Prenatal Development and Birth (Chapter 4)

Agents and conditions that can harm the prenatal brain, impairing the future child's intellectual and emotional functioning

Behavioral teratogen

Not physical but behavioral impairment. A stressed mom may have a collicky baby or the baby may be hard to soothe.

Behavioral teratogen

How do extremities develop?

Cephalocaudal and Proximodistal

Surgical birth more complications after birth

Cesarean section (C-section)

Why has the rate of cesarean sections increased?

Cesareans make scheduling a baby's delivery easier than the unpredictable vaginal birth, and the actual delivery is quicker than a vaginal birth. Cesareans also carry an added bonus for the hospital since they are quite expensive.

What factors increase or decrease the risk of spina bifida?

Data are definitive on a maternal allele that results in low levels of folic acid, which can produce neural-tube defects—either spina bifida, when the tail of the spine is not enclosed properly (in healthy embryos, enclosure occurs at about week 7) or anencephaly, when part of the brain is missing. Neuraltubeefects are more common in certain ethnic groups (Irish, English, and Egyptian) than in others (most Asian and African groups), which led researchers to discover the allele that prevents the normal utilization of folic acid.

What are the differences among a doula, a midwife, and a doctor?

Doulas support laboring women through massage of pressure points, careful timing of contractions, provide encouragement, and do whatever else is helpful. Midwives have training in the birth process and are often as skilled as physicians in delivery. Doctors are licensed and paid more.

(3rd through 8th week) Basic forms of all body structures develop

Embryonic Period

Neural tube develops and it later becomes the brain and spine. Head takes shape and the eyes, ears, nose, and mouth form. The heart begins to pulsate.

Embryonic Period (3rd to 8th week)

Decreased readiness of newborns to nurse

Epidural

Increased risk of cesarean sections

Epidural

Injection in the spine to alleviate pain

Epidural

What is the long-term prediction for the health of a very tiny or vulnerable newborn who survives?

Every developmental milestone--smiling, holding a bottle, walking, talking--is later. They also experience cognitive difficulties as well as visual and hearing impairments. They become infants and children who cry more, pay attention less, disobey, and experience language delays.

2 lbs, 3 oz

Extremely low birthweight

Indicated by test but not actually true and the opposite can happen

False-positive False-negative

(9th week until birth) Fetus grows in size and matures in functioning

Fetal Period

95% of weight is gained in this period

Fetal Period

Neurological sex differences begin

Fetal Period

Flat nose area, flat lips, small eye opening. Cognitive impairments, attention reasoning Lifelong impairments

Fetal-Alcohol Syndrome

the 23rd chromosome pair trigger development of sex organs

From 9th week until birth (the third month)

(1st two weeks after conception) Rapid cell division and beginning of cell differentiation

Germinal Period

First 14 days Begins with fertilization and ends with implantation

Germinal Period

Three main periods of prenatal development

Germinal Period Embryonic Period Fetal Period

What does cephalocaudal mean?

Head-to-tail Top-to-bottom

The process beginning about 10 days after conception

Implantation

What are the results of kangaroo care?

Kangaroo-care newborns sleep more deeply, gain weight quickly, and spend more time alert than do infants with standard care.

Gains 4 1/2 lbs during this time..

Last three months

Includes final maturation of organs (especially heart and brain)

Last three months

Involves expansion and contraction of lungs

Last three months

How do fathers experience pregnancy?

Levels of the stress hormone cortisol correlate between expectant fathers and mothers. Many fathers experience symptoms of pregnancy and birth, including weight gain and indigestion during pregnancy and pain during labor. (couvade)

5 lbs, 8 oz

Low birthweight

What are the differences among LBW, VLBW, and ELBW?

Low birthweight (LBW) is defined as birthweight that is less than 5 ½ pounds (2,500 grams). Babies who weigh less than 3 pounds, 5 ounces (1,500 grams) are classified as very low birthweight (VLBW); those who weigh less than 2 pounds, 3 ounces (1,000 grams) are classified as extremely low birthweight (ELBW).

Digestive and excretory system develop

Middle three months (fetal period)

Fingernails, toenails, buds for teeth form, and hair grows

Middle three months (fetal period)

When someone bangs on the table they are lying on, newborns fling their arms outward then bring them together on their chests, crying with wide-open eyes.

Moro reflex

Feelings of sadness and inadequacy Symptoms from baby blues to postpartum psychosis

Postpartum depression

Born before 38 to 40 weeks

Premature or Preterm

Alcohol is a type of which kind of teratogen? Prenatal or Behavioral

Prenatal

Any agent or condition, including viruses and drugs, resulting in birth defects or complications

Prenatal teratogen

Birth 3 weeks before "full term" at or before 35 weeks?

