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Flashcards in Pre-Conception Care Deck (20)
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What is PREPARE?

Programme of Research and Education in Pre-Conception Care


What can bad nutrition before/ during pregnancy cause?

Stunted growth and increased risk of miscarriage and premature birth


What is the life course approach?

Investigates long-term effects of biological, behavioural and social exposures during gestation, childhood, adolescence and young adulthood on health and chronic disease in later life and across generations


How can we decrease the risk of getting diseases in the future?

- Pregnancy acts as an early 'stress test' for future disease risk
- Highlights the potential for early intervention
- Physical and social exposures in utero, childhood and adult life affect health and the onset of disease


What are epigenetics?

Reversible, heritable changes in gene expression that occur without a change in DNA sequences - a change in phenotype without a change in genotype


What can affect epigenetics?

Nutrition, environment and stress


What is an example of a small change that may occur as a result of epigenetics?

- Terminal differentiation of cells into skin cells, brain cells etc
- Can develop into bigger problems such as disorders and fatal diseases (e.g. cancer)


List some healthy lifestyle choices in pre-conception

- Eat healthily
- Healthy weight
- Stop smoking
- No recreational drug use
- Reduce caffeine
- Moderate alcohol
- Regular dental checks
- Exercise
- Relax to reduce stress


How is BMI calculated?

weight / height squared


What is considered a healthy BMI?

18.5 - 25


Describe the effects of having a BMI below 18.5

- Called anorexia
- Weight loss affects cyclical ovarian function
- Anorexia disrupts hypothalamic-pituitary-ovarian axis
- Can lead to reduced bone density
- Fluctuations in body fat can disturb transport and metabolism of steroid hormones


Describe the effects of having a BMI above 25

- Called overweight/ obesity
- Affects conception rates
- PCOS associated with anovulation (not ovulating)
- MBRRACE shows that BMI >30 is a significant risk factor for direct and indirect maternal deaths


What is PCOS?

Polycystic Ovary Syndrome


What is the woman at higher risk of getting if she is obese?

- Gestational diabetes
- Gestational hypertension
- CS delivery
- Macrosomia (high birth weight)
- NTD (neural tube defects)
- Congenital heart disease
- Intestinal malformations


Who is pre-conception nutrition advice important for?

- BMI <20
- BMI >30
- Medical conditions affecting diet
- Poor obstetric histories or past foetal abnormality
- Low income women (especially adolescents)


What vitamins are beneficial in pregnancy?

- Vitamin B9 (folic acid), A, D, calcium and caffeine = prevent NTDs
- Vitamin A = immune function and reproductive and foetal health
- Vitamin E + C = antioxidants
- Vitamin D = regulates calcium and phosphorous
- Vitamin B = DNA synthesis


What is the recommended dosage for folic acid?

- 44mcg/day (low risk)
- 5mg/day (high risk)


Name some of the screening programmes available in pregnancy

- Immunisations (rubella, chicken pox, flu and whooping cough)
- STI screening
- Occupational hazard review (workplace)
- Genetic traits


Name some chronic conditions that cause women to need closer monitoring

1. Diabetes
2. Epilepsy
3. Mental health disorders
4. Hypertension
5. Sickle cell and thalassaemia


What is the woman at higher risk of if she has diabetes?

- Stillbirth = 4.7x risk
- Death of baby in first 4 weeks = 2.6x risk
- Major congenital anomaly = 2x risk