Foetal growth and nutrition

Question 1

Consequences of poor foetal growth?

Answer 1

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Question 2

Consequences of large babies?

Answer 2

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Question 3

Term defention

Answer 3

37 wks

Question 4

Full term defenition

Answer 4

39wks - babies born with lowest risk of health issues (Cerebral Palsy/ respiratory distress syndrome) at full term

Question 5

Appropriate weight for gestation

Answer 5

10th-90th percentile. Anything below or above is considered low growth or overweight.

Question 6

Main process of foetal growth?

Answer 6

Hyperplasia (inc. cell size)&raquo_space; Hypertrophy

Question 7

What is our Metabolic capacity determined by?

Answer 7

Metabolic capacity is determined by foetal growth as all our important organs such as kidney/heart/skeletal muscle do their growing early on in gestation.

Question 8

Embryonic nutrition

Answer 8

Histiotrophic: Uterine glands secrete carbs into intervillous space.

Question 9

Foetal nutrition and foetal supply line

Answer 9

Haemotrophic

Question 10

What is the biggest general cause of foetal growth restriction?

Answer 10

Placental

Question 11

Foetal diet substrates, mode of transport, and role.

Answer 11

Glucose - Facilitated diffusion - main energy source, foetal growth (carbon)

Amino acids- Active transport - Balance between oxidation (creating energy) and growth of placenta.

Lactate - Produced by placenta - Energy (oxidation)

Fatty acids- Readily diffuse - Cell membranes and energy source (adipose tissue)

Question 12

Determinants of foetal growth

Answer 12

1. Nutrition
2. Hormones
3. Genetics

Question 13

Main foetal hormones, where they are produced and their roles.

Answer 13

IGF-2 and IGF-1

Question 14

What regulates IGF-1 levels

Answer 14

Foetal nutrition, if maternal starvation, then dec. in IGF-1 levels. Vice versa

Question 15

What regulates IGF-1 levels

Answer 15

Foetal nutrition, if maternal starvation, then dec. in IGF-1 levels. Vice versa

AND

Insulin

Question 16

Actions of insulin in foetus.

Answer 16

Tissue accretion (protein disposition) and fuel storage (cell uptake of glucose)

Question 17

Growth hormone

Answer 17

High concentrations
Low effect on weight
Effects length/height
Does not regulate IGF-1

Question 18

Role of glucocorticoids

Answer 18

Determines timing of labor

Tissue maturation

Question 19

Maternal barrier to cortisol

Answer 19

Enzyme that breaks down maternal cortisol
If enzyme is deficient/damaged (protein malnutrition or ischaemic placental disease) then cortisol passes through placenta and induces preterm birth. Acts a s a protective mechanism, but causes growth defects.

Question 20

General genetic influences on foetal growth

Answer 20

Not much, race and sex <20% of variance
Determines lean muscle mass
Mostly determined by constrain to uterus (non genetic and non-pathological.)

Question 21

Maternal constraints of foetal growth

Answer 21

Maternal weight
Maternal height
Maternal nutrition.

Question 22

Constraints of embryogenesis

Answer 22

Main one is twins (less foetal growth with twins)

Periconceptual nutrition

Question 23

Causes of foetal undernutrition

Answer 23

Idiopathic
Vascular disease (no transformed spiral a.?)
Sever maternal undernutrition

Question 24

Genetic disorders affecting foetal growth

Answer 24

Beckwith Wiedmann’s syndrome: Overexpression of IGF-2 from PATERNAL mutation causing large tongue, hemi-hypertrophy .

Russell Silver syndrome: IGF-2 deficiency from maternal allele mutation. Causing SGA, small heigh, normal head size.

Question 25

Gestational diabetes

Answer 25

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