Preterm

How does the brain develop? Cephalocaudal or Proximodistal?

Proximodistal

When infants are cold, they cry, shiver, and tuck their legs close to their bodies. When they are hot, they try to push away blankets and then stay still.

Reflexes that maintain constant body temperature

The breathing reflex begins even before the umbilical cord, with its supply of oxygen, is cut. Hiccups, sneezes, thrashing (moving the arms and legs about) to escape something that covers the face.

Reflexes that maintain oxygen supply

First pregnancies last how long? What about subsequent pregnancies?

12 hours 7 hours

What is the avg weight of a fetus in the fetal period or the third month?

3 oz, 3 in (remember 3-3-3, 3rd month, 3 oz, 3 in)

What is the desired score for the Apgar scale?

7 or above

Why does risk analysis fail to precisely predict damage to a fetus?

Although all teratogens increase the risk of harm, none always cause damage. The impact of teratogens depends on the interplay of many factors, both destructive and protective, an example of the dynamic-systems perspective.

What are the potential consequences of drinking alcohol during pregnancy?

An embryo exposed to alcohol can develop fetal alcohol syndrome (FAS), which distorts the facial features (especially the eyes, ears, and upper lip). It leads to hyperactivity, poor concentration, impaired spatial reasoning, and slow learning.

Lack of oxygen to the brain

Anoxia

Quick assessment of newborn's heart rate, breathing, muscle tone, color, and reflexes. Completed twice at which minutes? Score of 0,1, or 2 in each category.

Apgar scale... 1 min and 5 min

baby whose weight is lower than expected based on conception date.

Small for Gestational Age

Why is the newborn mortality rate much higher in some countries than in others?

Some do not have access to healthcare.

How does timing affect the risk of harm to the fetus?

Some teratogens cause damage only during a critical period, when a particular part of the body is forming. Because the early days are critical, most obstetricians today recommend that before pregnancy women need to avoid drugs (especially alcohol), supplement a balanced diet with extra folic acid, iron, and other crucial vitamins, and update their immunizations.

Why is it difficult to establish the impact of behavioral teratogens?

Some teratogens cause no physical defects but affect the brain, making a child hyperactive, antisocial, or learning-disabled. Behavioral teratogens can be subtle but their effects may last a lifetime.

How do culture and customs affect one's exposure to teratogens?

Some things such as global warming, HIV, food shortages, wars, nutrition, drug use, and pollution trend in various cultures. Knowing the trend of a certain culture will help prevent one's exposure to such teratogens.

1)When newborns are held upright, feet touching a flat surface, they move their legs as if to walk. 2)When you touch the toes or feet of an infant, they curl their feet and toes upward.

Stepping reflex ; Babinski reflex

When held horizontally on their stomachs, newborns stretch out their arms and legs.

Swimming reflex

What teratogens may harm the fetus's developing body structure?

Teratogens that affect the developing body structure include the following: medicinal drugs, such as lithium, tetracycline, retinoic acid, ACE inhibitors, and thalidomide; psychoactive drugs such as excessive alcohol use, tobacco, marijuana, heroin, cocaine and inhaled solvents; and social and behavioral factors such as very high stress, malnutrition, and excessive, exhausting exercise

When do blood vessels form?

The 4th week

When do the arms and legs form?

The 5th week

How has the Apgar scale increased newborns' survival rate?

The Apgar scale alerts doctors to the condition of a newborn who needs medical attention.

What body parts develop during the embryonic period?

The embryonic period consists of the third through the eighth week after conception (day 14 to day 56). First, a thin line called the primitive streak appears down the middle of the embryo; it will become the neural tube 22 days after conception and eventually develop into the central nervous system (the brain and spinal column). The head appears in the fourth week, a minuscule blood vessel that will become the heart begins to pulsate. By the fifth week, buds that will become arms and legs emerge. The upper arms and then forearms, palms, and webbed fingers grow. Legs, knees, feet, and webbed toes, in that order, are apparent a few days later, each having the beginning of a skeletal structure. Then, 52 and 54 days after conception, the fingers and toes separate. The head develops first, in a cephalocaudal (literally head to tail) pattern, and the extremities form last, in a proximodistal (near to far) pattern.

What impact do fathers have during and after birth?

The father's presence reduces complications, in part because he reassures his woman. When father's acknowledge their role, birth is better for the mother and the child.

What major milestone is reached about halfway through the fetal period?

