PSYCH 212 Chapter 4 Notes
PSYCH 212 Chapter 4 Notes Psych 212
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This 12 page Class Notes was uploaded by Julie Notetaker on Saturday May 28, 2016. The Class Notes belongs to Psych 212 at Pennsylvania State University taught by Dr. Hunt in Summer 2016. Since its upload, it has received 7 views. For similar materials see Developmental Psychology in Psychlogy at Pennsylvania State University.
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Date Created: 05/28/16
Symptoms of pregnancy Tender, swollen breasts or nipples o Increased production of the female hormones estrogen and progesterone stimulates breast growth to prepare for producing milk (most noticeable in first pregnancy) Fatigue, need to take extra naps o Woman’s heart pumping harder and faster to produce extra blood to carry nutrients to the unborn baby o Stepped up production of hormones takes extra effort o Progesterone depresses central nervous system and may cause sleepiness o Concerns about pregnancy may sap energy Slight bleeding or cramping o Implantation bleeding may occur 10-14 days after fertilization when fertilized ovum attaches to lining of uterus o Women have cramps as the uterus begins to enlarge Nausea with or without vomiting o Rising levels of estrogen produced by placenta and fetus cause stomach to empty more slowly o Heightened sense of smell may trigger nausea in response to certain odors, such as coffee, meat, dairy products, or spicy foods o Morning sickness may begin as early as 2 weeks after conception, but usually around 4-8 weeks, and may occur at any time of day Food cravings o Hormonal changes may alter food preferences, especially during first trimester, when hormones have greatest impact Frequent urination o Enlarging uterus during first trimester exerts pressure on the bladder Frequent, mild headaches o Increased blood circulation cause by hormonal changes may bring on headaches Constipation o Increase in progesterone may slow digestion, food passes more slowly through intestinal tract Mood swings o Flood of hormones early in pregnancy can produce emotional highs and lows Faintness and dizziness o Lightheaded feeling may be triggered by blood vessel dilation and low blood pressure, also triggered by low blood sugar Raised basal body temperature o Basal body temperature (taken first thing in the morning) normally rises soon after ovulation each month and then drops during menstruation. When menstruation ceases, temperature remains elevated Prenatal development Gestation: period of development between conception and birth o Normal range is between 37 and 41 weeks Gestational age: age of an unborn baby, usually dated from the first day of an expectant mother’s last menstrual cycle Prenatal development takes place in 3 stages: germinal, embryonic, and fetal o During these stages of gestation, the fertilized ovum, or zygote, grows into an embryo and then a fetus o There are genes that produce molecules called morphogens, which are switched on after fertilization and begin sculpting arms, hands, fingers, vertebrae, ribs, brain, and other body parts Cephalocaudal principle: principle that development proceeds in a head-to-tail direction; that is, that upper parts of the body develop before lower parts of the trunk o An embryo’s head, brain, and eyes develop earliest and are disproportionately large until the other parts catch up o At 2 months of gestation, the embryo’s head is half the length of the body. By the time of birth, the head is only ¼ the length of the body but is still disproportionately large Proximodistal principle: principle that development proceeds from within to without, that is, that parts of the body near the center develop before the extremities Average development o 1 month Growth is more rapid than any other time during prenatal or postnatal life. Embryo reaches a size 10000x greater than the zygote, measuring about ½ inch in length Blood flows through veins and arteries. Miniscule heart beats 65x per minute Already has brain, kidneys, liver, and digestive tract. The umbilical cord is working Under a microscope, it is possible to see swellings of the head that eventually become eyes, ears, mouth, and nose. Sex cannot be detected o 7 weeks Fetus is less than 1 inch long and weighs only 1/13 an oz. Head is half its body length Facial parts developed, with tongue and teeth buds. Arms have hands, fingers, and thumbs. Legs have knees, ankles, and toes Fetus has a thin covering of skin and can make handprints and footprints Bone cells appear at 8 weeks Brain impulses coordinate the function of the organ system Sex organs developing and heartbeat is steady. Stomach produces digestive juices. Liver produces blood cells. Kidneys remove uric acid from the blood Skin is sensitive enough to respond to tactile stimulation If an aborted 8 week old is stroked, it reacts by flexing its trunk, extending its head, and moving back its arms o 3 months Fetus weighs about 1 oz. and measures 3 in in length Fingernails, toenails, eyelids, vocal