Healthier Pregnancy: Patient Safety Goals

Total Page:16

File Type:pdf, Size:1020Kb

Healthier Pregnancy: Patient Safety Goals HEALTHIER PREGNANCY: PATIENT SAFETY GOALS JASSIN M. JOURIA, MD DR. JASSIN M. JOURIA IS A MEDICAL DOCTOR, PROFESSOR OF ACADEMIC MEDICINE, AND MEDICAL AUTHOR. HE GRADUATED FROM ROSS UNIVERSITY SCHOOL OF MEDICINE AND HAS COMPLETED HIS CLINICAL CLERKSHIP TRAINING IN VARIOUS TEACHING HOSPITALS THROUGHOUT NEW YORK, INCLUDING KING’S COUNTY HOSPITAL CENTER AND BROOKDALE MEDICAL CENTER, AMONG OTHERS. DR. JOURIA HAS PASSED ALL USMLE MEDICAL BOARD EXAMS, AND HAS SERVED AS A TEST PREP TUTOR AND INSTRUCTOR FOR KAPLAN. HE HAS DEVELOPED SEVERAL MEDICAL COURSES AND CURRICULA FOR A VARIETY OF EDUCATIONAL INSTITUTIONS. DR. JOURIA HAS ALSO SERVED ON MULTIPLE LEVELS IN THE ACADEMIC FIELD INCLUDING FACULTY MEMBER AND DEPARTMENT CHAIR. DR. JOURIA CONTINUES TO SERVES AS A SUBJECT MATTER EXPERT FOR SEVERAL CONTINUING EDUCATION ORGANIZATIONS COVERING MULTIPLE BASIC MEDICAL SCIENCES. HE HAS ALSO DEVELOPED SEVERAL CONTINUING MEDICAL EDUCATION COURSES COVERING VARIOUS TOPICS IN CLINICAL MEDICINE. RECENTLY, DR. JOURIA HAS BEEN CONTRACTED BY THE UNIVERSITY OF MIAMI/JACKSON MEMORIAL HOSPITAL’S DEPARTMENT OF SURGERY TO DEVELOP AN E-MODULE TRAINING SERIES FOR TRAUMA PATIENT MANAGEMENT. DR. JOURIA IS CURRENTLY AUTHORING AN ACADEMIC TEXTBOOK ON HUMAN ANATOMY & PHYSIOLOGY. Abstract Preparing women early on in a pregnancy to follow a plan for routine prenatal care has been shown to promote healthy outcomes for expectant mothers and the developing baby during all phases of pregnancy. Proper nutrition and prevention should be reviewed at the first prenatal visit and for every visit throughout the pregnancy. To ensure that best care practices are followed and that promotion of maternal and infant health is of top priority, all health professionals should understand patient safety goals and standards of practice. The health team should understand the importance of working in unison not only with other clinicians and associates, but also with patients and their families. nursece4less.com nursece4less.com nursece4less.com nursece4less.com 1 Policy Statement This activity has been planned and implemented in accordance with the policies of NurseCe4Less.com and the continuing nursing education requirements of the American Nurses Credentialing Center's Commission on Accreditation for registered nurses. It is the policy of NurseCe4Less.com to ensure objectivity, transparency, and best practice in clinical education for all continuing nursing education (CNE) activities. Continuing Education Credit Designation This educational activity is credited for 5 hours. Nurses may only claim credit commensurate with the credit awarded for completion of this course activity. Pharmacy content is 0.5 hours (30 minutes). Statement of Learning Need Clinicians need to understand the components involved in the initial prenatal assessment including assessing for pre-existing hypertension, glucose in the urine, and sexually transmitted diseases. Additionally, identifying existing risks at the first prenatal appointment through open communication regarding unhealthy lifestyle choices can make a profound difference in the health outcomes of the expectant mother and baby. Course Purpose To provide nurses with the fundamental skills and elements involved in managing healthy pregnancies, as well as basic concepts, which should be well understood by healthcare clinicians at all levels of patient care. nursece4less.com nursece4less.com nursece4less.com nursece4less.com 2 Target Audience Advanced Practice Registered Nurses and Registered Nurses (Interdisciplinary Health Team Members, including Vocational Nurses and Medical Assistants may obtain a Certificate of Completion) Course Author & Planning Team Conflict of Interest Disclosures Jassin M. Jouria, MD, William S. Cook, PhD, Douglas Lawrence, MA, Susan DePasquale, MSN, FPMHNP-BC – all have no disclosures Acknowledgement of Commercial Support There is no commercial support for this course. Please take time to complete a self-assessment of knowledge, on page 4, sample questions before reading the article. Opportunity to complete a self-assessment of knowledge learned will be provided at the end of the course. nursece4less.com nursece4less.com nursece4less.com nursece4less.com 3 1. Using the Estimated Date of Delivery (EDD) method, the care