Preconception Flashcards
when is the critical window?
first 100 days of life
what is the critical window
brain development, healthy growth and a strong immune system
what does maternal nutrition at the time of conception influence
placental development and function
what is pre-conception
before (at least 2 years) and between consecutive pregnancies
what does proximal mean
period immediately preceding pregnancy (up to 2 years)
what does distal mean
adolescence or a longer time before pregnancy
fetal genomic imprinting and programming are directly tied to …
child’s long term health
maternal periconception nutrition
What is periconception
before, during and after conception
3 months before conception to up to the first trimester
5 stages of periconceptional reproductive development
gametogenesis
fertilisation
implantation
embryogenesis
placentation
how long may the periconceptional phase be considered in biological terms
5-6 months
how long after conception are all the major organs in place?
4 weeks
why is the female reproductive system more sensitive than a male
it is highest energy expenditure a woman will ever experience
why do many animals breed in spring
to time conception that give offspring the greatest chance of survival when food and climatic conditions are favourable
what are the short-term changes the reproductive functions are responsive to
Availability of calories
-likely to be signaled by leptin, insulin/glucose
where is leptin secreted from
adipose tissue
what are the long-term changes the reproductive functions are responsive to
inadequate BF- hypothalamic amenorrhea
what % BF reductions causes menstruation to holt
10-15% decrease in normal BW
what are the hormones related to hypothalamic amenorrhea
leptin, luteinising hormone and estradiol
what is the critical level of BF required to trigger and sustain normal reproductive functions
BMI >20
delays in the onset of menstruation and reduced fertility later in life are related to what
low BF in adolscense
what happened during the dutch famine
acute starvation
-400-800kcal/day for 6 months
Children of pregnant women exposed to the famine were more susceptible to ???
diabetes
obesity
CVD
microalbuminuria
What is the one-carbon metabolic pathway about
donating a carbon methyl group to DNA
high nutrient intakes can shift the OCM pathway
away from DNA synthesis and to methylation
what did the study of the agouti mice show
that high levels of methyl donor supplementation decreased the risk of obesity, diabetes, and cancer
what is the barker hypothesis
fetal undernutrition in middle to late gestation may cause disproportionate fetal growth and increased risk of CVD
what is the thrifty phenotype hypothesis (related to what happens to a fetus during starvation)
the fetus reduces insulin secretion and increases peripheral insulin resistance to direct more glucose to the heart and brain
what permanent change can a starved fetus undergo
glucose-insulin metabolism change
what is the thrifty gene hypothesis
If obesity is no longer a survival advantage, reduced fertility in obese people may be natures intent
what is the thrifty gene hypothesis?
If obesity is no longer a survival advantage, reduced fertility in obese people may be nature’s intent
what hormones do obese women tend to be higher in
estrogen, leptin and androgens
How does obesity affect hormones in men
higher estrogen and leptin
lower testosterone
what physical affects does obesity have on men
reduced sperm production
erectile dysfunciton
What physical affects does obesity have on women
menstrual cycle irregularity, ovulatory failure and amenorrhea
important nutrients during pregnancy
choline
folate
zinc
iron
Omega 3
B12
iodine
multivitamins
what is choline used for
brain development
what is iodine used for
neurocognition
what is zinc linked to
pre-term birth
placental function
what is B12 and omega 3 linked to
altered lipids metabolism
three types of neural tube defects
spina bifida
anencephaly
encepholocele
when does the neural tube develop
during the first 23 days
what is the NZ advice regarding folic acid supplementation
4 weeks before
12 weeks after
800mcg daily
what % of NZ woemn comply with folic acid reccomendations
33%
ways to increase success of campaigns
identify group not yet reached
make ads relevant
include benefits of folic acid early in lives of reproductive age women
What are the potential benefits of folic acid fortification
17 NTD reduction per year
