Prenatal Development and Birth PDF

THEORIES OF DEVELOPMENT DEVELOPMENTAL PSYCHOLOGY CHAPTER 3: PRENATAL DEVELOPMENT AND BIRTH CONCEPTION The first step in the development of an individual human being happens at conception, when each of us receives a combination of genes that will shape our experi...

THEORIES OF DEVELOPMENT DEVELOPMENTAL PSYCHOLOGY CHAPTER 3: PRENATAL DEVELOPMENT AND BIRTH CONCEPTION The first step in the development of an individual human being happens at conception, when each of us receives a combination of genes that will shape our experiences throughout the rest of our lives. Process of Conception  A woman typically produces one ovum (egg) per month from her ovaries.  If not fertilized, the ovum travels to the uterus, disintegrates, and is expelled during menstruation.  Fertilization occurs if intercourse happens during the ovum’s journey in the fallopian tube. NAME DESCRIPTION  Human cells contain 23 pairs of chromosomes; gametes (sperm and ovum) contain 23 unpaired chromosomes.  At conception, the sperm and ovum combine to form a zygote with 23 pairs of chromosomes.  The 23rd pair consists of sex chromosomes: XX for females and XY for males.  Female gametes (ova) carry X chromosomes, while male gametes carry either X or Y, Conception determining the baby’s sex.  gametes o cells that unite at conception(ova in females; sperm in males)  zygote o a single cell created when sperm and ovum unite  Most births result in single infants; however, about 3.3% of births in Canada involve multiple babies, mostly twins.  Types of Twins: o Fraternal Twins (Dizygotic): From two different eggs and sperm, genetically similar as Multiple Births any siblings. o Identical Twins (Monozygotic): From one zygote that splits, carrying identical genes.  Increased multiple births observed since the late 1980s, with a notable rise in triplets and higher-order multiples.  Women over 35 are more likely to conceive multiples, either naturally or through assisted reproduction.  AHR is regulated in Canada, ensuring the safety of treatments and born children.  Fertility Drugs: Stimulate gamete production.  In Vitro Fertilization (IVF): Combines sperm and egg in a lab, then implants the embryo. Can use donor gametes.  New cryopreservation methods (vitrification) enhance embryo survival rates compared to older techniques.  IVF success rates decline with maternal age: ~38% for women under 35, ~11% for those over 40. Successful IVF does not guarantee emotional attachment; post-birth warmth may be higher in IVF parents.  Multiple pregnancies present additional risks for mothers and infants.  Arguments exist regarding the definition of success in AHR—whether a single live birth or Assisted Human any birth counts as success. Reproduction (AHR)  Guidelines recommend limiting the number of embryos transferred during IVF to reduce multiple birth occurrences.  Artificial Insemination: Direct sperm injection into the uterus during optimal conception periods. Less likely to result in multiples.  Used for couples with male fertility issues or single women desiring motherhood.  Concerns over the genetic heritage of children conceived via donor gametes.  Canada's AHR Act includes a registry for nonidentifying medical information about donors, enabling offspring access to medical histories.  Assisted Human Reproduction (AHR): o “Any activity undertaken for the purpose of facilitating human reproduction” (Health Canada, 2001a).​  Cryopreservation: o Preserving cells or tissues through a freezing process that stops all biological activity.  Vitrification: o The use of cryoprotectants along with rapid cooling to prevent the fluid in biological tissues (e.g., eggs, semen, embryos) from forming ice crystals that act like glass shards on cell structures and from dehydrating. The tissue becomes an intact, non-crystalline, glass-like solid that can be preserved for years. THEORIES OF DEVELOPMENT DEVELOPMENTAL PSYCHOLOGY PREGNANCY AN PRENATAL DEVELOPMENT Pregnancy is a physical condition in which a woman’s body is nurturing a developing embryo or fetus. Prenatal development, or gestation, is the process that transforms a zygote into a newborn. Thus, the process that ends with the birth of a baby involves two sets of experiences: those of the pregnant woman, and those of the developing zygote, embryo, and fetus. The Mother’s Experience NAME DESCRIPTION  Pregnancy begins when the zygote implants in the uterine lining.  The zygote sends chemical messages to stop the woman’s menstrual periods. These chemicals can be detected in urine, allowing for early pregnancy diagnosis.  Breast enlargement occurs due to hormonal changes.  The cervix thickens and secretes mucus as a protective barrier against harmful organisms.  The uterus shifts position, putting pressure on the bladder and increasing urination frequency.  Common symptoms include fatigue and breast tenderness, which may disrupt sleep.  Nausea and vomiting in pregnancy (NVP), also known as morning sickness, occurs frequently, more commonly in the morning, but can happen at any time of day.  Prenatal care is critical during the first trimester to prevent congenital anomalies, as all 1st Trimester major organs develop within the first eight weeks.  Identifies maternal health issues (e.g., sexually transmitted diseases) that may affect prenatal development.  Encourages abstinence from drugs and alcohol to reduce risks of congenital anomalies.  Ectopic Pregnancy: o A potential condition where the zygote implants in a fallopian tube rather than the uterus. o Early surgical removal of the zygote is crucial for preserving the woman's future fertility.  Miscarriage: o About 15% of pregnancies result in miscarriage or spontaneous abortion. o Early-term miscarriage may feel similar to a menstrual period but typically involves more discomfort and blood loss. Medical care is necessary after a late-term miscarriage to ensure complete expulsion of the embryo.  The second trimester spans from the end of week 12 to week 24 of pregnancy.  Morning sickness typically disappears during this trimester, leading to an increased appetite.  The pregnant woman gains weight, and the uterus expands to accommodate the growing fetus. The woman begins to visibly “show” during this trimester.  The mother starts to feel fetal movements, usually between the 16th and 18th weeks.  Monthly checkups monitor the mother’s and baby's vital functions and track fetal growth.  