provider will always _____________________ from the first day of a woman’s last menstrual period. a. count forward 266 days b. count backward 266 days c. count forward 280 days d. count backward three months 2. ______________ of women deliver on their actual Estimated Date of Delivery (EDD). a. One half b. One-third c. Twenty percent d. Four percent 3. True or False: Properly determining a woman’s due date is nominally important because the patient’s contractions will provide enough notice. a. True b. False 4. Which pregnancy due date method or rule involves counting backwards three months from the first day of the last missed period and then subsequently adding 7 days? a. Naegele’s rule b. The hCG test c. The menstrual cycle method d. EDD method 5. Using the Estimated Date of Delivery (EDD) method, the care provider will always count forward 266 days from the date of conception if a. the woman took a home pregnancy test. b. the woman recorded the first day of her menstrual period. c. the exact date of conception is known. d. if the date is confirmed through urinalysis. nursece4less.com nursece4less.com nursece4less.com nursece4less.com 4 Introduction Having a child is a deeply personal and challenging experience even for the parents who have previously had a child. All health professionals providing care to expectant mothers and their families should promote feelings of confidence in them that pregnancy safety goals are a high priority of the health team. To ensure that best care practices are followed and that promotion of maternal and infant health is of top priority, all health professionals need to understand patient safety goals and standards of practice. The health team that works in unison not only with other clinicians and associates, but also with patients and their families, will be better able to develop detailed, open communication with a focus on building strong and long-term relationships. When working collaboratively, health professionals and patients can promote a positive pregnancy outcome of healthy mothers and babies. Planning The Prenatal Visit The initial prenatal visit is an emotionally charged event for most women. During this time there are a variety of competing factors related to physiological and environmental changes an expectant mother may be experiencing; her body is changing in ways she cannot control, her family will have begun anticipating big changes in their lives, and she is likely anxious about the health care. The pregnant woman and her family will want reassurance that they are safe and in good hands. Health clinicians working with pregnant women will need to understand their underlying feelings of becoming a mother; whether they are thrilled with being pregnant, terrified of the process, or unsure or even remorseful regarding their pregnancy. At the initial visit, all members of the health team should help the expectant mother through all of her emotions as well as nursece4less.com nursece4less.com nursece4less.com nursece4less.com 5 those of her family. Patient engagement and healthy responses to teaching during all aspects of the pregnancy is promoted through the initial encounter of building a warm and trusting atmosphere, and the use of compassionate and therapeutic communication. During the initial prenatal visit, the health clinician will determine the expected date of delivery, perform a physical assessment of the mother and fetus, identify any underlying risks to a successful pregnancy, and understand how the mother and other members of her family are adapting to the pregnancy. Assessing The Estimated Delivery Date This section discusses the various and common strategies used in identifying a pregnant woman’s expected delivery date. Properly determining a woman’s due date is of utmost importance, because the more accurate the prediction of the due date, the less likely complications related to unnecessary medical interventions will arise.1 Evaluation of Gestational Age and Expected Date of Delivery The estimated date of delivery (EDD) method2 has been the principal method in determining a pregnant woman’s due date for more than 200 years. On top of using paper wheels or charts, some clinicians will use EDD calculators online based on the 280-day rule. The clinician must always count forward 280 days from the first day of a woman’s last menstrual period, or forward 266 days from the date of