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PS1040 > Prenatal development and birth > Flashcards

Prenatal development and birth Flashcards

1
Q

how many weeks is a zygote?

A

0-2 weeks

conception to implantation

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2
Q

stages of prenatal development: Embryo

4 temporary organs

A

3-8 weeks: structural development
* neural tube: becomes brain & spinal cord
* amniotic sac: fluid-filled membrane protecting embryo
* placenta: disc-like structure connecting embryo to uterus
* umbilical cord: cord connecting embryo to placenta
provides O2 & nutrients
removes CO2 & waste
* miscarriage risk highest

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3
Q

stages of prenatal development: foetus

A

9-38 weeks: functional development
*birth development
* responds to stimulation
* wk 12: can tell sex
* reflexes develop
* wk 17-20: mother feels movement
* wk 22-26: viability

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4
Q

what are the risks in prenatal development

6 risks

A
  • teratogen: environmental agent that causes prenatal damage
  • effects during critical/sensitive periods
  • effects are specific
  • longer exposure is worse
  • some have no effect on mother
  • maternal/foetal genes may counteract effects
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5
Q

types of teratogens

2

A
  • thalidomide
  • DES
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6
Q

teratogens: thalidomide

effects on 6 different days

A

thalidomide - when started affected outcome. first taken
* day 20 - central brain damage
* day 21 - eye abnormalities
* day 22 - ears/face abnormalities
* day 24 - the arms
* day 28 - leg damage
* day 42 + - no ill effects

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7
Q

teratogens (legal substances): caffiene

A
  • miscarriage, LBW
  • avoid > 200mg
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8
Q

teratogens (legal substances): tobacco

A
  • chemicals in smoke - miscarriage & prematurity
  • nicotine affects placenta - poor nutrition - LBW
  • role of O2
  • potential ADHD
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9
Q

Roza et al. 2007 study on tobacco effects:

2 conclusions

A
  • affects head circumference
  • affects biparital measurement

BPD - from skull bone to skull bone

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10
Q

teratogens (legal substances): alcohol

A
  • Foetal alcohol syndrome (FAS):
    • stunted growth
    • physical changes
    • often mental retardation
      • foetal alcohol spectrum disorder (FASD)
    • role of O2
    • last trimerster worst
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11
Q

foetal alcohol syndrome in the UK stats:

A
  • 17% of UK children have symptoms consistent with FASD

McQuire et al., 2019

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12
Q

Teratogens: Environmental Toxins

A

radiation (nuclear meltdowns, ordinary x-rays)
* miscarriage
* stunted growth
* physical defects
* cancer
pollution (lead, mercury)
* prematurity
* LBW
* cognitive delays

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13
Q

Teratogens: Air pollution & brain development

why is it hard to establish casual links?

A
  • objective measure of brain development (e.g. use of self-report q’s, sample selection etc.)
  • what is precise exposure
  • most vulnerable ages particularly hard to study
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14
Q

Teratogens: Air pollution & brain development

experiment in mice

A
  • in mice - structural brain abnormalities
  • direct action
    • exposure to directly teratogenic substances
  • indirect action
    • reduced O2 availability

Sunyer & Dadvand, 2018

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15
Q

Teratogens: Infectious Disease

TORCH

A
  • Toxoplasmosis
  • Other virsus
  • Rubella
  • CMV
  • Herpes
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16
Q

Toxoplasmosis

A

parasitic infection in cats & raw meat
* brain & eye damage

17
Q

Other viruses

A

e.g. HIV & AIDS
* mortality, small head, physical & mental defects

18
Q

Rubella

A

virsus damages eyes, ears, heart
* causes mental retardation

19
Q

CMV

A

virus with mild (or no) flu-like symptoms

20
Q

Herpes

A

sexually-transmitted virus
* damages eyes, brain, motor system

21
Q

Teratogens: Infectious Diseases (2)

Zika Virus

A

mosquito-bourne infection, identified in Uganda -> 2016 epidemic: Asia, South America
* mild fever in mother
* casual link to infant microcephaly (small brain) confimed (2016)
* infects foetal brain tissue
* no vaccine (yet)
* lifelong sensory, motor & cognitive diability

