Final Study GuidePregnancy: Gravida= # of pregnancies Parity= # of deliveries Mortality= # of deaths in a given time and place  Morbidity= relative incidence of disease Pregnancy begins at conception approx 14 days before next cycle; Average 38 weeks; Trimester is aprox 3 months, 1st (Conception-12 wks) 2nd (Wk. 13-26) 3rd (Wk 27-40) Natality Statistics= occurrences of pregnancy complications, harmful behaviors, infant mortality, and morbidity rates First half= Anabolic phase which increases blood plasmas volume nutrient stores and placental size. 10% of growth occurs; Carb metabolism takes place when we eat then glucose levels in the blood increase secreting insulin and turning glucose into glycogen and fat Second half= Catabolic phase which uses extra stores to support fetal growth. 90% of growth occurs; Carb Metabolism occurs when we eat we secrete insulin and other hormones but hormones prohibit storage of glucose so it goes to developing fetus. Water retention= Increases 2-2 ½ gallons(2/3 from intracellular such as blood and body tissue and 1/3 is extracellular fluid btwn cell space); Greater expansion of plasma volume means higher birth weight; Dilution effect is when Fat soluble vit increase and water soluble decrease Hormonal Changes= Placenta produces steroid hormones (Estrogen and progesterone); Nutrient Metabolism= Glucose is preferred energy for fetus Accelerated Fasting Metabolism= allows mom to use stored fat so fetus can use glucose and amino acids. If there is no glucose fat makes ketones which can pass through placenta for energy use, but continuous ketone use in fetus (Caused by uncontrolled diabetes, fasting, and wt loss during pregnancy) causes reduced growth and impaired intellectual development.  Protein Metabolism= Nitrogen and protein needed for synthesis of new maternal and fetal tissues. Mom can’t store protein earlier in pregnancy for later use so fulfilled by mothers intake during pregnancy. Fat Metabolism= Fist half of pregnancy promotes fat stores and second half utilizes fat stores(Blood lipid and Cholesterol levels increase) Placenta: Placenta forms before fetus develops. Functions by producing hormones and enzymes, nutrient and gas exchange, and removal of fetal waste. Acts as barrier to someharmful compounds such as maternal red blood cells, bacteria, and large proteins but alcohol, excessive vits, drugs, and some viruses can pass through. Uses 30-40% of glucose delivered and fulfills its own needs before making nutrients available to fetus. Easily pass through (Water, Lipids, and Ketones). Untransferable (Insulin and Enzymes). Embryonic/Fetal Growth= Day 1(Conception; called the zygote) Day 2-3 (8 cells form called Morula) Day 6-8 (Morula becomes fluid filled and is called blastocyst comprised of250 cells) Day 10 (Embryo implants itself into uterine wall) Day 12 (Placental circulation begin forming) Week 4 (1/4 inch long, has head trunk arms spinal cord and 2 major brain lobes) Week 5 (Heart beats 65 bpm circulating own blood) Weel 7 ½ (1/2 inch long) Week 9 (embryo is now a fetus) Month 3 (Genitals begin to develop) Month 4(Weighs 6 oz) Month 5 (Weigh 1 lb skeleton calcifies and hair grows) Month 6 (Fat accumulates) Month 7 ( Gains ½-1 oz/ day) Month 8-9(Growth rate declines) Critical Growth Periods= Cells and tissues are formed during preprogrammed time; Tissues susceptible to nutrient deficiencies at this time; Hyperplasia is increase in all cell numbers including first development of brain and CNS (neural tube such as brain and spinal cord 3-4 wks, forebrain between 10-20 wks) then heart and adrenal glands. Skeletal and muscle growth continue after birth. Hypertrophy is growth in size of cells Fetal Growth= variations usually caused by environmental factors (underwt pre pregnancy, low wt gain during pregnancy, poor dietary intakes, smoking, drug abuse) not genetics; Insulin Growth factor= primary growth factor of fetus; Intrauterine growth retardation= weight/length for gestational age is low; Small for Gestational Age= born with wt <10% can be Disproportionally Small for Gestational Age meaning head and length are normal just a lower weight or Proportionally Small for Gestational Age where weight, length and head are all <10% dSGA= appear wasted, wrinkly, and skinny; Normal head size but abdominal is small; Smaller organs and cells (But have the same #), low glycogen stores in lover and body fat. Possible bc of malnutrition during 3rd trimester; if malnutrition was for short period of time recovery is possible and quick; As adults will have higher risk for heart disease, hypertension, and type 2 diabetes. pSGA= Appear small, wrinkly, but well proportioned; reduced number of cells in organs and tissue bc of long term malnutrition, low maternal weight, or chronic alcohol intake during critical growing periods; Fewer problems at birth but have harder time catching up with growth, throughout life will remain shorter with a smaller head circumference Large for Gestational Age (LGA)= Infants born w/ weight in 90%; Caused by pre pregnancy obesity, excessive wt gain during pregnancy, or poorly controlled diabetes; Lower death rates than SGA babies; Taller later in life; Cause difficult births and may cause damage to shoulder during delivery (Shoulder Dystocia) Preterm Delivery= increased mortality, malformations, and respiratory problems; Leads to decreased growth and low IQ; Characterized as being born <37 wks (Very preterm if <34 wks); Risk factors include multiples, decreased uterine placental blood flow, placental abruption, low folate or underwt during pregnancy, low weight gain during pregnancy, obesity pre pregnancyDiabetes: Type 1= onset before adult years where pancreas does not produce insulin so must be obtained externally by injecting insulin(Long or Fast acting). Goal is to maintain or improve control of blood glucose levels; Type 2= normally in obese individuals where body doesn’t use insulin properly, create enough insulin, or both treated by medications, insulin, and diet. ADA recommends decrease wt, trans and sat fats, cholesterol and increasing fiber, whole grains, and low GI foods. Metabolic Syndrome= cluster of abnormal metabolic/health indicators such as hg blood sugar, blood pressure, and triglycerides, low HDL’s, or abdominal obesity. Must have 3/5for diagnosis. Increases the risk of type 2 diabetes and