conception if this exact date is known, which is usually in cases of in vitro fertilization. The EDD method assumes that a woman’s ovulation occurs on day 14 of her cycle but this is untrue for many women, especially those with irregular nursece4less.com nursece4less.com nursece4less.com nursece4less.com 6 cycles. There are limitations of using the EDD method in evaluating gestational age.2 Only 4% of women deliver on their actual EDD because of natural biological variations in gestation and hormonal cycles. EDD is based on a 28-day menstrual cycle and does not account for women with varying period lengths or those with alternate fertile days due to changes in episodes of heightened luteinizing hormone (LH), the chemical signal responsible for the release of an ovum. Occasionally, the first day of the last menstrual cycle is unknown, either because the mother has irregular
Recommended publications
  • Prenatal Nutrition Table of Contents
    A GUIDE TO Prenatal Nutrition Table of contents Key nutrients 4 Fatigue during pregnancy 6 Constipation during pregnancy 8 Healthy calorie intake during pregnancy 10 Weight gain during pregnancy 12 Exercise during pregnancy 13 Eating fish during pregnancy 14 Eat right to sleep tight 15 Pregnancy superfoods for a super-pregnancy 18 Water: your pregnancy BFF 27 Foods and habits to avoid during pregnancy 28 Benefits of DHA and lutein during pregnancy 30 Planning to feed your baby: the benefits of breastfeeding 32 Breastfeeding tips before bringing your baby home 34 2 Welcome to this exciting time in your life Wherever you are on the path of motherhood, we know you are committed to supporting your little one with excellent nutrition. That is why we are excited to share this prenatal education guide with you. It covers everything from nutrition for you while you are pregnant and breastfeeding, to the latest science behind important nutrients for infant nutrition and development — such as lutein, DHA, and vitamin E. 3 Key Nutrients Why you and your baby need them, and where to get them During pregnancy, your blood volume is increasing and so is your baby’s. As blood quantity increases, so does your need for iron. Iron is necessary to carry oxygen to active and IRON growing cells. The daily recommended dose of iron during pregnancy is 27 mg. Iron can be absorbed more easily if iron-rich foods are eaten with vitamin C-rich foods, such as citrus fruits and tomatoes. You can get iron from eating red meats, beans, lentils, and fortified grains, and from taking an iron-fortified prenatal multivitamin.
    [Show full text]
  • Prenatal Vitamins and the Risk of Offspring Autism Spectrum Disorder: Systematic Review and Meta-Analysis
    nutrients Review Prenatal Vitamins and the Risk of Offspring Autism Spectrum Disorder: Systematic Review and Meta-Analysis Catherine Friel 1,*, Alastair H. Leyland 1, Jana J. Anderson 2, Alexandra Havdahl 3,4,5, Tiril Borge 6, Michal Shimonovich 1 and Ruth Dundas 1 1 Medical Research Council/Chief Science Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR, UK; [email protected] (A.H.L.); [email protected] (M.S.); [email protected] (R.D.) 2 Public Health Research Group, Institute of Health & Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK; [email protected] 3 Department of Mental Disorders, Norwegian Institute of Public Health, 222 Skoyen, 0213 Oslo, Norway; [email protected] 4 Nic Waals Institute, Lovisenberg Diaconal Hospital, Postboks 4970 Nydalen, 0440 Oslo, Norway 5 Promenta Research Center, Department of Psychology, University of Oslo, Boks 1072 Blindern, 0316 Oslo, Norway 6 Division for Health Services, Cluster of Reviews and Health Technology Assessments, Norwegian Institute of Public Health, P.O. Box 222 Skoyen, 0213 Oslo, Norway; [email protected] * Correspondence: [email protected] Abstract: Prenatal nutrition is associated with offspring autism spectrum disorder (herein referred to as autism), yet, it remains unknown if the association is causal. Triangulation may improve causal inference by integrating the results of conventional multivariate regression with several alternative approaches that have unrelated sources of bias. We systematically reviewed the literature on the Citation: Friel, C.; Leyland, A.H.; relationship between prenatal multivitamin supplements and offspring autism, and evidence for Anderson, J.J.; Havdahl, A.; Borge, T.; the causal approaches applied.