cords, lips, and a prominent nose Sex easily detected Organ systems functioning, fetus can breathe, swallow amniotic fluid into lungs and expel it, and occasional urinate Ribs and vertebrae have turned into cartilage Can move legs, feet, thumbs, and head. Mouth can open, close and swallow. Squints if eyelids are touched, makes fist if palm is touched, suck if lip is touched, fan out toes if sole is touched. These reflexes present at birth but disappear during first months of life o 4 months Head is only ¼ body length, same proportion at birth Fetus measures 8-10 inches and weighs about 6 oz. Umbilical cord as long as fetus and will continue to grow with it Placenta fully developed Mother may feel fetus kickingrdcalled quickening Reflexes that appeared in 3 month are brisker because of increased muscular development o 5 months Weighs 12 oz.- 1 lb. and measuring about 1 ft. Begins to show signs of individual personality, sleep-wake patterns, favorite place in uterus called lie, and becomes more active in kicking, stretching, squirming, and hiccupping Possible to hear heartbeat when placing ear to mother’s abdomen Sweat and sebaceous glands functioning. Respiratory system not adequate enough to sustain life outside womb; baby born now does not usually survive Coarse hair has begun to grow for eyebrows and eyelashes, fine hair is on head, and wooly hair called lanugo covers body o 6 months Rate of fetal growth has slowed; fetus is about 14 inch long and weighs 1 ¼ lbs. Fat pads under skin Eyes are complete, opening, closing, and looking in all directions Can hear and can make fist with a strong grip Fetus born has slight chance of survival because breathing apparatus has not matured o 7 months Fetus about 16 in long and weighing 3-5 lbs. Fully developed reflex patterns Cries, breathes, swallows, and may suck thumb Lanugo may disappear or may remain shortly after birth. Head hair continues to grow Chances that a fetus weighing at least 3 ½ lbs. will survive are good. Probably kept in an isolate until 5 lbs. o 8 months 18-20 in long and weighs between 5-7 lbs. Living quarters cramped and movements curtailed During this month and the next, a layer of fat develops over the fetus’s entire body, which enable it to adjust to varying temps outside the womb o 9 months About a week before birth, the fetus stops growing, at an average of 7 ½ lbs. 20 in, boys tend to be longer and heavier than girls Fat pads continue to form, organ systems are operating more efficiently, heart rate increases, more wastes expelled through umbilical cord Reddish color so kin fading At birth the fetus will have been in womb for about 280 days Germinal stage: first 2 weeks of prenatal development, characterized by rapid cell division, increasing complexity and differentiation, and implantation in the wall of the uterus o Within 36 hours after fertilization, the zygote enters a period of rapid cell division and duplication, or mitosis. 72 hours after fertilization, it has divided into 16-32 cells; 96 hours after, it has 64 cells o While the fertilized ovum is dividing, it is making its way down the fallopian tube to the uterus, 3-4 days o Blastocyst: new form of the fertilized ovum, it is a fluid filled sphere which floats freely in the uterus until the 6 day after fertilization, when it begins to implant itself in the uterine wall o Implantation: the attachment of the blastocyst to the uterine wall, occurring at about day 6. Only 10-20% of fertilized ova complete implantation Where the egg implants will determine the placement of the placenta o As cell differentiation begins, some cells around the edge of the blastocyst cluster on one side to form the embryonic disk, a thickened cell mass from which the embryo begins to develop Ectoderm: upper layer of embryonic disk, will become the outer layer of skin, the nails, hair, teeth, sensory organs, and nervous system Endoderm: inner layer of embryonic disk, will become the digestive system, liver, pancreas, salivary glands, and respiratory system Mesoderm: middle layer or embryonic disk, will become inner layer of skin, muscles, skeleton, and excretory and circulatory systems o Amniotic cavity/ amniotic sac: fluid filled membrane that encases the developing embryo, giving it room to move Outer layers are amnion and chorion o Placenta: contains both maternal and embryonic tissue, develops in uterus to allow oxygen, nourishment, and wastes to pass between mother and embryo Umbilical cord: Nutrients from the mother pass from her blood to the embryonic blood vessels and are then carried, via the umbilical cord, to the embryo. In turn, blood vessels in the umbilical cord carry embryonic wastes to the placenta, where they can be eliminated by maternal blood vessels Mother’s and embryo’s circulatory systems are not directly linked, instead the exchange occurs by diffusion across the blood vessel walls Placenta helps to combat internal infection and gives unborn child immunity to various diseases. Produces the hormones that support pregnancy, prepare the