1b Early Environment and Biological Impacts on Health Flashcards
What challenges might the fetus face in utero?
fetal infection
maternal nutrition
maternal illness
maternal stress
maternal medication
environmental factors/exposures
What did the Barker Hypothesis conclude?
DOHaD Hypothesis:
Undernutrition in utero
Followed by overnutrition as a child
Lead to increased risk of Metabolic Syndrome which in turns leads to increased risk of CVD events
What is DOHaD?
Developmental Origins of Health and Disease - a concept where environmental insults in early life can contribute to long-term risk of NCDs and an individual’s short- and long-term health
What is epigenetics?
heritable changes in marks on the DNA which do not effect the nucleotide sequences but influence how genes are expressed (where, when and how much a gene is switched off)
Describe the mechanism of the DOHaD
Maternal malnutrition - the baby is born underweight, therefore has a higher energy intake (to compensate for the lack of nutrition - this puts the baby at risk of an OVERSHOOT), so is more likely to have a high BMI, and puts the baby at risk of metabolic syndrome, or CVD
Describe how the DOHaD mechanism links to biology?
Foetal genes have particular sequences -> these are switch on and off during stages of development
Things like the uterine environment, nutritional supply, vascular blood supply (pre-eclampsia) -> these environmental impacts have an impact on gene expression.
When born, we are exposed to another set of environmental stimuli -> there impacts might eb amplified during infancy, and then adding adult behaviours -> leads to increased risk of CVD incidents
What are the benefits of the NHS Health Child Programme?
Universal
Reducing healthcare inequalities
Aims to prevent disease and promote good health
What are the aims of the NHS Health Child Programme?
Health promotion
Supporting care giving
Screening
Immunisation
Identification of high risk families
Signposting
What are the fundamentals of a good screening test?
Have to be able to be identified before a critical point, treatable and prevent/reduce morbidity
Acceptable and eay to administer
Cost effective
Provide Accurate Results
What are three examples of Early Screening tests?
Newborn check
Newborn Hearing Screen
Blood Spot Check
What is SureStart?
Aims to help and support families with under 5’s in low income households, parent and child education and health promotion
Describe one screening test which is undertaken pre-conception?
T1DM/T2DM- diabetic eye test
What is one screening tests which is done in the first trimester?
- Bloods for sickle cell and thalassaemia
- Blood for Hb, group, rhesus and antibodies
What is one screening tests which is done in the second / third trimester of pregnancy?
Screening for down’s syndrome and fetal abnormalities = for the foetus
Describe one screening tests which is undertaken in the new born period?
new born hearing screening
New born blood spot screening for MCADD, cystic fibrosis, PKU and congenital hypothyroidism and sickle cell disease