22
Q

Other Risks: Maternal Factors

age

A

age
* fertility problems increase w/ age
* miscarriage & chromosomal damage increases w/ age
* teen moms at risk

23
Q

Other Risks: Maternal Factors

nutrition

A
  • weight gain
  • affected by ethnicity and SES
  • folic acid: neural tube defects
    • Spina Bifida
    • Aencephaly
24
Q

Other Risks: Maternal Factors

prenatal care & health

A

toxemia/pre-eclampsia:
* pregancy-caused high blood pressure - restricted growth, preterm birth, stillbirth
* (gestational) diabetes - high birth weight, preterm birth, temporaty breathing problems

25
Q

Perinatal complications: Prematurity

36 weeks

A

preterm: < 36 wks
* avg weight: 2.3 kg (5 lb)
* risk of cognitive delay
* appropriate weight for pregnancy length

26
Q

Perinatal complications: Prematurity

32 weeks & 26 weeks

A

very preterm: < 32 wks
extremely preterm: < 26 wks
* inadequate surfactant (liquid in lungs that sends O2 into blood)
* may cause respiratory distress syndrome
* risk factors - only evident in half of cases

27
Q

Perinatal complications: Low Birth Weight

A

small-for-date
* full-term or preterm
* BELOW expected weight for pregancy length
* normal birth weight is approx. 3.5 kg (7.7 lb)

28
Q

Low Birth Weight (LBW)

A

< 2.5 KG (5.5 lb)

29
Q

Very Low Birth Weight (VLBW)

A

< 1.5 kg (3.3 lb)

30
Q

Extremely Low Birth Weight (ELBW)

A

< 1.0 kg (2.2 lb)

31
Q

can LBW babies catch up?

A

yes, most catch up by 4 years but:
* can have motor & cognitive problems longer term

32
Q

Stimulation Programmes for Preterm Babies

A
  • Used to be isolated to protect health
  • But under-stimulation delays development
  • mimics sensation of the womb
33
Q

The Breathing Bear with Preterm Infants

who was the study run by?

A

Thomas et al., 1995

34
Q

The Breathing Bear with Preterm Infants

what was investigated?

A

the sleep/wake states of preterm babies

35
Q

The Breathing Bear with Preterm Infants

method

A
  1. At 33 wks conceptual age (CA), babies were randomly assigned to a Breathing Bear (BB) or a Non-Breathing (NB) Bear
    condition
  2. At 35 wks CA, behavioral observations were made over a 2-hr period, recording babies’ sleep/wake states: active sleep, quiet sleep, sleep-wake transition,waking, or fuss/crying.
  3. movements and startles were also measured
36
Q

The Breathing Bear with Preterm Infants

results

A
  • BB bear babies showed less waking, more quiet sleep, fewer startles in quiet sleep, and less crying.
  • BB babies were more likely to smile than grimace during active sleep, whereas NB babies had the opposite pattern
37
Q

Massage Stimulates Growth in Preterm Infants

Field, 1990

A

Preterm infants were assigned to treatment and control groups.
* Treatment infants received three 15-min massages daily for 10 days.
* Control infants received no massage.
* Treated infants gained more weight per day
* Discharged from hospital several days earlier than control infants.

38
Q

parent interventions

why are preterm babies likely to get less sensitive care?

A

preterm babies need even more sensitive care than full-term babies, but likely to get even less senstivie care due to:
* physical appearance
* high-pitched cry
* feeding difficulties
* lower responsiveness
* hospital or home-based interventions aim to improve parent-infant interaction

39
Q

parental interventions

effectiveness of interventions: what does it depend on (5 factors)

A
  • Nature of intervention (e.g., massage, maternal sensitivity, infant self- regulation)
  • Infant charecteristics (e.g., how preterm, how stable/healthy otherwise)
  • intervention duration and/or intensity
  • Length of follow-up (e.g., 6 months, 9 years)
  • Outcome measures (e.g., physical dev., cognitive dev., atttion, behaviour problems)

PS1040 (10 decks)

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