Cardio 1 Flashcards
What is low birth weight?
less than 2500g (2%)
What SD constitutes small for gestational age?
> 2SD below population mean (10%)
What is low birth weight caused by in western societies?
Uteroplacental insufficiency
What is low birth weight caused by in third world societies?
Maternal undernutrition
What is the common feature of babies born small?
Insufficient nutrient delivery across the placenta
What disease do babies born small have an increased risk of?
Diabetes, obesity, osteoperosis, CVD, hypertension, renal disease
What percentage of babies born small have accelerated growth in the first 6 months and what is the effect of this?
90% - good if they are catching up but excessive growth increases risk for disease (early is protective, late is detrimental)
What is fetal programming?
Babies born small have an increased risk of developing adult disease
What happens to the mothers milk when the baby is born small?
Reduced nutritional quality - mothers milk matches babies size
What happens to restricted males?
Low nephron number (decreased by 30% at 6m), glomerular hypertrophy, normal glomerular volume, increased BP (9 weeks), reduced skeletal muscle mitochondrial biogenesis
What happens to restricted females?
Low nephron number but no increase in BP, glomerular hypertrophy at 18 months, increased plasma creatinine (renal insufficiency at 18 months)
What happens to the born small phenotype with age?
Worsens
What happens to the born small phenotype with exercise?
Endurance exercise prevents beta cell deficit and metabolic dysfunction
What did cross fostering do for the born small phenotype?
Improved phenotype and nutrition
What is the greatest physiological challenge facing females?
Pregnancy
What happens to girls born small who get pregnant?
Display glucose intolerance - glomerular hypertrophy and reduced kidney function
What is associated with maternal stress?
Reduced fetal growth and placental weight
What was present in the baby of a mother born small?
Nephron number low (15-22%) in boys and girls at E20, but restored by PN35 - late nephrogenesis
What percentage of Australian pregnant women are obese?
34%
What prevents gestational diabetes?
Endurance exercise before and during pregnancy
If a father born small mates with a normal female what is present in male offspring?
Glucose intolerance, decreased 1st phase insulin secretion and increased heart wall thickness
How does small birth weight affect mortality?
2-3 x increased
What do restricted males and females both have?
Bone deficits, decreased beta cell mass (68%), vascular dysfunction (boys mesenteric, girls uterine)
What happens to the babies of girls born small if they have a stressful pregnancy?
Small babies with pancreatic and nephron deficits
