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Leah Rodewald

on 15 October 2013

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Transcript of Pregnancy

The Before
The During
The After

Leah Rodewald
Preconception Care
http://weemade.com/wp-content/uploads/2012/07/premature-baby.jpg (premature)
http://www.chiangraitimes.com/news/6956.html (premature 2)
http://physioforu.blogspot.com/2009/04/spina-bifida-latin-split-spine-is.html (spina bifida)
http://cdn.sheknows.com/articles/2012/05/sarah_parenting/baby-surprise.jpg (happy baby)

Used to transport oxygen throughout the body
Anemia is prevalent among women
Women should have iron levels of >300 mg prior to conception
Preconception Care
What is it?
How will it help?
Folic Acid
Daily supplementation lowers risk of neural tube defects as well as other adverse pregnancy outcomes
More than 400 micrograms per day can help!
However, the effects of too much folic acid are unknown. Anything over 1000 micrograms per day may be adverse.


Supplementation of certain vitamins is good!

Do not overdo it though.

Follow the recommendations and see a physician or a dietitian if you have any questions
Banhidy F, Acs N, Puho E, Czeizel A. Iron deficiency anemia: Pregnancy outcomes with or without iron supplementation. Nutrition 27 (2011) 65-72.
Gardiner P et. al. The clinical content of preconception care: nutrition and dietary supplements. AJOG, December 2008, S345-S356.
Hoyo et al. Folic acid supplementation before and during pregnancy in the Newborn Epigenetics Study (NEST). BMC Public Health 2011, 11:46.
Moos et al. Healthier women, healthier reproductive outcomes. AJOG, December 2008, S280-S289.
Viteri F, Berger J. Importance of Pre-Pregnancy and Pregnancy Iron Status. Nutrition Reviews. December 2005: (II) S65-S76.
Importance during Pregnancy
Sara Greer
Nutrition & Wellness
Postpartum Depression
Most common complication during pregnancy
Arises within 4 weeks after pregnancy (1)
Has a direct impact on babies health
Child mortality
Low birth weights
Underdeveloped cognitive abilities
1. Diagnostic and Statistical Manual of Mental Disorders IV
Signs & Symptoms
Trouble sleeping
Disconnect from baby
Research Study #1
112 women
Edinburgh Postnatal Depression Scale
21% were diagnosed "possibly depressed"
These 24 women all expressed lower levels of DHA
Si. Otto, R.H.M. de Groot, G. Hornstra. 2003
Research Study #2
"Depressed women produce higher levels of stress chemicals during pregnancy, which reduce fetal growth and are associated with an increased risk for premature labor"
Center on the Developing Child at Harvard University (2009).
Bottom Line
Further research needs to be done
Invest in a high quality DHA supplement
Physical Activity
During Pregnancy
By Megan Cannon
History of Physical Activity
Third Century BC
Aristotle expressed the difficulty of enduring childbirth due to a mother's sedentary lifestyle
First physical activity guidelines during pregnancy published
Physical activity during pregnancy thought to cause preterm birth and small for gestational age babies.
Extensive research done on safety of maternal exercise.
Physical activity guidelines updated to meet current research.
Benefits and risks of exercise during pregnancy clearly known and utilized.
(Smith, 2013)
Myth or Fact?
You should never get your heart rate over 130 bpm while exercising during pregnancy?
Extensive research has been done to show that there is no universal target heart rate that everyone should stick to when exercising during pregnancy.
(Szymanski, 2012)
Myth or Fact?
If I did not start exercising before I was pregnant, I can't start exercising now.
It is safe for the mother and baby to do moderate exercise during pregnancy. A pregnant mother should always check with her doctor before starting an exercise plan.
(Szymanski, 2012)
Reduced risk of gestational diabetes
Reduced risk of preeclampsia
Reduced risk of operative birth
Improved cardiovascular function
Improved overall fitness
Psychological well being
Mood stability
Reduced risk of prematurity
Improved fetal growth
Decreased resting fetal heart rate
- (Smith, 2013)
- (Prather, 2012)
- http://thepasadenatexasdentist.com/index.php/blog-5/pasadena-texas-family-dentist/
How much?
According to the 2008 Physical Activity guidelines for Americans:
Healthy women: at least 150 minutes (2 hours and 30 minutes) per week of moderate-intensity aerobic activity
Healthy women who already do vigorous-intensity aerobic activity continue doing so!
Healthy Pregnant or Postpartum Women. Center for Disease Control and Prevention website.
http://www.cdc.gov/physical activity/everyone/guidelines/pregnancy.html. Updated March 30, 2011. Accessed September 3, 2013.