    [Show full text]
  • Nutrition for a Healthy Pregnancy
    Nutrition for a Healthy Pregnancy Healthy eating plays a very important role in a healthy pregnancy. Eating a well balanced diet gives your baby healthy nutrients to grow and develop. Eating foods from a variety of sources will help ensure you get all the vitamins, minerals and nutrients you and your developing baby need. Eating well will also help you feel better, give you more energy and help you gain a healthy amount of weight. It also helps lower your risk of having health problems such as low iron or high blood pressure. Healthy Eating Guidelines Aim for three meals a day with healthy snacks in between. Eat a variety of healthy foods each day by following Canada’s Food Guide (for more information visit www.Canada.ca/FoodGuide): Get your energy from healthy foods such as vegetables and fruit, whole grains, lower fat milk, cheese & yogurt, lean meats and legumes (beans, peas, lentils). Limit foods high in fat, sugar and salt like chips, salted pretzels, candy, sweetened beverages, cakes and cookies. Drink water regularly to satisfy your thirst. During your 2nd and 3rd trimesters of pregnancy, you need some additional calories each day to support the growth of your baby. Eat “twice as healthy” not “twice as much.” One extra snack is often enough. The following are examples of nutritious snacks or foods to add to a meal: o Have an apple and cheese or yogurt and fresh fruit or hummus with vegetable sticks as an afternoon snack o Have an extra slice of toast at breakfast and an extra glass of milk at supper o Have an extra morning snack of fruit with yogurt and an extra serving of vegetables with supper o Have an extra glass of milk with lunch and supper o Have an extra afternoon or evening snack of whole grain cereal with milk and sliced fruit or chopped nuts o Have an extra afternoon snack of half a sandwich or whole grain toast with nut butter and fruit Take a prenatal multivitamin every day.
    [Show full text]
  • Kentucky Prenatal Nutrition Guide Second Trimester 14 Weeks-28 Weeks
    Kentucky Prenatal Nutrition Guide Second Trimester 14 weeks-28 weeks 1st trimester 2nd trimester 3rd trimester NUTRITION Eating for a Healthy Baby The kinds of food you eat are as important as how much you eat. To make sure you are getting enough of the right foods for proper weight gain and growth of the baby, choose from all five food groups in “MyPlate”. It is helpful to plan meals and snacks in advance. Eating healthy snacks can help you meet your daily nutritional needs for pregnancy. Remember to take your prenatal vitamin daily. Good Snack Choices Choose More Often Choose Less Often Fresh Fruit Fresh Vegetables Pudding Dried Fruit Lowfat yogurt Unbuttered popcorn Cheese Ice Cream Vegetable Juice Skim/1% Milk Nuts Instant Breakfast WIC Cereals Reduced Fat Cheese Shakes Peanut Butter Eggs Whole or 2% Milk Weight Gain in Pregnancy Weight gain during pregnancy is very important. The right amount of weight gain can help prevent having a baby who is too small or may have medical problems. Women need to gain 25-35 pounds during pregnancy. Underweight women need to gain 28-40 pounds and overweight and obese women will need to gain 11-25 pounds during the pregnancy. Women expecting twins will need to gain more, about 35—45 pounds. During the 2nd trimester you can expect to gain about ½ to 1½ pounds per week. Losing weight during pregnancy is not recommended. For baby‟s health and development, wait until baby is born to start your weight loss. YOUR BABY‟S HEALTH Tobacco, alcohol and drugs A healthy baby is the one whose mother does not use tobacco, drugs or alcohol.
    [Show full text]
  • 382 Fetal Alcohol Spectrum Disorders
    382 Fetal Alcohol Spectrum Disorders UPDATED 8/2020 Definition/Cut-off Value Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person whose mother consumed alcohol during pregnancy (1). FASDs is an overarching phrase that encompasses a range of possible diagnoses, including fetal alcohol syndrome (FAS), partial fetal alcohol syndrome (pFAS), alcohol-related birth defects (ARBD), alcohol-related neurodevelopmental disorder (ARND), and neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE) (2). Presence of condition diagnosed, documented, or reported by a physician or someone working under a physician’s orders, or as self-reported by applicant/participant/caregiver. See Clarification for more information about self-reporting a diagnosis. Participant Category and Priority Level Category Priority Pregnant Women 1 Breastfeeding Women 1 Non-Breastfeeding Women 6 Infants 1 Children 3 Justification Justification Prenatal exposure to alcohol can damage the developing fetus and is the leading preventable cause of birth defects and intellectual and neurodevelopmental disabilities (2). (See risk #372 Alcohol and Substance Use for more information.) FASD is an umbrella term describing the range of effects that can occur in an individual whose mother consumed alcohol during pregnancy (2). These effects include physical, mental, behavioral, and/or learning disabilities with possible lifelong implications (1, 2). Often, a person with FASD has a mix of these conditions (1). The term FASDs is not meant for use as a clinical diagnosis and encompasses all other diagnostic terms, such as fetal alcohol syndrome (FAS) (1, 2). FASDs refer to the whole range of effects that can occur in a person whose mother consumed alcohol during pregnancy.