mother’s breasts for lactation, and eventually stimulate the uterine contractions that will expel the baby from the mother’s body Embryonic stage: second stage of prenatal development (2-8 weeks), characterized by rapid growth and development of major body systems and organs o Organogenesis: development of the respiratory, digestive, and nervous systems o Critical period when the embryo is most vulnerable to destructive influences in prenatal environment. Any organ system that is developing at the time of exposure is likely to be infected o Most defective embryos usually do not survive beyond 1 trimester Fetal stage: final stage of prenatal development (8 weeks-birth), characterized by increased differentiation of body parts and greatly enlarged body size o First appearance of bone cells o Fetus grows to about 20x normal length, organs and body systems become more complex, and fetus puts on a layer of fat in preparation for birth. Right up until birth, fingernails, toenails, and eyelids continue to develop o Fetuses breathe, kick, turn, flex their bodies, do somersaults, squint, swallow, make fists, hiccup, and suck their thumbs o Flexible membranes of uterine walls and amniotic sac, permit and stimulate limited movement o Fetuses can feel pain but it is unlikely before 3 trimester o Ultrasound: prenatal medical procedure using high frequency sound waves to detect the outline of a fetus and its movements, used to determine whether a pregnancy is progressing normally Other instruments can monitor heart rate, changes in activity level, states of sleep and wakefulness, and cardiac reactivity o Males, regardless of size, are more active and tend to move more vigorously than females o Fetus swallows and inhales substances that cross the placenta, these substances may stimulate the senses of taste and smell and may contribute to development of organs need for breathing and digestion Early exposure to different flavors may influence later taste preferences Mature taste cells appear at 14 weeks. And olfactory system is developed before birth o Fetuses respond to mother’s voice and heartbeat and vibrations of her body, suggesting that they can hear and feel. Responses begin at 26 weeks and reach plateau at 32 weeks Hungry infants, turn toward the breast in the direction they hear the mother’s voice. Thus familiarity with the mother’s voice may help newborns locate the source of food Fetuses nearing full term recognize mother’s voice and native language o Fetuses seem to learn and remember One experiment showed 3-day-old infants sucked more on a nipple that activate the recording of a story their mother had read aloud during last 6 weeks of pregnancy than did nipples that activated other recordings. A control group that had not read a story showed no preference Newborns prefer mother’s voice to other women, female voices to male voices Recognition of smell Spontaneous abortion: natural expulsion from the uterus of a embryo that cannot survive outside the womb, also called a miscarriage o ¼ pregnancies result in miscarriage, maybe even ½ since most women miscarriage before they know they are pregnant o ¾ of miscarriages happen in first trimester o Most miscarriages happen from abnormal pregnancies. 50-70% involve chromosomal abnormalities and happen early. Smoking, drinking, and drug use increases chances of miscarriage later in pregnancy o Males are more likely than females to be miscarried or stillborn. More die early in life and at every age they are more susceptible to many disorders o Stillborn: dead at or after the 20 week of gestation o Mourning a miscarriage Mizuko kuyo: Japanese ritual observed as a means of making amends to lost life. Small statues of infants are left as offering to Jizo, an enlightened being who watches over miscarried and aborted fetuses and guides them to a new life Mizuko means, “Water child”. Japanese Buddhists think that life flows into an organism gradually and a mizuko is somewhere on the continuum between life and death In English, friends, families, and professionals tend to avoid talking about such losses, which may seem insignificant compared with the loss of a living child Grief is worse without social support and people who ignore the subject make it hard for families to get the help they need Woman may feel inadequate, angry at herself of spouse, guilt, or anxious Children in the family blame themselves, especially if they had negative feelings about the birth Men may not have been as focused on pregnancy and don’t have their body as a reminder. This may cause tension in the relationship One study showed that grieving parents found friends and family most helpful and the doctors least helpful Adjustment to a pregnancy loss may be eased if parents are allowed to see and hold their deceased baby, which is often not possible Environmental influences o Teratogen: environmental agent, such as a virus, drug, or radiation, that can interfere with normal prenatal development and cause developmental abnormalities A substance may be risky for some