Postnatal and Child Development Flashcards
(52 cards)
1
Q
How do genetics impact prenatal development?
A
- minor overall effect
- mainly determined by maternal genetic factors and maternal size
2
Q
How do genetics impact postnatal growth?
A
- largely determines final adult height
- XY results in taller height than XX
3
Q
Which hormones are most important in prenatal growth?
A
- insulin and IGFs
- IGF-2 for embryonic growth
- IGF-1 for late fetal and infant growth
4
Q
What is the most important hormone in post-natal growth?
A
Human Growth Hormone
5
Q
How is nutrition provided to the fetus?
A
Placenta provides all nutrients
6
Q
How can fetal nutrition impact prenatal growth?
A
- placental insufficiency is most common cause of IUGR
- placenta controls hormones necessary for fetal growth
- placental nutrition is influenced by maternal diet
7
Q
How does nutrition impact postnatal growth?
A
Poor nutrition can limit growth potential and delay puberty onset
8
Q
How does the uterine environment influence prenatal development?
A
- uterine capacity and placental sufficiency needed for optimal environment
- placenta function more important than uterine capacity
9
Q
Which environmental factors can influence postnatal development?
A
- socioeconomic status
- chronic disease
- emotional status
- altitude (low O2 sats)
10
Q
What are the four phases of growth?
A
- fetal
- infantile
- childhood
- pubertal
11
Q
What happens during the fetal growth phase?
A
- fastest period of growth
- accounts for 30% of final height
- growth mainly driven by fetal hyperplasia
12
Q
How many cycles of cell division are ther before birth and after birth?
A
- 42 pre birth
- 5 after birth
13
Q
What is the infantile growth phase?
A
- first 18 months after birth
- 15% of final height
- slower than fetal phase
- largely dependent on nutrition
- increase in length, head circumference and weight
14
Q
What is the childhood growth phase?
A
- 18months to 12 years
- 40% of eventual height
- steady, slow growth
- increases 5-6cm and 3-3.5kg annually
- determined by nutrition, good health and endocrine growth regulation
15
Q
What is the pubertal growth phase?
A
- pubertal growth spurt
- 15% of final height
- rising sex hormones and hGH
- XY grow more than XX
- sex hormones cause fusion of growth plates
16
Q
What are the determinants of fetal growth?
A
Uterine environment
17
Q
What are the determinants of infantile growth?
A
- nutrition
- good health and happiness
- thyroid hormones
18
Q
What are the determinants of childhood growth?
A
- growth hormone
- thyroid hormone
- genes
- good health and happiness
19
Q
What are the determinants of pubertal growth?
A
- testosterone and oestrogen
- growth hormone
20
Q
What is the development of the HPG axis?
A
- fetal development of GnRH network and sexual organs
- neonatal priming of HPG axis (mini-puberty)
- childhood linear growth and developmental milestones with no HPG axis activity
- adolescent sexual maturation (puberty)
- reproductive capacity plateaus in adulthood
21
Q
What is mini puberty?
A
- gonadotrophin secretion begins at the end of the first trimester
- peaks mid-pregnancy and then declines
- HPG axis is activated again after birth after release from placental hormones
- continues for 6 months after birth
22
Q
What is the purpose of mini-puberty?
A
- contributes to normal gonadal development in males
- may be important in development of mammary tissue in females
- may influence body composition and linear growth in males
23
Q
What triggers puberty?
A
- influenced by metabolic status
- neurokinin KNDy neurons may regulate kisspeptin which stimulates GnRH release
24
Q
A mutation in which gene can cause pubertal delays?
A
KISS1R
25
What is consonance?
Compliance with the typical sequence of pubertal milestones
26
How has the onset of menarche changed over since the 19th century?
Decreased by 4+ years
27
What are the four developmental domains?
- gross motor skills
- fine motor skills
- speach, language and hearing skills
- social behaviour and play skills
28
Which developmental skill should be present in newborns?
- flexed posture
- fixes on and follows faces
- stills to voice and startles to loud noises
- smiles responsively
29
Which developmental skills are present at 7 months?
- sitting without support
- transferring objects from hand to hand
- polysyllabic babble and turning to voice
- finger feeding and fearing strangers
30
Which developmental skills should be present by 12 months?
- standing independently
- pincer grip
- knowing a few words and understanding name
- drinking from a cup and waving
31
Which developmental skills should be present at 15-18months?
- walking independently
- immature grip of pencils/crayons
- knowing 6-10 words and being able to point to four body parts
- feeding self with spoon and starting to dress self
32
Which developmental skills should be present at 2.5 years?
- running and jumping
- drawing
- short sentences and understanding joint commands
- playing with others
33
How many children are born with a genetic disorder?
1 in 25
34
How many children are born with congenital defects?
1 in 45
35
How many children experience some sort of developmental delay during childhood?
1 in 10
36
What is the NHS Healthy Child Programme?
- prevent diseases and promotes good health
- universal
- reduces health inequalities
37
What does the NHS Healthy Child Programme provide?
- health promotion
- obesity prevention
- supporting care giving and care givers
- screening
- immunisation
- identifying individuals who need additional support
- signposting for accident prevention and dental hygiene§
38
What are some important early childhood screening programs?
- newborn check
- new born hearing check
- blood spot check
39
What are the fundementals of a good screening program?
- able to identify disease before critical point
- disease is treatable
- prevents morbidity and mortality
- easy to administer
- cost effective
- reproducible and accurate results
40
What does the newborn physical exam measure?
- weight
- eyes
- heart
- hips
- testes
41
What does the blood spot test test for?
- cystic fibrosis
- sickle cell
- congenital hypothyroidism
- inherited metabolic disorders
42
What is a newborn hearing test?
Hearing test done in hospital before discharge, can be up to 3 months
43
What is an infant physical exam?
- done at 6-8 weeks by GP
- measures length and head circumference
- oppurtunity to discuss vaccinations
44
What is the Sure Start program?
- helps support low-income families with children under 5 years old
- provides parent and child education
- health promotion
44
What are the two different types of developmental delays?
- global development delays
- specific developmental disorder
45
What is a global developmental delay?
Significant delay in reaching two or more developmental milestones
46
What is a specific developmental disorder?
Delays in specific developmental domains in absence of sensory deficits, subnormal intelligence or poor education conditions
47
What are the causes of global developmental delays?
- chromosomal abnormalities
- metabolic e.g hypothyroidism
- antenatal and perinatal factors
- environmental-social issues
- chronic illness
48
What are some antenatal and perinatal factors which can cause global developmental delays?
- infections
- drugs
- toxins
- anoxia
- trauma
- folate deficiency
49
What are some screenings which asses language skill development?
- schedule of growing skills
- Griffith's developmental scale
- Bayley Scales of Infant Development
49
What are some causes of motor skill developmental delays?
- cerbral palsy
- congenital hip dislocation
- muscular dystrophy
- neural tube defects
- social deprivation
49
What are some causes of language skill developmental delays?
- hearing loss
- autism spectrum disorders
- lack of stimulation
- imparied language comprehension
- impaired speech production e.g. stammer, dysarthia
