developmental origins of adult disease Flashcards
what is the barker Hypothesis?
A hypothesis proposed in 1990 by the British epidemiologist David Barker (b. 1939) that intrauterine growth retardation, low birth weight, and premature birth have a causal relationship to the origins of hypertension, coronary heart disease, and non-insulin-dependent diabetes, in middle age.
what did David barker discover?
25 yrs ago - showed for 1st time low birth weight
infants at greater risk of coronary heart disease later.
• Common chronic diseases result from poor nutrition in
the womb
what is the thrifty phenotype hypothesis?
Nutritional insult during critical period of
gestation may leave permanent “memory”
throughout life.
Maternal nutritional status can alter epigenetic
state of the fetal genome and imprint gene
expression.
the thrifty phenotype hypothesis proposes that the epidemiological associations between poor fetal and infant growth and the subsequent development of type 2 diabetes and the metabolic syndrome results from the effects of poor nutrition inert life, which produces permanent changes in glucose-insulin metabolism
what are late systemic effects of IUGR?
- CHD
- risk of heart disease is higher in LBW
- hypertension
diabetes
osteoporosis
breast and ovary cancer
how does IUGR increase risk of CHD?
before birth heart muscle cells sensitive to environment
• Malnutrition can speed up maturation, perhaps in
preparation for an early birth
• Reduced number muscle cells, diminished reserve for
repair in later life
• Reduced growth limiting reserve
why do LBW babies have increased risk of renal hypertension?
LBW babies 3 times fewer nephrons than normal
weight babies – renal hypertension
why do LBW babies have increased risk of osteoporosis?
LBW babies have lower bone mass that persists throughout
life
what is the short term benefit of insulin resistance?
Muscles of undernourished baby become resistant to insulin
Raised blood sugar available to protect brain growth - the thrifty
hypothesis.
maternal and feta risk associated with assisted conception pregnancy
- Maternal risks
- OHSS
- ??Cancers
- Fetal risks
- Miscarriage
- Ectopic pregnancy
- Heterotopic pregnancy
- Pregnancy complications
what are the names of noninvasive prenatal genetic tests?
Nateras panorama
Verinatas Verifi
Sequenoms MaterniT21 PLUS
Arisonas harmony
they test for trisomy 12,18,21 and sex chromosomes
advantages in prenatal screening for aneuploidy?
High detection rates • Lower false positive rates • Effect on pregnancy terminations? • Improved continuation of normal pregnancies or pregnancies affected by abnormalities?
