Prenatal Developmental Concerns Flashcards
What are determinants of intra-uterine growth and birth weight?
Infant sex
Ethnicity/race
Maternal height
Pregnancy weight
Alcohol consumption
Pregnancy height and weight
Maternal birth weight
Parity (the more pregnancies you have the better the following pregnancies are)
Gestational weight gain
Prior low birth weight infant
Caloric intake
Cigarette smoking
Pregnancy height and weight
Tobacco chewing
Maternal age (indirect)
SES (indirect)
What are characteristics of Low birth weight babies?
Full term infants @10th percentile birth weight = 2.5x risk of mortality
Birth weight <2500 gm (5lbs 8oz) is classified as low birth weight
Two distinct groups:
-pre-term
- small-for-date, small for gestational age (SGA)
Pre-term= physiological immaturity
SGA display intrauterine growth retardation or fetal growth restriction
What effect does low birth weight have on growth?
low birth weight has significance for postnatal growth:
- shorter status during childhood and at maturity and
- Possible deficiencies in neuromuscular coordination and power
What are the most common causes of spontaneous abortions?
Faulty or incompatible gametes
What is the percentage of clinically recognized pregnancies that end in a miscarriage (loss prior to week 20)?
10-25%
What are causes of miscarriage?
Maternal age
Illness
Lifestyle
Trauma
What are congenital malformations?
Indicates an abnormal condition present at birth
It does not specify the what or why
Causal factors can be both genetic and environmental
Which period is most critical with respect to genetic malformations?
Period of the embryo
What is crucial in congenital malformations? What are causal agents of congenital malformation?
Timing is crucial
Trauma, chemicals or therapeutic drugs
Radiation, infections, hypoxia
Maternal metabolic imbalances
Maternal substance abuse
What factors is prenatal nutrition related to?
Placental
Fetal and
Maternal factors
The effects of prenatal nutrition are determined by what?
The timing, persistence and degree of nutritional inadequacy
What do placental nutrition factors relate to?
Circulation and the transport of nutrients from placenta to fetus
What do fetal nutritional factors relate to?
The utilization of available nutrients
What do the maternal nutritional factors relate to?
Mother’s overall nutritional status
Especially the adequacy of energy and nutrient intake and weight gain during pregnancy
What are teratogens?
Defined as an environmental agent that causes harm to the embryo or fetus
The amount of harm a teratogen can cause is a function of what?
Baby’s genetic makeup
Amount of exposure
Time/duration of exposure
What is the effect of maternal smoking?
Effects on prenatal growth determined by number of cigarettes smoked daily
Dose response, deficits in weight and length range from:
70g, 0.7 cm ==> 9 cigarettes daily
210g, 1.0cm ==> 20 cigarettes daily
Effects on physical development continue postnatally
What is maternal alcohol consumption associated with?
fetal growth restriction
abnormal facial development
impairment of the CNS
Dose - response effect:
=<2 drinks per day = 65g weight loss
>= 2 drinks per day= 150g weight loss
What are the characteristics of maternal exercise?
Moderate PA:
Has no negative effect on fetal development
Benefits from the mother are well documented
Guidelines are well established
What are the guidelines for exercise during pregnancy?
Same as before
Avoid HIIT
Stay in a thermoregulated environment
Stay under 60-80% of MaxHR
If person was not active before the pregnancy, it is not the time to start
What is the fetal origins of adult disease hypothesis?
Originated by Dr. David Barker
“events that happen very early in fetal development can have a profound impact on the risk for incurring disease as an adult
Implications of FOAD extend beyond LBW babies to include nutritional and non nutritional stress during different periods of development
What are some gene based disorders?
Phenylketonuria (intellectual disability, seizures, behavioral problems, mental disorders, musty odor)
Cystic fibrosis
Sickle-cell disease and trait
When can genetic testing be done and what does it include?
Can be done at multiple points throughout pregnancy
Includes: fetal ultrasound and maternal blood testing
What can genetic testing screen for?
Cystic fibrosis
Duchenne muscular dystrophy
Polycystic kidney disease
Sickle cell disease
Tay-sachs disease
Thalassemia
Down syndrome
What are lifespan reflexes versus infant reflexes?
Most Infant reflexes will disappear by the end of the first year (i.e. sucking reflex, labyrinthine reflex, etc..)
Lifespan reflexes: knee jerk reflex, flexor withdrawal
What are primitive reflexes?
Reflexes that dominate the first 6 months
Role is to ensure survival
What are the characteristics of primitive reflexes?
Produced subcortically
Occur in all normal developing newborns
Appear during gestation and at birth to 6 months
Used predominantly for protection, nutrition or survival
Where are postural reflexes produced?
Cortically, higher brain centers
some are considered direct precursors to complex movement
Which reflexes are commonly used for diagnosis of neurological conditions?
Moro reflex
Asymmetrical tonic neck reflex
Monitoring motor function:
- milani Comparetti Neuromotor Development
- Primitive Reflex Profile
What are stereotypies?
rhythmic, patterned, centrally controlled movement behavior of infancy apparently not learned through imitation or a consequence of external stimuli
Can be exhibited in lower or upper extremities, head and neck, torso
Number of stereotypies and frequency of occurrence is greatest from 2-42 weeks and then diminishes.
What is the purpose of stereotypies?
Uncertain
could be calming, practice?