fetuses but not for others. Vulnerability may depend on a gene in the fetus or mother Transforming growth factor alpha: variant of growth gene, have greater risk of developing cleft palate if the mother smokes while pregnant o Maternal weight Pregnant women need 300-500 additional calories/day, including extra protein Women of normal weight and body build who gain 16-40 lbs. are less likely to have complications in birth 1/3 of mothers gain more or less than recommended amount Not gain enough o Baby may suffer growth retardation in womb, be born prematurely, experience distress during labor, or to die at or near birth o Puts children at risk for later obesity, by setting metabolism to be thrifty Gain too much o Large baby that must be induced or C-section o Baby likely to be overweight in life Pre-pregnancy BMI Overweight or obese o Longer deliveries, more health care services o Infants with birth defects o Miscarriage o Difficulty inducing labor, greater likelihood of C-section Nutrition Newborns whose mothers ate fish high in DHA showed more mature sleep patterns and were more attentive at 12 and 18 months Folic acid, or folate, is very important to prevent anencephaly and spina bifida, neural-tube defects o In US enrichment of grains with folic acid has been mandatory since 1998 o Women encouraged to take folate supplements and eat lots of fruits and vegetables before becoming pregnant Vitamin D deficiency during pregnancy in women with a gene variant called DRB1*1501 may increase risk of child developing multiple sclerosis later in life o Malnutrition In Gambia, people born during the hungry season, when harvests are depleted, are 10x more likely to die in early adulthood In UK, children whose mothers had low vitamin D late in pregnancy, showed low bone mineral content at age 9, increasing risk of osteoporosis Link between malnutrition and schizophrenia Malnourished women who take dietary supplements while pregnant tend to have bigger, healthier, more active, and visually alert babies Women who take zinc supplements are less likely to have babies with low birth weight and small head circumference Supplements make infants grow more rapidly and less likely to be anemic o Physical activity Moderate exercise at any time during pregnancy does not endanger the fetus of healthy women Regular exercise helps prevent constipation, improves respiration, circulation, muscle tone, and skin elasticity, all of which contribute to a more comfortable pregnancy and safer delivery Employment during pregnancy entails no specific hazards Strenuous working conditions, occupational fatigue, and low working hours associated with premature birth Safest for women to exercise moderately, not raising their heart rate above 150, and to taper off at the end of each session than to stop abruptly o Drug intake Drugs cross the placenta Medical drugs Thalidomide: banned in 60s after it caused stunted or missing limbs, severe facial deformities, and defective organs in 12000 babies Harmful: tetracycline, certain barbiturates, opiates, and other central nervous system depressants, several hormones including diethylstilbestrol and androgens, certain anticancer drugs such as methotrexate, Accutane (drug for acne), drugs for epilepsy, several anti-psychotic drugs Angiotensin-converting enzyme ACE inhibitors and nonsteroidal anti-inflammatory drugs NSAIDs such asstaproxen and ibuprofen have been linked to birth defects when taken from 1 trimester on AAP Committee on Drugs recommends that no medication be prescribed for a pregnant or breast feeding woman unless it is essential for her health or her child’s Psychotropic medications should be withdrawn prior to conception when practical o Infants whose mothers took antidepressants during pregnancy show signs of disrupted neurobehavioral activity and are at increased risk of respiratory failure o Certain antipsychotic drugs like lithium have serious effects such as withdrawal symptoms at birth o Psychotropic drugs in can be found in breast milk of lactating women. Concentration low and little effect on infants Alcohol Fetal alcohol syndrome FAS: combination of mental, motor, and developmental abnormalities affecting the offspring of some women who drink heavily during pregnancy o 5/1000 infants born in US suffer from FAS o Retarded growth, facial and bodily malformations, and disorders of the central nervous system o Reduced responsiveness to stimuli, slow reaction time, reduced visual acuity, shortened attention span, distractibility, restlessness, hyperactivity, learning disabilities, memory deficits, and mood disorders, including aggressiveness o Children are less likely to develop behavior and mental health problems if they are diagnosed early and reared in nurturing environments Prenatal alcohol exposure is most common cause of mental retardation and leading preventable cause of birth defects in US Risk factor for development of drinking problems and alcohol disorders in young adulthood The more the mother drinks, the greater the effects Moderate or