    [Show full text]
  • Nutrition Guideline: Pregnancy: Multiples
    Nutrition Guideline For Professional Reference Only Pregnancy Applicable to: Nurses, Physicians and Other Health Professionals Recommendations: • Women who could become pregnant are encouraged: o To eat a variety of food every day and make healthy eating and physical activity part of everyday life. o To take a multivitamin and mineral supplement that contains 0.4 mg (400 mcg) of folic acid every day. Women are recommended to start supplementation at a minimum of 3 months prior to conception. o To maintain a healthy body weight before and between pregnancies. • During pregnancy, women are advised to: o Eat a variety of foods and follow Canada’s Food Guide. o Include additional foods every day in the 2nd and 3rd trimesters of pregnancy in amounts appropriate to meet healthy pregnancy weight gain recommendations for their pre-gravid BMI category. o Choose a multivitamin and mineral supplement that contains 0.4 mg (400 mcg) folic acid, 16 – 20 mg of iron, vitamin B12, and 400 IU of vitamin D every day. o Follow safe food handling practices and avoid foods that increase chances of getting a food-borne illness during pregnancy. o Limit caffeine intake to 300 mg per day. o Drink 10 cups (2.5 L) of fluid each day. Water is recommended as the main fluid. • Health care providers are advised to provide pregnant women with nutrition information that will help them make informed choices about: o Healthy pregnancy weight gain. o Nutrients of special concern during pregnancy (e.g. folic acid, iron, calcium). o Nutrient supplements. o Beverage and fluid choices.
    [Show full text]
  • First Steps Nutrition Modules Module 3 – Nutrition Assessment
    First Steps Nutrition Modules Module 3 – Nutrition Assessment Introduction The nutrition-related objectives for pregnancy include the following: Infant born at full-term infant (37 weeks gestational age or later) weighing 2500 to 4200 g (5 lb, 8 oz to 9 lb, 6 oz) Maternal pregnancy weight gain within the Institute of Medicine (IOM) guidelines Hemoglobin/hematocrit levels maintained within acceptable levels for gestation Appropriate prenatal vitamin and/or mineral supplement use Dietary intake adequate to meet essential nutrient needs of mother and baby Breastfeeding discussed and promoted as the infant feeding method Family planning goals and method(s) identified Attaining these objectives begins with a thorough nutrition assessment. The initial nutrition assessment provides the dietitian with valuable information about the nutritional status of the individual as well as information with which to identify potential nutrition interventions. Subsequent assessments help the dietitian evaluate the effectiveness of each intervention and identify additional risk factors. In order to be useful, the dietitian must gather accurate information and carefully evaluate it. Hamaoui and Hamaoui (1998) summarize this: “To provide meaningful guidance, the nutritional assessment must answer at least four basic questions: First, with what nutrient reserves has the woman entered pregnancy? Second, what are her own physiologic needs, and what are the added requirements of her pregnancy? Third, does she have any disease process or is she receiving any therapy that might affect her nutrient requirement or nutrient tolerance? Fourth, is her current intake meeting her nutritional needs?” First Steps Nutrition Training Modules – http://depts.washington.edu/pwdlearn/firststeps Module 3 – Nutrition Assessment page 1 This module reviews the process of nutrition assessment, highlighting the nutritional issues of the pregnant woman.
