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CHAPTER 4 PRENATAL DEVELOPMENT AND BIRTH

CHAPTER 4 PRENATAL DEVELOPMENT AND BIRTH. Prenatal Development. Time of fastest development in life span Environment extremely important Conception Ova travels from ovary to uterus Penetration by 1 of 300-500 sperm Outcome: Single-celled ZYGOTE. Prenatal Stages.

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CHAPTER 4 PRENATAL DEVELOPMENT AND BIRTH

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  1. CHAPTER 4PRENATAL DEVELOPMENT AND BIRTH

  2. Prenatal Development • Time of fastest development in life span • Environment extremely important • Conception • Ova travels from ovary to uterus • Penetration by 1 of 300-500 sperm • Outcome: Single-celled ZYGOTE

  3. Prenatal Stages • Germinal period: Days 1-14 • Implantation: One-half are successful • Miscarriage: 15% to 50% • Embryonic period: 3rd to 8th week • Organogenesis, Sexual differentiation • Fetal period: 9th week – birth • Proliferation, Migration • Differentiation of stem cells • Ends in tremendous brain development

  4. Prenatal Environment • Reciprocal influence • Person and environment • Good and bad influences important • Teratogen: Environmental agent • Harms the developing fetus • Critical Period: Organogenesis • Dosage and duration • Genetic make-up: Susceptibility

  5. The critical periods of prenatal development. Teratogens are more likely to produce major structural abnormalities during the third through the eighth prenatal week. Note, however, that many organs and body parts remain sensitive to teratogenic agents throughout the nine-month prenatal period

  6. Teratogens: Drugs • Thalidomide (for morning sickness) • All or parts of limbs missing • Tobacco: Miscarriage, low birth weight, SIDS, slows fetal growth • Cocaine: Processing difficulties

  7. Fetal Alcohol Syndrome (FAS) • Male infant born at term and died at 10 weeks due to a sudden cardiac arrest (see picture at right). The mother's alcohol drinking included   up to a gallon of wine at a time several times a week. The child had hydrocephalus (excess water in the brain) and typical facial features of fetal alcohol syndrome (FAS). The cerebellum (which controls coordination and movement) was "extremely small and poorly shaped (see picture at right)." The brainstem (responsible for processes such as breathing and body temperature) was also grossly malformed.

  8. The photograph at left shows the brain of an infant girl who died at 6 weeks. The mother was categorized as a chronic alcoholic. The child’s head circumference was 27 centimeters at birth and did not grow at all during her 6 weeks of life (normal head circumference is approximately 35 centimeters - about 13 and 3/4 inches).

  9. Fetal Alcohol Syndrome • (A)Characteristic features of a child with fetal alcohol syndrome (FAS).

  10. (B) Child with FAS, illustrating many features in the drawing. Such children may also have cardiovascular and limb defects.

  11. Fetal alcohol effects • One of a spectrum of neurological impairments that can affect a child who has been exposed to alcohol in the womb. • Children with FAE are not as obviously impaired as children diagnosed with Fetal Alcohol Syndrome (FAS) -- usually lack the distinctive FAS facial features and have normal IQs -- and so FAE is sometimes described as less serious. • More likely to have negative outcomes such as trouble with school, trouble with the law and teen pregnancy; • Look "normal" but can't behave that way due to brain damage causes them to face unrealistic expectations without appropriate support. • The term Fetal Alcohol Spectrum Disorder (FASD) is being used more and more to stress the fact that there are a variety of ways in which alcohol can affect a developing child and no particular set of impairments is "better" or "worse."

  12. Teratogens: Environmental Hazards • Radiation: MR, leukemia, cancer, mutations, spontaneous abortions, etc. • Avoid X-rays when pregnant • Pollutants • In air and water • Lead: MR (also postnatally)

  13. The Mother’s State • Age: Typically age 16-35 • 15 or younger don’t seek prenatal care • Birth complications, low birth weight • Over 35: Miscarriage, Down Syndrome • Emotion: Stress can stunt fetal growth • Positive outlook most helpful • Nutrition: 25-35 lb weight gain • Malnutrition: Smaller neurons, brain, child, schizophrenia

  14. The Father’s State • Research limited except for genetic contribution • Father’s age can also be influential • Over 35: Increased number miscarriages, heart defects, Down Syndrome, • Over 50: Higher risk for schizophrenia & bipolar disorder • Exposure to environmental toxins • Radiation, anesthetic gases, pesticides • Damage to genetic material in sperm

  15. The Perinatal Environment • Birth Process: Three step process • Possible Hazards • Anoxia: Oxygen shortage: Can be severe • Complicated delivery • Cesarean(“C”) section • Medications: Can reach baby

  16. Breast or Bottle? • Breast feeding most natural nutrition • Practices vary across cultures • Health benefits great for breast-fed infants • At least first 6 months recommended • More likely to bottle feed: • Younger, low SES, less education, employed, African American • US values toward breast feeding ambivalent

  17. Postnatal Depression • Baby Blues: mild, common • Clinical depression: 1/10 • Previous depression: more common • Children of Depressed Mothers • Insecurely attached, less responsive • Negative to other children

  18. The Father’s Experience • Accepted, expected in delivery rooms • Attend prenatal classes with wife • Experience described as a significant event • Anxiety, stress common during delivery • Relief, pride, joy when baby is born • Sometimes depression following birth • Fathers also need support • Disappointed if sex does not resume soon

  19. Low Birth-Weight Babies • < 5½ pounds: “Small for date” or “preterm” • Leading cause of infant mortality • 8% of all births, 65% of all infant deaths • Factors: Low SES, smoking, stress, multiples • Worse for minority, poverty, single-parent children • For most, significant catch-up growth • Greater risk for blindness, deafness, CP, autism, health problems - especially respiratory problems

  20. Factors Helpful for LBW Infants • Breastfeeding, skin-to-skin contact, massage • Responsive parenting, intellectual stimulation • Early intervention programs work with parents • Childcare education and support • Growth-enhancing home environment • Consistently attentive, responsive parenting

  21. Risk and Resilience • Not all high-risk infants have problems • Werner: Kauai Longitudinalstudy (40 yrs) • Findings: • Effects decrease over time • Outcomes depend on postnatal environment • Protective factors • Personal resources • Supportive postnatal environment

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