Perinatal Epidemiology Flashcards by Malgorzata Gorajek

What is descriptive epidemiology?

Comparing disease levels between populations which differ in person, place or time.

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What are the important elements of descriptive epidemiology?

Case definition

Case ascertainment

Population definition

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What is case definition?

How you define who has got the disease

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What is case ascertainment?

How you find out who has got the disease

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What is population definition?

Who you explore disease rate in - how you define person, place or time.

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What is perinatal epidemiology?

Epidemiology after 22 completed weeks of gestation to 7 completed days after birth. (UK 1 year post-natal).

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What is the importance of perinatal epidemiology?

Identifying the effects of events during pregnancy on pregnancy outcome.

Effects of factors inherent to the pregnant woman’s voluntary harmful exposures during pregnancy,

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What is the fetal origins hypothesis?

Proposed by David Barker in 1995
states that undernutrition in the womb during middle to late pregnancy causes improper fetal growth, which in turn, causes a
predisposition to certain diseases in adulthood.

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What is fetal programming?

Events occurring during critical points of pregnancy may cause permanent effects on the fetus and the infant long after birth

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What are the methodological challenges of perinatal epidemiology?

Randomising woman

Recruitment

Age, ethnicity, genes are non-modifiable

Multiple births from the same mother

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How to calculate total birth prevalnce?

No. Cases (LB + FD + IA) / No. Births (live and still)

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What is cases?

Cases of congenital anomaly in population

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What is LB?

Live born

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What is FD?

Fetal deaths from 20 weeks gestation

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What is IA?

Induced abortion or termination of pregnancy after prenatal diagnosis at any gestational age

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What is a still birth?

A baby born dead after 24 completed weeks of pregnancy.

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What is it called when a baby dies before 24 completed weeks?

known as a miscarriage or late foetal loss

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What is a neonatal death?

Death among live born infants prior to the first 28 days of life.

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When is early neonatal mortality?

0-6 days

What is late neonatal mortality ?

7-28 days

What is perinatal mortality used for?

Monitor deaths

Compare the quality of perinatal healthcare between countries

Indicator of obstetric care

What factors affect perinatal mortality?

Genetic

Environmental

Diagnostic services

Methods of data collection

Termination of pregnancy options

What is the biggest risk to pregnancy?

Maternal age

What are the health and survival challenges to the fetus?

Abnormal placentation

Poor nutrition

Multiple births

Congenital anomalies

Infection

What are congenital anomalies?

Birth defects, structural or functional present themselves at birth.

What causes congenital anomalies?

Genetics Teratogenic exposures to the intrauterine environment of the fetus.

How can genetics cause congenital anomalies?

Large portions or entire chromosomes Inheritance of abnormal genes Sporadic mutations in one of the germ cells

How do terarogenic exposures cause

Dietary deficiencies Toxic effects Maternal infections

What is Zika Virus?

Virus transferred by mosquitos, causes birth defects when pregnant woman is affected.

What are the health and survival challenges to the neonate?

Consequences of challenges to the fetus Infectious disease Infant death

What kinds of consequences of challenges to the fetus cause neonate death?

Premature delivery Low birth weight Cerebral palsy

What kinds of infectious disease presents challenges to the neonate?

Respiratory tract infection Pneumonia

What is infant death?

Sudden unexpected infant death

What are the consequences of preterm birth?

Patent ductus arteriosus PDA Developmental delay Respiratory distress Neonatal death

What is patent ductus arteriosus PDA?

Delay of closure to blood vessel diverting blood from lungs.

What are the diseases of late pregnancy?

Pre-eclampsia Fetal growth restriction Pre-term labour

What is pre-eclampsia?

Severe high blood pressure Risk of kidney and liver problems Stroke Seizures

What is fetal growth restriction?

Due to placental problems leading to inadequate fetal nutrition.

What causes low birth weight?

Alcohol consumption Use of cocaine Multiple births Preterm induction

What is cerebral palsy?

Term used to describe a group of non-progressive neurological disabilities in the development of human movement and posture.

Where does cerebral palsy develop from?

Disturbance in the development

What is gastroschisis?

Gastroschisis is a birth defect in which the baby's intestines extend outside of the abdomen through a hole next to the belly button.

When does gastroschisis occur?

Occurs during 4th week of development due to lack of meeting between lateral body walls of the embryo

What is gastroschisis associated with?

Young maternal age

How is gastroschisis treated?

Requires surgical treatment soon after birth Fatal to the new born if left untreated

What is the cause of gastroschisis?

Low social class Smoking Alcohol Medications Drugs Urogenital infection