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What is referred by infant mortality?
Reflects first year of life
How many deaths occur in first month after brith?
2/3s of deaths
What's US ranking in infant mortality?
What do improvements in infant mortality represent changes in which departments? (3)
-infectious disease control
-availability of safe and nutritious foods
Which category of high risk infants are more vulnerable to die in first year?
- Low birth weight infants
- *they comprise of the majority of infant deaths
How much do low birth weight infants weigh?
weigh less than 5.8 pounds
Which population is more at risk of low birth weight infants?
What is very low birth weight classified as?
weigh less than 3.4 pounds
What is pre term infants?
-infants born less than 37 weeks gestation
What are the 3 categories that comprise of high risk infants?
-low birth weight
-very low birth weight
Healthy objectives for year 2020) what are 3 goals for pregnant women and newborns?
-reduction of LBW babies
Healthy objectives for year 2020) 8 specific objectives
-reduce anemia among low income pregnant female in 3rd trimester
-reduce infant mortality
-reduce incidence of spinal bifida and other neural tube effects
-reduce low birth weight
- reduce pre term births
-increase abstinence from alcohol use which pregnancy
-increase proportion of women who gain healthy weight during pregnancy
What is the critical period define as?
Period of development in which certain evens occur that will have irreversible effects on later developmental stages
*this period is usually a time of rapid cell division
Summary of when critical period is and when malnutrition occurs
-basically if malnutrition occurs in critical period then the baby will not be able to full recover from the damage done. If malnutrition occurred at some other time, they have a better chance of recovering
Early pregnancy and malnutrition
Severe limit of nutrients would cause retarded growth but if there isn't enough nutrients for cell division or cell synthesis, malformation will occur or fetus will die
Malnutrition and 3rd month of pregnancy
Malnutrition would not have teratogenic effects but it could interfere with fetal growth
During last trimester of pregnancy and malnutrition
nutrient needs are greatest bc cells are increasing rapidly in both number and size
What causes variations in fetal growth? (5)
-low weight gain during pregnancy
-poor dietary intakes
Conditions that interfere with genetically stimulated growth and development) what 3 functions does insulin-like growth factor have?
-primary growth stimulator of the fetus
-promotes uptake of nutrients by the fetus
-inhibits fetal tissue breakdown
Conditions that interfere with genetically stimulated growth and development) malnutrition and insulin like growth factor
IGF-1 is decreased with maternal malnutrition thus decreases muscle and skeletal mass with asymmetrical growth
Intrauterine growth retardation) newborns are generally considered likely to have experience intrauterine growth retardation IF
Their weight for gestational age or length is low
2 categories under small for gestational age
-disproportional small for gestational age
-proportionally small for gestational age
2 general characteristics of infants that are small for geeational age
-weigh below 10% for weight for gestational age
- -full term infants but poorly developed
- *conditions are variable suggesting multiple causes and timings
Disproportionately small for gestation age) 4 characteristics
-weigh less than 10%tile of weight for gestational age
-growth retardation affecting primarily weight
-have normal length and head circumference for age
-infants have poorly developed muscles and little subcutaneous fat
Disproportionately small for gestation age) when did malformation most likely occur?
- Later in 3rd trimester
- *part which comprised liver glycogen and fat storage
Proportionally small for gestational age) 3 characterisitics
-look small but well proportioned
-growth reduction in both weight and height
-size of all body parts is reduced proportionally
Proportionally small for gestational age) what might've caused this?
- Long term malnutrition
- *these guys have harder time adjusting
Large for gestational age) how are infants classified in this category?
Infants than weigh more than 90%ile for gestational age
Large for gestational age) what is this related to? (3)
-poorly controlled diabetes
-excessive weight gain, more than 44 pounds
Large for gestational age) small or large for gestational age experience more problems?
How are miscarriages caused? (3)
-genetic, uterine, or hormonal abnormalities
-reproductive tract ifnections
-tissue rejection due to immune system disorders
What percent of implanted embryos are lost by reabsorption into uterus or expulsion before 20th week fo pregnancy?
3 nutritional causes that increases chance of miscarriage?
-large amounts of caffeine
- -high homocysteine levels
- *this causes inflammation
How does preterm delivery occur? (8)
It is unclear but can be related to...
- -genital tract infections
- -insufficient uterine-placental flow
- -placental abruption
- -pre-pregnancy underweight
- -low weight in pregnancy
- -high levels of stress
- -low levels of folate
Preterm delivery infants) common problems with these infants (4)
-conditions due to immaturity of organs
Preterm delivery infants) these babies may have..
-low stores of fat, glycogen, fatty acids, and other nutrients
Fetal origins hypothesis of later disease) what is the theory about?
- That exposure to adverse nutritional and other conditions during critical periods of growth can permanently affect body structures and functions
- *these changes may predispose individuals to CVD, DM, HTN etc
Fetal origins hypothesis of later disease)Summary of birth weight and risk of diseases
The lower the birth weight the higher the rates were for heart disease and stroke
*validating the theory
Fetal origins hypothesis of later disease) if there are less than optimal growing condition during gestation... then
fetal tissues make adaptations to cope with energy and nutrient shortages and excesses by changing its requirements for energy and nutrients to help it survive and biologically preparing fetus for similar nutritional circumstances after birth
Fetal origins hypothesis of later disease) why is nutrition programming significant?
- The availability of energy and nutrients during fetal development influences the programming of gene functions
- *the structure of the gene is not changed but it switches off
Fetal-origins hypothesis of later disease risk) research findings on adaptations to ensure CNS receives adequate glucose when glucose is limited...
expression of genes that produce insulin receptors on muscle cell membrane may be suppressed in response to low glucose levels thus leads to decrease uptake of glucose leaving more glucose available for CNS development
Fetal-origins hypothesis of later disease risk) low weight gain around mid pregnancy is asscoaited with...
Higher blood pressure in children
Fetal-origins hypothesis of later disease risk) low levels of maternal body fat during pregnancy associated with...
Increased risk of heart disease in offspring
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