    [Show full text]
  • Prenatal Nutrition Guidebook Arizona WIC Training Trainee Edition
    Prenatal Nutrition Guidebook Arizona WIC Training Trainee Edition Trainee Version Arizona WIC Training Prenatal Nutrition Guidebook Bureau of Nutrition and Physical Activity Page 1 11/24/2020 Prenatal Nutrition Guidebook Arizona WIC Training Trainee Edition Contents Contents ........................................................................................................................................................ 2 What Will You Learn?.................................................................................................................................... 3 Items Needed for This Course ....................................................................................................................... 3 Recommended Time ..................................................................................................................................... 3 Things to Remember ..................................................................................................................................... 3 Prenatal Nutrition Course Instructions ......................................................................................................... 4 Module 1: Prenatal Care and Physical Activity ............................................................................................. 5 Module 1: Activity ..................................................................................................................................... 5 Module 2: Healthy Eating and Supplements ...............................................................................................
    [Show full text]
  • Prenatal Nutrition Checklist Is to Help Guide Client Discussions
    November 2013 Welcome to the Prenatal Nutrition Manual for healthcare professionals working with pregnant women. This manual was designed by Public Health Dietitians from the Winnipeg Regional Health Authority and was created especially for use during Healthy Baby community drop-in programs. The purpose of the Prenatal Nutrition Checklist is to help guide client discussions. It is not intended to be used in the following manners: - as a form for the client to fill out without follow up - as an assessment - as a form of charting to be kept on file The client’s name or other identifying information should not be written down on the checklist. The goal of the Prenatal Nutrition Checklist is to provide evidence based prenatal nutrition information and corresponding handouts to equip healthcare professionals in their work with prenatal women. How to use this manual: 1. Following this page is the Prenatal Nutrition Checklist. This is a conversation guide for you, the healthcare professional, to use when initiating a discussion with a prenatal client. The checklist encompasses all the major discussion points for a conversation on optimizing pregnancy outcomes through healthy eating and nutrition. 2. Each tab thereafter corresponds to each of the questions asked on the Prenatal Nutrition Checklist in the order in which they appear on the checklist. Within each tab, there are summaries of background evidence for the topic. 3. The colourful folder on the left contain handouts pertaining to each of the topics in the checklist. 4. A memory stick has been included with the electronic copies of resources that can easily be printed by each user of this manual as needed.
    [Show full text]
  • How to Feed the Fetus
    Vol. 78, Suppl. 1, 20–21 How to Feed the Fetus Guest Editor Ferdinand Haschke, Salzburg Editorial Board Jatinder Bhatia, Augusta, GA Weili Lin, Chapel Hill, NC Carlos Lifschitz, Buenos Aires Andrew Prentice, Banjul/London Frank M. Ruemmele, Paris Hania Szajewska, Warsaw Supported by Basel • Freiburg • Hartford • Oxford • Bangkok • Dubai • Kuala Lumpur • Melbourne • Mexico City • Moscow • New Delhi • Paris • Shanghai • Tokyo https://www.nestlenutrition-institute.org Reprint of Annals of Nutrition and Metabolism Vol. 76, Suppl. 3, 2020 Sponsor Note This publication was supported by an unrestricted educational grant by the Nestlé Nutrition Institute. The institute is a not-for-profi t association which was created to provide latest medical and scientifi c information to health profes- sionals in the fi eld of pediatric and adult nutrition and nutrition-related disorders (available at www.nestlenutrition-institute.org). Any liability of the sponsors for the content of the papers is hereby expressly excluded. Disclosure Statement Guest Editor Ferdinand Haschke declares honoraria for scientifi c lectures from Nestlé and other food companies. S. Karger Disclaimer All rights reserved. Medical and Scientifi c Publishers Th e statements, opinions and data contained in this publica- No part of this publication may be translated into other tion are solely those of the individual authors and contributors languages, reproduced or utilized in any form or by any means, Basel • Freiburg • Hartford • Oxford • and not of the publisher and the editor(s). Th e appearance of electronic or mechanical, including photocopying, recording, Bangkok • Dubai • Kuala Lumpur • advertisements in the journal is not a warranty, endorsement, microcopying, or by any information storage and retrieval Melbourne • Mexico City • or approval of the products or services advertised or of their system, without permission in writing from the publisher or, Moscow • New Delhi • Paris • eff ectiveness, quality or safety.
