Transcript Consequences - McGraw Hill Higher Education

Prenatal Factors Affecting
Development
©Gallahue, D.L., Ozmun, J.C., & Goodway, J.D. (2012). Understanding Motor
Development. Boston: McGraw-Hill.
McGraw-Hill/Irwin
© 2012 McGraw-Hill Companies. All Rights Reserved.
A number of prenatal factors, many of which
can be controlled, affect motor development
during infancy and beyond.
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Medical Conditions:
 Diseases
 Disorders
Exposure to:
 Certain
medications
 Pollutants
 Radiation
 Infections
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Use of:
 Alcohol
 Illicit Drugs
 Tobacco
Medical History:
 Age
 Genetics
 Nutritional status
 Poverty
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Types:
 Placental Malnutrition: supply transport issues
 Fetal Malnutrition: fetal metabolism complications
 Maternal Malnutrition: inadequate nutritional intake
Reasons for Maternal Malnutrition:
 Dietary habits
 Poverty
 Stress
Consequences:
 >Prematurity (LBW,VLBW & preterm)
 >Birth defects
Maternal weight gain (table 5.2)
 General indicator of nutritional status
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Considerations for Maternal Drug Use:
 Timing during pregnancy
 Dosage of the drug
 Length of consumption
 Genetic predisposition
 Interaction effects
Common Drugs (table 5.3)
Necessary Drugs (table 5.4)
Illicit Drugs (table 5.5)
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Fetal Alcohol Spectrum Disorder
 Occurrence: 40,000 FASD yearly in USA
 Consequences:
 FAS: Cognitive impairments; growth, physical and
motor deficits; facial deformities
 FAE: attention deficit disorder
Tobacco Use
 Occurrence: 13% USA pregnant women smoke
 Consequences:
 >LBW & VLBW
 >Cleft lip/palate
 >Cognitive deficits
 > Sudden Infant Death Syndrome (SIDS)
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Union of Sperm & Egg:
 23 + 23 = 46 total chromosomes
 20,000 genes per chromosome
Chromosome Based Disorders:
 Spontaneous abortion: Estimated 15-50% of all pregnancies
 Live births occur in 1% with damage
 Down syndrome: Most common
Gene Based Disorders:
 Autosomal dominate gene mutations: Few developmental
issues
 Autosomal negative gene mutations: Many developmental
issues
 Talipes
 Sickle-Cell Disease
 Tay-Sachs Disease
 Phenylketonuria (PKU)
 Spina Bifida
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Occurrence:
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About 1 in 800-1000 births
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Age-related: Age 35 = 1/400; 40 = 1/110; 45 1/35
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Consequences:
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Frequent premature birth (LBW + YFD)
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Slower growth rate

Slower development
 Delays in primitive & postural reflexes
 Hypotonia & hyperfexia
 Delays in attaining motor milestones
 Intervention Strategies:
 Infant/toddler stimulation programs
 Developmentally appropriate activities
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Occurrence:
 About 1/700
 2x more in males
Types: (figure 5.1)
 Equinovarus: Foot twists in and down
 Calcaneal Valgus: Foot twists up and out
 Metatarsus Varus: Front of foot twists in
Consequences:
 Untreated: Problems with upright locomotion
 Treated: Favorable outcomes
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Occurrence:
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About 1/400 African-Americans
1/2 are carriers
Consequences:
 Anemia, pain, organ damage
 Slow growth & motor development
 Possible death
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Occurrence:
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Most prominent among European Jews
Also found among French-Canadians & Cajuns
Carriers in USA: About 1/30
 2 parents = 25% chance
 1 parent = 0% chance (but 50% chance of being a
carrier)
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Consequences:
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Loss of motor control
Paralysis
Possible death
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Phenylketonuria (PKU)
 Occurrence:
 Completely treatable metabolic disorder
 Inability to metabolize phenylalanine
 Check your diet soda
 Consequences:
 Untreated = severe mental retardation
 Treated at birth = favorable outcome