The fetal period consists of the ninth week after conception up until birth. The sex organs of the fetus start to develop forming either a boy or girl. Organs also become more mature and the fetus reaches age of viability, when it may be able to survive outside the mother's uterus if specialized care is available.

What are three major reasons pregnancy continues months after the fetus could live outside the uterus?

The final three months improves the odds, not only of survival but also of life without disability. In the final three months of prenatal life, the lungs begin to expand and contract, and breathing muscles are exercised as the fetus swallows and spits out amniotic fluid. The valves of the heart go through a final maturation, as do the arteries and veins throughout the body. Among other things, this helps to prevent "brain bleeds," one of the hazards of preterm birth in which paperthin blood vessels in the skull collapse. The fetus usually gains at least 4 ½ pounds during these final three months. By full term, human brain growth is so extensive that the cortex (the brain's advanced outer layers) forms several folds in order to fit into the skull. Simply put, the neurological, respiratory, and cardiovascular systems mature dramatically

What are three major developments in the germinal period?

The germinal period consists of the first two weeks of prenatal development after conception, characterized by rapid cell division and the beginning of cell differentiation. About a week after conception, the cell mass, now called a blastocyst, forms two distinct parts a shell that will become the placenta and a nucleus that will become an embryo. The first task of the outer cells is to achieve implantation--that is to embed themselves in the nurturing lining of the uterus.

What is the most important stage of development?

The middle three months (The fetal period)

How have U.S. LBW rates changed in the past decade?

The rate fell throughout most of the twentieth century, reaching a low of 7.0 percent in 1990. But then it rose again, with the 2010 rate at 8.1 percent. The U.S. rate is higher than that of virtually every other developed nation.

Babies turn their mouths toward anything that brushes against their cheeks--a reflexive search for a nipple--and start to suck.

The rooting reflex

Causes newborns to suck anything that touches their lips--fingers, toes, blankets, and rattles, as well as natural and artificial nipples of various textures and shapes.

The sucking reflex

3 lbs, 5 oz

Very low birthweight

What affects the parent-infant bond?

active involvement in pregnancy, birth, and care of the newborn.

List four reasons a baby might be born LBW.

baby born preterm maternal malnutrition Small for Gestational age (SGA) underweight, under eating, underage, and smoking

Baby is given skin-to-skin contact, hearing mom's heartbeat

kangaroo-care

Unlearned, involuntary action or movement in response to a stimulus

reflex

When can the baby begin to hear?

week 28 (month 7)

Age at which life outside of the womb is possible. What is the minimum amount of weeks?

Age of Viability; 22 weeks

Why are the developmentalists concerned that surgery is often part of birth?

C- sections are warranted in only about 15 percent of births. While they are generally safe, they are performed for convenience's sake. In the case of microsurgery required by some infants in distress, there is concern for the fragile life that is sustained needing long-term, costly care.

What does Proximodistal mean?

Near-to-Far Proximal-to-distal

What do newborns do to aid their survival?

Newborns exhibit reflexes that maintain their oxygen supply, body temperature, and feeding. ● Reflexes that maintain oxygen supply. The breathing reflex begins even before the umbilical cord, with its supply of oxygen, is cut. Hiccups, sneezes, thrashing (moving the arms and legs about) to escape something that covers the face. ● Reflexes that maintain constant body temperature. When infants are cold, they cry, shiver, and tuck their legs close toheir bodies. When they are hot, they try to push away blankets and then stay still. ● Reflexes that manage feeding. The sucking reflex causes newborns to suck anything that touches their lipsfingers, toes, blankets, and rattles, as well as natural and artificial nipples of various textures and shapes. In the rooting reflex, babies turn their mouths toward anything that brushes against their cheeks--a reflexive search for a nippleand start to suck. Swallowing also aids feeding, as does crying when the stomach is empty and spitting up when too much is swallowed quickly. ● Babinski reflex: When newborns are held upright, feet touching a flat surface, they move their legs as if to walk. ● Swimming reflex: When held horizontally on their stomachs, newborns stretch out their arms and legs. ● Palmar grasping reflex: When something touches newborns' palms, they grip it tightly. ● Moro reflex: When someone bangs on the table they are lying on, newborns fling their arms outward then bring them together on their chests, crying with wide-open eyes.

What are the signs of postpartum depression?

One sign is feelings of euphoria after birth that give way to sleeplessness and feelings of sadness and inadequacy. Caring for the infant becomes a burden or seems overwhelming.

When something touches newborns' palms, they grip it tightly.

Palmar grasping reflex

symptoms of pregnancy and birth experienced by fathers

couvade