    [Show full text]
  • Investigating Alcohol Consumption
    Ceccanti et al. Obstet Gynecol cases Rev 2016, 3:076 Volume 3 | Issue 2 Obstetrics and ISSN: 2377-9004 Gynaecology Cases - Reviews Review Article: Open Access Investigating Alcohol Consumption during Pregnancy for the Prevention of Fetal Alcohol Spectrum Disorders (FASD) Mauro Ceccanti1*, Daniela Fiorentino1, Paola Ciolli1, Giovanna Coriale1, Marisa Patrizia Messina1, Maria Concetta Marcella Scamporrino1, Simona Solombrino1, Marco Fiore2 and Valentina Carito2 1Centro Riferimento Alcologico Regione Lazio, Universita’ di Roma ‘‘La Sapienza’’, Roma, Italy 2Istituto di Biologia Cellulare e Neurobiologia, CNR, Roma, IRCSS Santa Lucia, Italy *Corresponding author: Mauro Ceccanti, Centro Riferimento Alcologico Regione Lazio, DAI di Medicina Interna, Immunologia Clinica, Nutrizione Clinica ed Endocrinologia, Policlinico Umberto I-Università Sapienza, Viale del Policlinico 155, 00186-Rome, Italy, Tel: (0039) 06 4997 2093/5/7, Fax: (0039) 06 4997 2096, E-mail: [email protected] during pregnancy shows that many Countries all over the world Abstract officially released recommendations on the safest drinking behavior The term FASD (Fetal Alcohol Spectrum Disorders) is used to during pregnancy, from total abstention to no more than 1 or 2 drinks1 describe the entire spectrum of pathologies and disorders caused once or twice a week (i.e. the United Kingdom)2. Some countries by alcohol exposure in uterus. Alcohol assumed in pregnancy made health warning labels on alcoholic beverages mandatory: the passes directly through the placental barrier causing a broad range US enacted such a law in 1989, China in 2005, France in 2006, Russian of symptoms whose severity can greatly vary in degree. The alcohol 3 teratogenic effect may result in physical damage and specific Federation and South Africa in 2007 .
    [Show full text]
  • Comparison and Characterization of Prenatal Nutrition Counseling Among Large-For-Gestational Age Deliveries by Pre-Pregnancy BMI
    nutrients Article Comparison and Characterization of Prenatal Nutrition Counseling among Large-for-Gestational Age Deliveries by Pre-Pregnancy BMI Kiley B. Vander Wyst 1, Guadalupe Quintana 2, James Balducci 2 and Corrie M. Whisner 1,* 1 College of Health Solutions, Arizona State University, Phoenix, AZ 85007, USA; [email protected] 2 Maricopa Integrated Health System, Phoenix, AZ 85008, USA; [email protected] (G.Q.); [email protected] (J.B.) * Correspondence: [email protected]; Tel.: +1-(602)-496-3348 Received: 4 November 2019; Accepted: 6 December 2019; Published: 10 December 2019 Abstract: It is recommended that prenatal care include nutrition counseling; however, <70% of women report receipt of nutrition counseling during pregnancy. In this study, we aimed to characterize prenatal nutrition counseling (PNC) among large-for-gestational age deliveries at a low-income and minority-serving hospital by performing a retrospective chart review of infants with a birth weight > 4000 g. Of the 2380 deliveries, 165 met the inclusion criteria. Demographics, PNC receipt, and pregnancy outcomes were compared among normal-weight (NW; BMI: 18.5–24.9 kg/m2, 19%, n = 31), overweight (OW; BMI: 25–29.9 kg/m2, 29%, n = 48), and obese (OB; BMI > 30 kg/m2, 52%, n = 86) women. The majority (78%, n = 129) of women were Hispanic White with a mean age of 30.4 5.7 ± yrs and gestational weight gain of 12.1 5.8 kgs. A total of 62% (n = 103) of women received PNC. ± A total of 57% gained above the Institute of Medicine (IOM) recommendations (n = 94). OB women were 2.6 and 2.1 times more likely to receive PNC than OW (95% CI: 1.1–2.0) and NW (95% CI: 0.9–1.9) women, respectively.
    [Show full text]