Spina Bifida
 Occurrence:
 About 1/2000,
 Familial: 1/40 to 1/20
 Folic acid and spina bifida
 Consequences:
 Loss of sensation in lower extremities
 Paralysis of the legs
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Excess Radiation
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Occurrence: >25 rads during pregnancy
Consequences: >incidence of microcephaly 7 other
birth defects
Chemical Pollutants:
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Occurrence: >lead and mercury
Consequences: >birth defects
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Occurrence:
 Chlamydia: Estimated 3 million yearly in USA
 Genital Herpes: Estimated 45 million in USA
 Gonorrhea: About 7000,000 yearly in USA
 Syphilis: On the decline in the USA
 Perinatal HIV: Estimated 6,000 births yearly in USA
Consequences:
 Chlamydia: Prematurity, stillbirth, pneumonia, eye infections,
blindness
 Genital Herpes: Brain damage, death
 Gonorrhea: Ectopic pregnancies, eye damage
 Syphilis: Severe illnesses, nervous system damage, death
 HIV/AIDS: Fever, weight loss, lethargy, diarrhea, pneumonia,
death
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Hormonal/Chemical Imbalances:
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Untreated Hypothyroidism: Cretinism
Untreated Diabetes: Cognitive limitations;
cardio/respiratory problems; possible death)
Rh Incompatibility (Erythroblastosis Fetalis):
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Rh+ father & Rh- mother = Rh+ baby
 With first child mom builds antibodies = no problems
 Subsequent babies: Rhogam injection = no problems;
without = severe problems
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Cytomegalovirus (CMV)
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Occurrence: estimated 5% of newborns
Consequences:
 Untreated: Mild to moderate deficits in speech, gross and
fine motor control; possible cognitive deficits; blindness;
deafness
 Treated: Positive outcome
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Rubella (three day measles)
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Occurrence: no new cases in the USA since 1994
Consequences:
 Untreated: Deafness; blindness, cognitive deficits
 Treated: Positive outcome
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Teenage Pregnancy
 Consequences:
 >Maternal death rate < age 15
 >LBW
 >Young for date
Toxoplasmosis
 Occurrence:
 Protozoa found in 1/1000 infants
 3000 infected each year in the USA
 Spore transmission (cat & mouse, meat)
 Consequences:
 Cognitive deficits
 Sensory and motor disabilities
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Amniocentesis: Amniotic fluid sample analyzed
between wk. 16-18
Chorionic Villus Sampling: Chorionic villi
fragments analyzed prior to wk. 16
Ultrasound: Provides visual reference for above
techniques & size/position data
Fetoscopy: Fetoscope inserted into uterus, rarely
used due to >risk of abortion
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Maternal Affects;
 >Fitness
 <Weight gain & fat retention
 Easier labor
 Positive psychological & emotional benefits
Fetal Affects:
 <Fat
 >Stress tolerance
Delivery Affects:
 Easier labor
Infant Development Affects:
 Leaner body composition
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Pregnancy: 279 days +/- 2 weeks
Labor: 1-24 hours (3 stages)
 Beginning labor (Stage 1):
 Dilation to 4 cm.
 Amniotic sac breaks
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Full labor & delivery (Stage 2):
 Dilation to 10cm.,
 Primiparas: About 90 minutes to delivery
 Multiparas: About 45 minutes to delivery
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Delivery of Placenta (Stage 3)
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Obstetrical Medications (table 5.8):
 Oxytocics: Initiate, augment labor
 Analgesics: Relieve pain
 Sedatives: Relieve anxiety
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Birth Entry:
Breech: Feet first; 4/100
 Transverse: Shoulder first; 1/100
 Forceps: Used in emergencies only
 Cesarean deliveries: about 38% USA
 Prepared childbirth (Lamaze & Leboyer)
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Both mother- and father-to-be have an obligation
to their unborn child to ensure optimal
development by monitoring those factors over
which they can exercise control.
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