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Question: Linda is an African-American woman who has been taking hormonal contraceptive pills for 10 years….

Linda is a black lady who has been using hormonal contraceptives for ten years. She believes she is ready to start a family at the age of 35, and has had no trouble conceiving. She has, however, had four miscarriages between the ages of 35 and 38. During those three years, her blood work revealed 172 mg/dL triglycerides, 135/100 mm Hg blood pressure, 175 mg/dL LDL, and 242 mg/dL total cholesterol. She is 5 feet 5 inches tall and weighs 180 pounds at the age of 38. (pre-pregnancy). She is expecting her fifth child and is overjoyed that she has reached the 20-week mark (the cut off period for a miscarriage). She is 27 weeks pregnant and weighs 185 pounds. She is a one-room studio dweller who engages in very little physical activity and rarely ventures outside. Linda becomes a vegan after reading a recent magazine article advocating a strict vegan diet for the fetus’s optimal growth and development. She does, however, occasionally indulge in her passion for yogurt. She decides not to take any vitamin supplements because she believes her body’s nutrient resources are sufficient for the baby. She has read about the dangers of being overweight and has resolved to “eat healthy.” Her objective is to give birth to a full-term baby while also losing weight during the pregnancy. Her reasoning is that if she eats well and doesn’t gain weight, she’ll be able to pass her “excess weight” to the kid. Aside from a family history of hypertension, she believes she and her baby are in good health. 1. What were the possible causes of Linda’s recurring miscarriages? 2. What are your thoughts on her blood work throughout her miscarriage period? What is the most likely cause of these numbers, based on the case study? 3. Is Anna at a greater risk for chronic disease, regardless of her pregnant status? Why? 4. Based on Linda’s pre-pregnancy weight, determine her IBW, BMI and EER. Do you think she’s underweight, average weight, overweight, or obese? 5. Comment on Linda’s weight gain during the second trimester of her pregnancy. What impact might these patterns have on the pregnancy outcomes?