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Prenatal Care to the Life Course Perspective

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Traditional medical evaluation and record. Chief complaint. History of illness. Past medical history. Family history. Social History. Physical exam. Diagnostic tests ... – PowerPoint PPT presentation

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Title: Prenatal Care to the Life Course Perspective


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Diabetes
Mild
Severe
Mother Fetus Adult Pregnant Fetus Adult
Hyperactive B-cells Hyperinsulinemia Macrosomia
Overstimulated B-cells Hypoinsulinemia Microsomia
Deficient insulin response Impaired glucose
tolerance
Excessive insulin response Insulin resistance
Gestational Diabetes
Hyperinsulinemia Macrosomia
Impaired glucose tolerance
Aerts L et al. Intra-uterine transmission of
disease. Placenta 200324905-911.
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Nurses Health Study
Curhan et al., Rich-Edwards et al.
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From Life Course Health Development A
Framework to Guide Research, Practice and
Reform Neal Halfon, MD, MPH Helen M. DuPlessis,
MD, MPH
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  • Stressed
  • Increased cardiac output
  • Increased available
  • Glucose
  • Enhanced immune
  • Functions
  • Growth of neurons in
  • hippocampus
  • prefrontal cortex
  • Stressed Out
  • Hypertension
  • cardiovascular diseases
  • Glucose intolerance
  • insulin resistance
  • Infection inflammation
  • Atrophy death of
  • neurons in hippocampus
  • prefrontal cortex

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It is unreasonable to expect that people will
change their behavior easily when so many forces
in the social, cultural, and physical
environment conspire against such
change. --Institute of Medicine
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  • Prospective Evaluation and Record
  • Health profile summary
  • Current health status
  • Health risk analysis
  • Genetic
  • Environmental
  • Lifestyle
  • 1-year health plan
  • 5-year health plan
  • Traditional medical evaluation and record
  • Chief complaint
  • History of illness
  • Past medical history
  • Family history
  • Social History
  • Physical exam
  • Diagnostic tests
  • Assessment and plan

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Source Snyderman R. AAP presidential address
the AAP and the transformation of medicine.
Journal of Clinical Investigation. 2004114(8)
1169-1173 (suppl)
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