1. METABOLISM TRACKING DURING PREGNANCY:
TOOLS FOR UNLOCKING OUR KNOWLEDGE OF THE PLACENTA
CORRIE WHISNER AND ERICA FORZANI
ARIZONA STATE UNIVERSITY
CASE STUDIES – RESTING ENERGY EXPENDITURE AND WEIGHT GAIN
Fig. 1. Weight control: balance between calorie intake and energy
expenditure. Resting energy expenditure (REE) constitute >75% of total
energy expenditure, which cannot be measured by the existing
accelerometer-based devices. Current REE measurement technologies
are bulky, complicated and expensive, which are available only in
clinical and research labs.
WHAT ELSE TO TRACK DURING PREGNANCY TO IMPROVE HEALTH AND UNDERSTAND PLACENTAL FUNCTION
0 20 25 30 35 40
900
1200
1500
1800
2100
2400
After birth
1540
1890 (+/-150) 1680
(+/- 50)
REE(RMR)(kcal/day)
Pregnancy week
1830
(+/- 30)
Baseline REE = 1,200 kCal/day
Cold/
Flu
0 20 25 30 35 40
42
44
46
48
50
52
54
56
58
60
Weight(kg)
Pregnancy weeks
After birth
53
Baseline ~ 44 kg
Cold/Flu
0 20 25 30 35 40
0
1000
2000
3000
4000
5000
Pregnancy weeks
WeeklyAverageSteps
CASE ONE:
REE increased during second
trimester and remained relatively
stable through delivery
0 20 25 30 35 40
0
1000
2000
3000
4000
Pregnancy weeks
Total Energy Expenditure,
Calorie Intake & Caloric Balance
kcal/day
Activity EE
REE
1890 (+/-150)
1680
(+/- 50)
1830
(+/- 30)
Baseline TEE ~ 1,300 kCal/day
Cold/Flu
0 20 25 30 35 40
0
1000
2000
3000
4000
Diet
Baseline TEE ~ 1,300 kCal/day
HEART RATE / BLOOD PRESSURE BLOOD GLUCOSE PHYSICAL DIMENSIONS /
ANTHROPOMETRICS
CARDIAC OUTPUT
CONCLUSIONS:
- REE is unique for each individual, and it is a complex variable that depends on several factors.
- It can increase, remain constant or decrease during pregnancy, and therefore is necessary to track it.
HANDHELD METABOLISM TRACKING
-= [ + ]
CASE TWO:
REE stayed the same throughout
pregnancy
CASE THREE:
REE decreased with nausea and
remained low later in pregnancy
Metabolism changes greatly during pregnancy. Despite an increased
need for calories, excessive gestational weight gain affects many
women, contributing to adverse maternal and child health outcomes.
Real-time tracking of health parameters may improve prenatal health.
0 20 25 30 35 40
65
70
75
80
85
90
Waist/Hip
Bellybutton(cm)
Pregnancy week
-20246 20 40
0.70
0.75
0.80
0.85
0.90
0.95
1.00
0 5 10 15 20 25 30 35 40
0
40
80
120
HeartRate(BPM)
BloodPressure(mmHg)
Pregnancy week
0 5 10 15 20 25 30 35 40
40
50
60
70
80
90
100
110Av. Sys. BP = 101 (+/- 6) mmHg
Av. Dia. BP = 61 (+/- 6) mmHg
Av. HR = 57 (+/- 12) mmHg
Average after
week 15th =
80 (+/- 5) mg/dl
-5 0 5 10 15 20 25 30 35 40
70
80
90
100
BloodGlucose(mg/dl)
Pregnancy week
Average before
pregnancy =
96 (+/- 5) mg/dl
0 5 10 15 20 25 30 35 40
0
5
10
15
20
25
30
35
40
45
Pregnancy week
DailySteps(10
3
)
Average =
6700 (+/- 5000)
steps/day
Point Of Care device for real-time monitoring of cardiovascular parameters for clinical
and home use. The device comprises a mouthpiece integrated with a heart rate
sensor with breath carbon dioxide analysis for non-invasive assessment of
cardiovascular functions, and wireless communication with professionals.
 Cardiovascular
 Data sharing
(professional)
 CO: Cardiac output
 SV: Stroke volume
 COI: Cardiac output Index
 SV: SV Index
 HR: Heart Rate
 Wireless communication
 Graphic user interface
 Secure Database
Heart Rate
Rebreathing Reservoir (bag)
DEtCO2
CO2 Rebreathing test
VCO2,1
VCO2,2
Carbon Dioxide & Acoustic Flow