heavy drinking disturbs an infant’s neurological and behavioral functioning, and this may affect early social interaction with mother, which is vital for emotional development Heavy drinkers are likely to have babies with reduced skull and brain growth Alcohol becomes concentrated in breast milk, and can inhibit milk production Breastfeeding should be avoided for 2 hours after a small drink Nicotine Low birth weight babies Miscarriage, growth retardation, stillbirth, small head circumference, sudden infant death, colic, hyperkinetic disorder (excessive movement), Long-term respiratory, neurological, cognitive, and behavioral problems Caffeine Not a teratogen for human babies A study of women who consumed 2 coffees or 5 sodas daily had twice the risk of miscarriage as those with no caffeine Four or more cups a day is related to increased risk of sudden death in infancy Marijuana Heavy marijuana use can lead to birth defects, low birth weight, withdrawal like symptoms at birth, and increased risk of attention disorders and learning problems later in life 2 longitudinal studies showed that marijuana was associated with impaired attention, impulsivity, and difficulty in use of visual and perceptual skills after age 3, suggesting that drug may affect functioning of brain’s frontal lobes Cocaine Spontaneous abortion, delayed growth, premature labor, low birth weight, small head size, birth defects, impaired neurological development, and mild cognitive Newborns show acute withdrawal and sleep disturbances High prenatal exposure associated with childhood behavioral problems Some states have taken action against suspected mothers that use cocaine Some studies have not found any connection between cocaine exposure and physical, motor, cognitive, emotional, or behavior deficits that could not be attributed to other risk factors Methamphetamine Low birth weight and be too small for gestational age, associated with fetal growth restriction Fetal welfare vs mother’s rights US Supreme Court invalidated a SC hospital policy that made it alright to test a woman’s urine for drugs without her knowledge and report the results to police 2003 A SC woman was convicted of homicide and sentenced to 12 years in prison after her stillborn babies autopsy revealed cocaine. SC Supreme Court upheld conviction and US Supreme Court declined to hear an appeal At least 36 states have enacted fetal homicide laws, and 19 of these laws apply to the earliest stages of pregnancy Unborn Victims Act of 2004in response to murder of a pregnant woman that also took life of her unborn son Opponents say that jailing a pregnant woman cannot undo the damage done to the fetus and that mother’s with a drug problem need treatment, not prosecution Jan 2004, Melissa Ann Rowland was charged with murder of one of her newborn twins, who was born dead. She had refused the doctor’s recommendation that she have a C-section until it was too late. The second child was born with cocaine and alcohol in system and was adopted Woman’s rights advocates say that this reflects a view that women are just vehicles for carrying offspring and not persons in their own right Could hurt doctor patient relationship and cause women to avoid doctors and not get prenatal care they need o Maternal illness Acquired immune deficiency syndrome AIDS: viral disease that undermines effective functioning of the immune system Caused by human immunodeficiency virus HIV Perinatal transmission: virus may cross over to the fetus’s bloodstream through the placenta during pregnancy, labor, or delivery, or after birth through breast milk o Biggest risk factor is a mother who is unaware she has HIV o Risk reduced by C-section, especially when woman has not received antiretroviral therapy, and by alternatives to breast feeding Rubella (German measles) th If contracted before 11 week of pregnancy, almost certain to cause deafness and heart defects in baby Vaccine is now administered to children and infants Toxoplasmosis: caused by a parasite harbored in the bodies of cattle, sheep, and pigs and in the intestinal of cats, typically produces either no symptoms or symptoms like those of a common cold In pregnant women, especially in 2 ndand 3 trimester, it can cause fetal brain damage, severely impaired eyesight or blindness, seizures, miscarriage, stillbirth, or death of baby If baby survives, there may be later problems such as eye infections, hearing loss, and learning disabilities Treatment with antiparasitic drugs during first year of life can reduce brain damage and eye damage Mothers should not eat raw or very rare meat, should wash all hands and work surfaces after touching raw meat, should peel or wash raw fruits and vegetables, and should not dig in a garden where cat feces may be buried Women who have a cat should have it checked for the disease, not feed it raw meat, and have someone else empty the litter box Diabetes Offspring of mothers with diabetes are 3-4x more likely than offspring of other women to develop a wide range of birth defects Research on