Lecture 21 - fetal growth and nutrition

Question 1

Problems faced by small babies

Answer 1

• Increase in mortality and morbidity
• IQ decrease
• behavioural problems

Question 2

Hyperplasia > hypertrophy

Answer 2

in fetal life - increase number of cells , for many things such as neurons, skeletal muscles fibers you dont increase no. after birth
-in Postnatal growh you get increase size and function of these cells - hypertrophy.

Question 3

fetal growth restriction

Answer 3

In utero growth potential limited by a pathological process

• decrease accretion of fat and lean tissue
• most cases due to poor placentation
• key risk factor for stillbirth and asphyxia

Question 4

glucose

Answer 4

fetus cannot make much glucose

• amino acids - important for metabolic balance
• lactate
• fatty acids -

Question 5

glucose

Answer 5

get from placenta 
fetus cannot make much glucose 
-amino acids - important for metabolic balance
-lactate 
-fatty acids -

Question 6

Most important hormones in fetus

Answer 6

Insulin like growth factors - will have impaired growth, produced in fetal tissue and placenta
-is regulated by nutrtion - starvation - igf decreases

restriction if dont have these
Insuilin - promotes tissue accretion and fuel stroage (increase glucose uptake, protein antabolism)

Question 7

After birth - hormone

Answer 7

Growth hormone important -can be shorter if dont have this

• GLucocoriticoids increase at birth, so get maturation of cells and differentiation
• helps turn on growth hormone in the liver

placenta stops maternal cortisol going in

Question 8

Genetics

Answer 8

Can influence lean wieght
-Doesnt really make a difference
-More non-genetic, non-pathological factors limit fetal growth will contstraint normal growth e.g capacity for placenta to supply nutrients and oxygen
, also maternal size, age ect.

Question 9

Fetal vs postnatal growth

Answer 9

Fetal - is normally constrained by the maternal environment
-if endocrine status is adequate growth is normally regulated by substrate supply

Postnatal - genetic potential, if nutrition status is adequate, growth is normally regulated by endocrine status

Question 10

Fetal undernutrition

Answer 10

defiency in placenta (in the trophoblst invasion and remodeling of spiral arteries, effects fetal development due to reduced blood flow )

• maternal undernutrition

genetic disorders - could have genes regulating growth imprinted

Question 11

Beck wiedemann syndrome

Answer 11

normally only one fucntional gene working, but if have two - then babys are large, lots of problems

-underexpression of IGF2 - russel silver sydrome - very small

Question 12

gestational diabetes

Answer 12

GLucose intolerance developing in pregnacy

-get excess fetal insulin, which causes excess growth