mom = stress –> release cortisol (steroid)

good for development of organs (short term), bad for hypertension (long term)

38
Q

what happens to protein metabolism when the mom is undernourished?

A

IGF-1 is suppressed shifting AA metabolism for energy rather than protein synthesis

39
Q

categories for nutritional risk for pregnancy (8)

A
  • poverty
  • low pre-preg and preg weight
  • short interconception interval
  • chronic systemic illness
  • unusual dietary patterns (like eating sand)
  • history of anemia or obesity
  • poor reproductive history
  • adolescence
40
Q

what’s the recommended PAL?

A

1.6-1.7 (active)

41
Q

what happens to BEE and PAL when preg?

A

BEE increases

PAL decreases

42
Q

what happens to TEE during preg?

A

increase by 8 kcal/gestational week

43
Q

protein rq during preg?

A 
needs to support GROWTH
depends on trimester
1) growth, tissue deposition
2) increased growth
3) mega high growth (includes placenta)

RDA for preg woman = 25 g/d of additional protein

44
Q

what happens if u don’t have enough protein during pregnancy?

A

increased risk of LBW

45
Q

the requirement for N-6 fatty acids (increases/decreases) during preganancy

A

increase

AI = 13 g/day. median intakes are shown to be sufficient

46
Q

when is the median intake for EFAs insufficient for pregnant women?

A

when overall energy intake is insufficient

47
Q

when is n-9 FA (mead) higher?

A

when n-6 and n-3 are low

48
Q

vegetarians have (higher/lower) amounts of arachidonic acid and (higher/lower) amounts of docosahexaenoic acid compared to omnivores

A

arachidonic: higher
DHA: lower

49
Q

the pregnant state (increases/decreases) CHO requirements

A

increases

50
Q

why does the pregnant state increase CHO requirement

A
  • establishment of placental-fetal unit
  • energy supply for growth and development of fetus
  • establishment of maternal fat stores in EARLY pregnancy
  • energy to sustain growth of fetus during the last trimester
51
Q

how much glucose is transferred from mother to fetus in late gestation?

A

17-26 g/d

52
Q

true or false: the fetal brain uses ketoacids

A

true - up 30% of fuel

32.5 g

53
Q

fiber requirement (increases/decreases) in the pregnant state

A

neither - there’s no evidence that there’s a different beneficial effect

28 g/d

54
Q

what is the AI for water in the preg state based on?

A

median intakes

total intake is 3 L/d

NUTR 337 (12 decks)

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