Spread out activity during the week
Do moderate/vigorous activity for at least 10 minutes at a time
Sunday Monday Tuesday Wednesday Thursday Friday Satuday
Walk 30 minutes with friends
Swimming @ 8:00 pm
Aerobics class @ 7:00 am
Walk dog 30 minutes
Aerobics class @ 7:00 am
Mothers who did not exercise before pregnancy:
Get at least 30 minutes of exercise 5 days a week by:
Briskly walking with you dog, spouse, friend or child
Low impact aerobics
Riding a stationary bike
Mothers who participated in vigorous activity before pregnancy:
Continue with normal exercise regimen but consult a doctor on how and when activity should be adjusted over time.
Tennis or racquetball
Leah Rodewald, Sara Greer, Megan Cannon & Samantha Hopkins
Postpartum Weight Loss:
What is acceptable for lactating women?
Samantha Hopkins
Weight Retention and Gain
In the United States:
Average retention after childbirth
Rooney and Schauberger
60% of women are considered overweight, 36.1% obese
= 1-6 lbs, 15-20% retained up to 10 lbs a year later
Those that lost their pregnancy weight after 6 months postpartum weight on average 13 lbs less 8.5 years later than those who retained their weight.
The Balancing Act
How much weight loss is healthy for mom and baby?
Breastfeeding helps with weight loss but isn't entirely effective
What is a safe amount of calorie restriction and exercise?
What Mom Needs During Lactation
The Effects of Dieting on Food and Nutrient Intake of Lactating Women
Study done by Lovelady et. al.
Diet and Exercise Group vs. Control Group
Can restrict calories by 500 Kcal with moderate exercise four times a week
Calcium and Vitamin D as well as a variety of fruits and vegetables
The diet and exercise group chose less items such as:
Weight Loss and Baby
True or false: Your body can produce sufficient quality and quantity of milk on a reduced-calorie diet?
According to Lovelady et al (2000) and Doran and Evers (1997), weight gain and growth of infants was not effected by whether mom was in a diet and exercie group (cutting 500 kcal) or maintaining her current weight.
One issue...
Mom's health might suffer if vitamin and mineral recommendations are not met.
Focus on fruits and vegetables
Consider a multivitamin and/or calcium & vitamin D supplement
Your Success
Online calorie-counting is very easy with tools like babyfit.com
Making a profile is easy and free
Record all workouts and calorie intakes
Get tips for menu planning and lifestyle
Finding Balance in Weight Management: tips from other women.
Make exercise useful/fun:
Playing in the backyard
Walking to the park/store
Dance classes
Utilize your resources:
Farmer's market
local health clubs
Doran, L., Evers, S. Energy and nutrient inadequacies in the diets of low income women who breastfeed. J. Am Diet Assoc. 1997; 97:1283-1287.
Lovelady, A. Garner, K. Mereno, K. Willims, J. The effects of weight loss in overweight, lactating women on growth of their infants. N Engl J Med 2000; 342: 449-453.
Lovelady, C. Stephenson, K. Kuppler, K. Williams, J. The effects of Dieting on Food and Nutrient Intake of Lactating Women. J Am Diet Assoc. 2006; 106: 908-912.
Any final questions?
Thank you!
Smith KM, Campbell CG. Physical activity during pregnancy: impact of applying 1different physical activity guidelines. J Pregnancy. 2013
Healthy Pregnant or Postpartum Women. Center for Disease Control and Prevention Website. http://www.cdc.gov/physicalactivity/everyone/guidelines/pregnancy.html . Updated March 30, 2011. Accessed September 3,2013.
Currie S, Sinclair M, Murphy MG, Madden E, Dunwoody L, Liddle D. Reducing the Decline in Physical Activity during Pregnancy: A Systematic Review of Behaviour Change Interventions. PLoS One. 2013; 8(6).
Prather H, Spitznagle T, Hunt D. Benefits of Exercise During Pregnancy. PM&R 2012; 4(11):845-850.
Szymanski LM, Satin AJ. Strenuous Exercise During Pregnancy; Is There a Limit? Am J Obstet Gynecol. 2013; 207(3).
(Hoyo, 2011)
(Banhidi, 2011)
(Viteri, 2005)
(Gardiner, 2008)
(Moos, 2008)
Y'all are beautiful!
DZ Kisses
Postpartum depression can be prevented!
Supplements are meant to be 'supplemental' NOT a substitute
DHA is
for mothers
& babies.
Shonkoff J, Duncan G. Maternal Depression can undermine the development of young children. Center on the Developing Child at Harvard University. December 2009.

Otto SJ, de Groot RH, Hornstra G. INcreased risk of postpartum depressive symptoms is associated with slower normalization after pregnancy of the funcational dexosahecaenoic acid status. Prostaglandins, Leukotrienes and Essential Fatty Acids 69 (2003) 237-243.
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