Define maternal mortality. What are major causes? Describe the disparity between developed and developing countries and that in Texas. Is there a problem in Texas? What are potential causes in health disparities for maternal mortality?
- Definition: death of a woman while pregnant or within 1 year of birth via a pregnancy-related complication
- Causes: severe bleeding, infection, high blood pressure, delivery complications, unsafe abortion
- Non-hispanic black and native american are far more likely to have maternal mortality
Thoroughly explain the concept of the critical period of development (include mention of hyperplasia and hypertrophy in your response).
- body structures develop along a predictable timeline
- Critical period of development is when structures are forming
- structures are most vulnerable to disruptions during this time
List and describe agents that may affect critical periods. Include examples.
Disruptions:
- physical agents (x-rays, heat, fever)
- chemical agents (steroids, alcohol, drugs, lead)
- viruses
- parasites
- obesity
- diabetes
- hypertension
Describe risks associated with Toxoplasma gondii infection; what is the definitive host? How can infection be avoided by pregnant women (by lifestyle and dietary restrictions)? What are potential consequences of contracting an infection during pregnancy?
- definitive host: cat
- avoided by avoiding cat feces, no raw meat
- fatal effects to the fetus, fever, swollen glands, small or large head, rash, bruises, anemia, brain or nervous system issues
Alcohol. How many US women drink during pregnancy? Binge drink during pregnancy? Why is alcohol intake contraindicated?
- 84% of non-pregnant women drink alcohol, 10% drink during pregnancy
- 3% report binge drinking
- contradicted from doctors saying 1-2 is fine, or red wine is good for you
Describe fetal alcohol spectrum (FASD), FAS, FAE and ARBD. Anecdotally, people claim that doctors provide more lenient advice about alcohol consumption during pregnancy. What is your opinion about lenient advice? How does FASD affect adults?
- Fetal Alcohol Spectrum disorders:
- small head, reduced height/weight
- problems with learning, memory, attention span, vision, hearing
- intellectual problems, behavioral problems, poor impulse control
- defects in heart, lungs, kidneys, hearing impaired
- Adults: mental health problems, confinement, legal troubles, inappropriate sexual behavior, inability to live independently, problems with employment, alcohol and drug problems
- alcohol during pregnancy is hard NO
Toxins/Pathogens. What foods should be avoided during pregnancy and why? Give a detailed list of what foods should be avoided and explain why.
- raw eggs (salmonella)
- unpasteurized eggs (stillbirth risk)
- undercooked meat (salmonella, toxoplasmosis)
- fresh juice (salmonella, e. coli)
- raw sprouts, unwashed produce (bacteria)
- sushi (parasites, bacteria, mercury)
- predatory fish (parasites)
- smoked fish (parasites)
- raw shellfish (parasites)
- no potluck (bacteria)
- no alcohol (birth defects)
- caffeine in moderation
Physical activity. Describe the 2018 Physical Activity Guidelines for Americans for pregnant women. What is added by the ACOG? Be able to provide specific advice regarding different activities, as discussed in class (WebMD). Who should not exercise?
For all healthy pregnant women:
- get at least 2.5 hours of moderate-intensity aerobic activity/week, preferably spread throughout
-engage in moderate strength training
-Avoid high altitudes, move smoothly, beware of high temperatures, no scuba diving
Gestational diabetes mellitus (GDM). When is it diagnosed? How common? What is prognosis for mom (with respect to risk for type 2 diabetes and pregnancy risk)? What are risk factors for developing GDM? Outcomes for kids?
- usually diagnosed 24-28 weeks for those without previous diabetes conditions
- 2-10% of all pregnancies
- usually resolves after birth, but greater risk for Type II later in life
- effects: pregnancy complications such as LGA infant, cesarean sections, neonatal hypoglycemia
- Risk factors: older, excess weight, history of GDM, history of PCOS, family history of type II
- Outcomes: children higher risk of developing metabolic complications, impaired glucose tolerance
- Treatment: diet/exercise, MNT, sometimes medications
Hypertension (HTN). What is the definition of HTN (be specific)? What are the 3 categories?
- Definition: systolic blood pressure of > 140 mm Hg, diastolic pressure > 90 mm Hg, or both
- 3 categories: preeclampsia, chronic hypertension, gestational hypertension
- prevents placenta from getting enough blood
- treatment: rest and drinking at least 8 cups water each day
Preeclampsia. What are symptoms? How is this different from hypertension? Be specific. What is the cure?
- Symptoms: high blood pressure, high level protein In urine, swelling, can lead to eclampsia (risk for death)
- Causes aren’t understood
- different from hypertension in that it usually accompanies many of symptoms
Moms with obesity face increased risk for what 7 issues?
1) gestational diabetes
2) pregnancy induced hypertension
3) pre-eclampsia
4) preterm labor in less than 34 weeks
5) cesarean section
6) instrumental deliveries
7) postpartum infection
What issues are faced by infants of an obese pregnancy?
Infants:
1) premature delivery
2) LGA
3) birth defects
4) shoulder dystocia
Lead. What are sources of lead? Which nutrients can combat some exposure?
- avoid lead exposure
- sources: paint in older homes, glazed pots, construction, plumbing, soil
- consume diet rich in calcium and iron