mice suggests that high blood glucose levels, deprive the embryo of oxygen, resulting in cell damage, during first 8 weeks of pregnancy when its organs are forming Women with diabetes need to be sure blood glucose levels are under control before becoming pregnant Use of multivitamin supplements during the 3 months before conception and the first 3 months of pregnancy can help reduce risk of diabetes associated birth defects o Maternal Anxiety and stress Some tension and worry are normal and do not increase risk of birth complications such as low birth weight. Moderate anxiety may even spur organization of the developing brain In a series of studies, 2 year olds whose mothers showed moderate anxiety midway through pregnancy showed higher on measures of motor and mental development than age mates whose mothers had not shown anxiety during pregnancy A mother’s anxiety has ben associated with an 8-month-old’s inattentiveness during a developmental assessment and a preschooler’s negative emotionality or behavioral disorders in early childhood One study, pregnant women whose partners or children died or were hospitalized for cancer or heart attacks were at elevated risk of giving birth to children with malformations, such as cleft lip, cleft palate, and heart malformations Stress before conception may have long term effects When female rats were subjected to ongoing, unpredictable stressors, such as 24 hour isolation, food and water deprivation, constant light, crowding, and electric shocks for 7 days before being mated, their adult offspring engaged in less social interaction and more fearful than the offspring of a control group o Maternal Age Birthrates of US women in 30s and 40s are at highest levels since 1960s, associated with fertility treatments (history graded influence) The risk of miscarriage or stillbirth rises with maternal age, reaching 90% for women 45 or older Women over 30-35 are more likely to experience complications due to diabetes, high blood pressure, or severe bleeding and are at higher risk of premature delivery. Babies more likely to show retarded growth, birth defects, and chromosomal abnormalities, such as Down syndrome Due to widespread screening of older women, fewer malformant infants are born nowadays Adolescents tend to have premature or underweight babies. Heightened risk of death in 1 month, disabilities, or health problems o Outside environmental hazards Pregnant women who regularly breathe air that contains high levels of fine combustion related particles are more likely to bear infants that are premature or undersized or have chromosomal abnormalities Exposure to high concentrations of disinfection by products is associated with low birth weight and slowed fetal growth Women who work with chemicals used in manufacturing semiconductor chips have about twice the rate of miscarriage as other female workers Women exposed to DDT have more preterm births The insecticides, chlorpyrifos and diazinon have caused stunting of prenatal growth 33% increase risk of nongenetic birth defects among families within 2 miles of hazardous waste sights Fetal exposure to low levels of environmental toxins, such as lead, mercury, and dioxin as well as nicotine and ethanol, may help explain sharp rise in asthma, allergies, and autoimmune disorders such as lupus A longitudinal study of a cohort of children born in NYC, where prevalence of asthma is among highest in US, children exposed to polycyclic aromatic hydrocarbons emitted by carbon containing fuels were at heightened risk of developing asthma symptoms by age 5 Childhood cancers, like leukemia, have been linked to pregnant mothers’ drinking chemically contaminated groundwater and use of home pesticides Infants exposed prenatally even to low levels of lead, especially during 3 trimester show IQ deficits during childhood Women who have routine dental X-rays triple risk of having full term low birth weight babies In utero exposure to radiation 8-15 weeks after fertilization has been linked to mental retardation, small head size, chromosomal malformations, Down syndrome, seizures, and poor performance on IQ tests and in school Paternal factors o A man’s exposure to lead, marijuana or tobacco smoke, large amounts of alcohol or radiation, DES, pesticides, or high ozone levels may result in abnormal or poor quality sperm o Offspring of male workers at a British nuclear processing plant were at elevated risk of being born dead o Diagnostic X-rays within the year prior to conception or high lead exposure at work tend to have low birth weight and slowed fetal growth o Men who smoke have increased likelihood of transmitting genetic abnormalities o A pregnant woman’s exposure to father’s secondhand smoke has been linked with low birth weight, infant respiratory infections, sudden infant death, and cancer in childhood and adulthood o Study of nonsmoking mothers In NYC, exposure to both paternal smoking and urban pollution resulted in 7% reduction in birth weight and 3% reduction head circumference o Older fathers source