Physiology 4700A/B Lecture Notes - Lecture 10: Eclampsia, Essential Fatty Acid, In Utero
15 Apr 2017
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Downregulation of nutrient transporters --> decr"d nutrient supply --> decreased fetal growth --> Upregulation of nutrient transporters --> increased nutrient supply --> increased fetal growth --> fetal overgrowth. Light, bmi <18: preterm birth, reduced plac weight, reduced fetal weight, hypoxia. Heavy, bmi >25 (overweight) or bmi >30 (obese): gdm, ht, c-section, lga infants, pre- eclampsia, eclampsia. Morbidly obese, bmi >40: increased risk of pre-eclampsia, stillbirths, early neonatal death. Transgenerational effects from placental insufficiency and obesity. Majority born to mothers with normal glucose levels: need to check pre-pregnancy bmi and triglyceride levels, which are the best indicators for later life trajectory. Normal women who become obese at the end of pregnancy give a risk of obesity to the offspring at later life. Low placental lactogen (pl), promoting an anabolic state. Late pregnancy, mobilize fat (lipolysis); mother feeds on fat stores, so fetus gets glucose: Insulin-resistant so tissues don"t respond to glucose, sparing it for the fetus.
