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Questions and Answers
What does the DOHaD theory suggest about environmental factors during fetal development?
What does the DOHaD theory suggest about environmental factors during fetal development?
- They are solely responsible for neurodevelopmental disorders.
- They only influence genetic predispositions.
- They have no impact on future health.
- They can induce predictive adaptive responses affecting health in adulthood. (correct)
Which of the following disorders is NOT mentioned as being associated with prenatal environmental factors?
Which of the following disorders is NOT mentioned as being associated with prenatal environmental factors?
- Schizophrenia
- Attention-Deficit Hyperactivity Disorder (ADHD)
- Down Syndrome (correct)
- Autism Spectrum Disorder (ASD)
Which factor is NOT recognized as an exogenous factor affecting neurodevelopment during pregnancy?
Which factor is NOT recognized as an exogenous factor affecting neurodevelopment during pregnancy?
- Genetic mutations from the father (correct)
- Stress
- Drug exposure
- Maternal immune activation
What is the reported prevalence of Autism Spectrum Disorder (ASD) in the US?
What is the reported prevalence of Autism Spectrum Disorder (ASD) in the US?
How does maternal immune activation (MIA) influence offspring health?
How does maternal immune activation (MIA) influence offspring health?
Which characteristic is NOT typical of Attention-Deficit Hyperactivity Disorder (ADHD)?
Which characteristic is NOT typical of Attention-Deficit Hyperactivity Disorder (ADHD)?
According to the fetal programming hypothesis, future health conditions are influenced by which period?
According to the fetal programming hypothesis, future health conditions are influenced by which period?
What role does early fetal environment play according to the DOHaD theory?
What role does early fetal environment play according to the DOHaD theory?
What does 'teratogen' refer to in the context of embryonic development?
What does 'teratogen' refer to in the context of embryonic development?
Which of the following maternal factors is NOT associated with an increased risk of intellectual disability (ID)?
Which of the following maternal factors is NOT associated with an increased risk of intellectual disability (ID)?
During which period of gestation is the human embryonic brain considered particularly vulnerable to environmental influences?
During which period of gestation is the human embryonic brain considered particularly vulnerable to environmental influences?
Advanced maternal age is defined as age greater than what number of years?
Advanced maternal age is defined as age greater than what number of years?
What are the potential consequences of maternal immune activation (MIA) during pregnancy?
What are the potential consequences of maternal immune activation (MIA) during pregnancy?
What weight defines low birth weight (LBW)?
What weight defines low birth weight (LBW)?
Which of the following is an effect associated with prenatal exposure to tobacco?
Which of the following is an effect associated with prenatal exposure to tobacco?
What is the primary cause of preterm birth in developed countries?
What is the primary cause of preterm birth in developed countries?
What condition is associated with a 2.76 times greater risk of intellectual disability when experienced by the mother during pregnancy?
What condition is associated with a 2.76 times greater risk of intellectual disability when experienced by the mother during pregnancy?
The period between weeks 3 to 8 of gestation is critical for what aspect of embryonic development?
The period between weeks 3 to 8 of gestation is critical for what aspect of embryonic development?
Caffeine consumption during pregnancy is classified as what type of agent?
Caffeine consumption during pregnancy is classified as what type of agent?
Which of the following is NOT a known human teratogen?
Which of the following is NOT a known human teratogen?
The risk of intellectual disability is highest for which category of low birth weight?
The risk of intellectual disability is highest for which category of low birth weight?
What does the term 'perinatal' refer to?
What does the term 'perinatal' refer to?
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Study Notes
Prenatal Factors and Neurodevelopment
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The Developmental Origins of Health and Disease (DOHaD) theory proposes that environmental factors during development influence offspring health, including risk for later disease.
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Prenatal factors that affect neurodevelopment: Maternal immune activation (MIA), stress, undernutrition, drug exposure.
Neurodevelopmental Disorders (NDDs)
- Autism Spectrum Disorder (ASD): Characterized by social communication deficits, repetitive behaviors, and sensory sensitivities. Prevalence in the US is 1.85%.
- Attention-Deficit Hyperactivity Disorder (ADHD): Characterized by hyperactivity, attention deficits, and impulsivity. Worldwide prevalence is 5.29%.
Prenatal vs. Perinatal
Prenatal:
- Preconception Factors: Advanced maternal age (>35 years) associated with 1.53 times higher risk of intellectual disability.
- Exposure to Toxins: Teratogens (agents that disturb fetal development) are most dangerous during the embryonic period (weeks 3-8). Known human teratogens include: alcohol, tobacco, chemotherapy, caffeine, cocaine, androgens, lead, mercury, radiation, and certain medications.
- Maternal Infections/Illness:
- Urinary tract infections (UTIs) associated with greater risk of mild-moderate and severe intellectual disability.
- Maternal diabetes, hypertension, asthma, and epilepsy also associated with increased risk of intellectual disability.
Gestational Factors - Exposure to Toxins & Maternal Illnesses
- Alcohol: Associated with 1.63 times higher risk of intellectual disability and Fetal Alcohol Spectrum Disorder.
- Tobacco: Associated with 1.10 times higher risk of intellectual disability, irritability, poor self-regulation, reduced sensory reactivity, information processing deficits, and behavior problems.
- Maternal Illness:
- Urinary tract infections (UTIs) associated with 1.83 times greater risk of mild-moderate ID and 1.41 times greater risk of severe ID.
- Maternal diabetes: 1.15 times greater risk of ID.
- Maternal hypertension: 1.33 times greater risk of ID.
- Maternal asthma: 1.48 times greater risk of ID.
- Maternal epilepsy: 2.76 times greater risk of ID.
Developmental Stages of the Human Brain
- First Trimester (0-13 weeks): Formation of the neural tube, production of neurons, and neuronal migration.
- Second Trimester (14-27 weeks): Synapse formation.
- Third Trimester: Production of axons, glial cells, and integration into neural circuits.
Brain Development and Risk Periods for Neurodevelopmental Disorders
- First Trimester: MIA (maternal immune activation), maternal stress, and drug exposure (e.g., thalidomide, valproic acid) can increase risk of neurodevelopmental disorders.
- Second Trimester: Continued risk period for NDDs from maternal factors.
Preterm Birth
- Defined as birth before 37 weeks gestation.
- Leading cause of perinatal mortality in developed countries.
- Frequency is 12-13% in the USA, but lower in some other developed countries.
- Major causes: spontaneous labor, preterm premature rupture of membranes (PPROM), and medically indicated labor induction/C-section.
- Associated with a 2.03 times higher likelihood of intellectual disability and a linear decrease in IQ score with shorter gestational age.
Low Birth Weight (LBW)
- Defined as less than 2500 grams (5 lbs 8 oz) at birth.
- Can be preterm, but some full-term babies are born LBW.
- Risk factors include maternal hypertension, smoking, drug use, and poor maternal weight gain.
- Associated with a 3.56 times higher likelihood of intellectual disability and a higher risk for very low birth weight (< 1500 g) than moderately low birth weight (1500-2499 g).
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