of birth defects due to damaged or deteriorated sperm Advancing paternal age is associated in increases in risk of several conditions, including dwarfism May be linked to schizophrenia, bipolar disorder, autism and related disorders Prenatal assessment techniques Ultrasound (sonogram): high frequency sound waves directed at the mother’s abdomen produce a picture of a fetus in uterus. o Sonoembryology: uses high frequency transvaginal probes and digital images processing to produce a picture of embryo in uterus Can detect unusual defects during embryonic stage o Monitor fetal growth, movement, position, and form; assess amniotic fluid volume, judge gestational age, detect multiple pregnancies o Detect major structural abnormalities or death of a fetus o Guide amniocentesis and chorionic villus sampling o Help diagnose sex-linked disorders o No known risks; done routinely in many places o Can be used for sex screening of unborn babies Embryoscopy, fetoscopy: tiny viewing scope is inserted in woman’s abdomen to view embryo or fetus o Can guide fetal blood transfusions and bone marrow transplants o Can assist in diagnosis of nonchromosomal genetic disorders o Embryoscopy is still in research stage o Riskier than other prenatal diagnostic procedures Amniocentesis: sample of amniotic fluid is withdrawn and analyzed under guidance of ultrasound o Most commonly used procedure to obtain fetal cells for testing o Can detect chromosomal disorders and certain genetic or mutifactoral defects; more than 99% accuracy o Usually performed in women age 35 and older; recommended if prospective parents are known carriers of Tay-sachs disease or sickle-cell anemia or have family history of Down syndrome, spina bifida, or muscular dystrophy o Can help diagnose sex-linked disorders o Normally not performed before 15 weeks gestation o Results usually take 1-2 weeks o 0.5-1.0% risk of fetal loss or injury; early amniocentesis is more risky and not recommended o Can be used for sex screening of unborn babies Chorionic villus sampling CVS: Tissues from hair like chorionic villi (projections of membrane surrounding fetus) are removed from placenta and analyzed o Early diagnosis of birth defects and disorders o Can be performed between 10-12 weeks gestation; yields highly accurate results within a week o Should not be performed before 10 weeks gestation o Some studies suggest 1-4% more risk of fetal loss than amniocentesis Preimplantation genetic diagnosis: after in vitro fertilization, a sample cell is removed from the blastocyst and analyzed o Can avoid transmission of genetic defects or predispositions known to run in the family, a defective blastocyst is not implanted in the uterus o Can test for more than 100 disorders. Can screen for defective embryo that might be miscarried. o No known risks Umbilical cord sampling (cordocentesis or fetal blood sampling): needle guided by ultrasound is inserted into blood vessels of umbilical cord o Allows direct access to fetal DNA for diagnostic measures, including assessment of blood disorders and infections, and therapeutic measures such as blood transfusions o Fetal loss or miscarriage is reported in 1-2% of cases; increases risk of bleeding from umbilical cord and fetal distress Maternal blood test: a sample of the prospective mother’s blood is tested for levels of alpha fetoprotein AFP, human chorionic gonadotropin hCG, and cestriol o May indicate defects in formation of brain or spinal cord (anencephaly or spina bifida); also can predict Down syndrome and other abnormalities o Permits monitoring of pregnancies at risk for low birth weight or stillbirth o No known risks, but false negatives possible o Ultrasound and/or amniocentesis needed to confirm suspected conditions Disparities in prenatal care Poor women who get prenatal care benefit by being put in touch with other needed services, and are more likely to get medical care for infants after birth In developing countries, ¼ of pregnant women get no prenatal care, and 2/5 give birth with no skilled attendant In US, prenatal care is widespread but not as universal as in Europe and it lacks uniform national standards and guaranteed financial coverage Use of prenatal care rose modestly between 1990-2003 but plateaued and declined in 2006 due to changes in welfare and Medicaid policies Rates of low birth weight and premature birth continue to rise o Many multiple births which are usually early o Women most at risk for bearing low-birth-weight babies are least likely to receive it Ethnic disparity in fetal and post birth mortality Preconception care CDC issued comprehensive research based guidelines for preconception care for all women of childbearing age o Physical examinations and taking of medical and family history o Vaccinations for rubella and hepatitis B o Risk screening for genetic disorders and infectious diseases such as STDs o Counseling women to avoid smoking and alcohol, maintain a healthy body weight, and take folic acid supplements
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