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MRCOG Maternal Medicine > Obstetricians role in preventing cardio metabolic disease 2019 Impact of the intrauterine environment on future reproductive and metabolic health > Flashcards

Obstetricians role in preventing cardio metabolic disease 2019 Impact of the intrauterine environment on future reproductive and metabolic health Flashcards

1
Q

Leading cause of death in women in UK

A

CVD and stroke

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2
Q

Risk of T2DM after GD<

A

7.43, highest risk 3-6 years post party

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3
Q

GDM and relative risk
- future CVD?
- CAD?
- Stroke?

A
  • CVD 1.74
  • CAD 2.09
  • Stroke 1.25
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4
Q

PET, RR of developing HTN in year following pregnancy

A

3.1
Recurrent PET 6

Higher if preterm

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5
Q

If hypertensive disease of pregnancy risk of T2DM (vs non hypoertensive)

A

2-3 fold

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6
Q

If HDP and GDM risk of T2DM, vs GDM alone

A

RR 18

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7
Q

Risk gestational hypertension and CVD within 14 years

A

HR 1.8

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8
Q

What can obstetricians do to reduce risk of T2DM in the future for mothers with GDM

A

Diet and exercise

Counselling AN

Communicate with GP, pregression highest within 3-6 years of GDM. Fasting blood glucose 6-13 weeks. Annual HbA1c

Breast-feeding (>4-12 weeks) reduced risk 50% by 2 ytears and 78% by 5 years

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9
Q

What can obstetricians do to reduced risk of women with hypertensive disorders of pregnancy decwloping CVD in future?

A
  • Inform of risk of HTN in future
  • Risk HTN/PET future pregnancy - aspirin
  • Lifestyle advice - weight, smoking, exercise diet
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10
Q

What proportion of prengnacy
- Overweight/obese
- Dx GDM
- Smoke in pregnancy

A
  • 50%
  • 1/20
  • 1/10
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11
Q

Risk low BMI in pregnancy to long term offspring health

A

Obesity
Hypertenion

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12
Q

Risk obesity in pregnancy to long term offspring health

A

Obesity
Dyslipidaemia
CVD
T2DM

→ weight loss, physical activity, aspirin

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13
Q

Risk smoking in pregnancy to long term offspring health

A

Obesity
Hypertension
Insulin resistance

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14
Q

Risk chronic fetal hypoxia in pregnancy to long term offspring health

A

Obesity
CVD

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15
Q

What % pregnancies ART?

A

6%

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16
Q

Suboptima growth in utero can left to which later life impacts?

A

Obesity
Diabetes
CV disease
Dyslipaideami
PCOS
Decreased ovarian reserve
Pubertal timing

17
Q

For beer 1 kg in birthweight there is a corresponding what % increase in being overweight in mid-childhood?

18
Q

What is maternal undernutrition rated to in terms of long term weight

A

Higher risk of obesity

19
Q

Risk of smoking on long term weight of child

A

Dose dependent increase up to 15/day

20
Q

Can fatty acids cross the plancenta?

21
Q

How much more hepatic adiposity in mother with GDM vs non GDM

A

70% increase septic adiposity but no increase in submit or abdominal fat

MRCOG Maternal Medicine (41 decks)

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