Early environmental & biological impacts Flashcards
What are some in utero lasting impacts on the foetus?
Maternal: nutrition, illness, stress, medications
Environmental factors: pesticides etc
Foetal infection
What are some social and environmental impacts on the child?
Family
School
Nutrition
Social behaviours witnessed
Access to healthcare
What is the DOHaD hypothesis?
Developmental Origins of Health and Disease
Undernutrition in utero + overnutrition as a child
= increased risk of metabolic syndrome & cardiovascular events
What does the NHS Healthy Child Programme do? (6)
Screening
Immunisation
Signposting
Supporting care giving and care givers
Health promotion (e.g. obesity prevention)
Identification of high-risk families/individuals
What are the fundamentals of a good screening test?
In terms of the screened disease and the test itself
Screened disease should be:
Treatable
Able to be identified early/before critical point
Prevented to reduce morbidity/mortality
Test:
Acceptable/easy to administer
Cost effective
Reproducible and accurate results
What are some pre-conception screening tests?
Commence folic acid
Give screening info ASAP
Diabetes - eye check
What are some screening tests for the 1st trimester?
Blood test for sickle cell & thalassaemia
Combined test - checks for Down’s, Patau’s and Edward’s syndromes
Ultrasound
Infectious diseases - HIV, hep B, syphilis
2nd/3rd trimester tests
Ultrasound in more detail, structural abnormalities
Quadruple test (up to 20 weeks if combined test not done) - Down’s
Newborn screening
<24h - hep B vaccine
<72h - newborn physical examination
day 5 - heel prick (sickle cell, cystic fibrosis etc), hearing test
6-8 wks - infant physical examination
What is the heel prick test for?
CF, congenital hypothyroidism, sickle cell anaemia
Heel prick can be done up to one year if test missed except CF which is up to 8 weeks