Ultrasound tests are commonly performed, allowing determination of the baby’s sex after 2nd Trimester approximately the 13th week.  Monthly urine tests screen for gestational diabetes, which can develop during pregnancy.  Women with any form of diabetes, including gestational diabetes, require careful monitoring to prevent rapid fetal growth, which may lead to premature labor or complications during delivery.  The risk of miscarriage decreases in the second trimester; however, some fetuses may still die between the 13th and 20th weeks. Premature labor after the 21st week can result in the delivery of very small babies, with a small survival rate and significant health issues for most.  The third trimester begins at 25 weeks of pregnancy.  Weight gain and abdominal enlargement are prominent experiences during this period.  Breasts may start secreting colostrum, preparing for nursing.  Many women feel a stronger emotional connection to the fetus during the third trimester.  Individual differences in fetal behavior, such as hiccupping or thumb-sucking, become noticeable in the final weeks. 3rd Trimester  Most women observe regular patterns of fetal activity and rest.  Monthly prenatal visits continue until week 32, after which visits typically occur once a week.  Blood pressure monitoring is crucial during this trimester due to the risk of developing toxemia of pregnancy.To  Toxemia of pregnancy is marked by a sudden increase in blood pressure and can lead to serious complications, including stroke. THEORIES OF DEVELOPMENT DEVELOPMENTAL PSYCHOLOGY Prenatal Development  The three stages of prenatal development are defined by specific developmental milestones.​  These stages are not of equal length. Two primary patterns of development are observed: o Cephalocaudal Pattern:  Development progresses from the head downward.  Example: The brain develops before the reproductive organs. o Proximodistal Pattern:  Development occurs from the center of the body outward to the extremities.  Example: Structures closer to the center, such as the rib cage, develop before fingers and toes. NAME DESCRIPTION Germinal Stage: The first stage of prenatal development, beginning at conception and ending at implantation (approximately two weeks).​  The germinal stage lasts for the first two weeks of gestation, from conception to implantation.  Cells differentiate into those that will form the fetus's body and those that will support its development. Rapid cell division occurs, resulting in dozens of cells by the fourth day.  On day 5, cells form a hollow, fluid-filled structure called a blastocyst. Inner cells that will become the embryo begin to cluster together.  By day 6 or 7, the blastocyst contacts the uterine wall. By the 12th day, it is fully implanted in the uterine tissue, combining with cells of the uterine lining to form the placenta.  Implantation: The attachment of the blastocyst to the uterine wall. Germinal Stage  The placenta facilitates the transfer of oxygen, nutrients, and other substances between the mother’s and baby’s blood without mixing them. The placenta secretes hormones that stop menstrual periods, maintain uterine connection, increase pelvic flexibility, induce breast changes, and boost the mother's metabolic rate. A specialized organ that allows substances to be transferred from mother to embryo and from embryo to mother without their blood mixing.  Inner cells of the blastocyst start specializing into: o Umbilical Cord: Connects the embryo to the placenta and carries blood between the baby and mother. o Yolk Sac: Produces blood cells until the embryo's blood-cell-producing organs develop. o Amnion: A fluid-filled sac where the baby floats until birth.  By the 12th day, cells that will constitute the embryo's body are also formed. THEORIES OF DEVELOPMENT DEVELOPMENTAL PSYCHOLOGY  The embryonic stage begins at implantation (approximately two weeks after conception) and continues until the end of week 8.  By three weeks after conception, the embryo's cells start specializing to form the foundations of all body organs.  The cells of the nervous system, the neurons, form a structure called the neural tube, from which the brain and spinal cord will develop.  Week 3 Developments: o A primitive heart and early kidney structures develop. o Three sacs that will form the digestive system also appear.  Week 4 Developments: o The neural tube swells to form the brain; spots for future eyes appear. o The heart starts beating, backbone and ribs become visible, and the face begins to shape. o The endocrine system starts to develop.  Week 5 Developments: o The embryo measures about 6.5 millimeters, significantly larger than the zygote. o Rapid development of arms and legs occurs, with five visible fingers on each hand. o Eyes develop corneas and lenses, while lung development initiates.  Week 6 Developments: o The brain produces electrical activity patterns, prompting movement in response to stimuli. Embryonic Stage o Gonads develop, with differentiation influenced by the presence of testosterone in male embryos. Sex glands (ovaries in females; testes in males) o At first, the gonads of male and female embryos are identical. However, between the weeks 4 and 6, genes on the Y chromosome cause the male embryo to produce the male hormone testosterone. o The testosterone causes the gonads to become testes. o In the absence of testosterone, the gonads develop into ovaries.  Week 7 Developments: o Male embryos begin to develop a penis. o Male and female exhibit spontaneous movement. o Skeletons and fully developed limbs become visible; bones start hardening and muscles mature. o Eyelids seal shut, ears are fully formed, and tooth buds are detectable via X-ray.  Week 8 Developments: o The liver and spleen begin functioning, enabling blood cell production and filtration. o The heart is well developed, pumping blood effectively throughout the body. o Increased movements and more organized brain activity, with established connections between the brain and body. o Digestive and urinary systems become functional. o Organogenesis, or the process of organ development, is finalized by the end of week 8.  The final phase is the fetal stage, beginning at the end of week 8 and continuing until birth.  The fetus grows from a weight of about 2 grams and a length of 2.5 centimeters to a baby born around 38 weeks weighing about 3.2 kilograms and having a length of about 50 centimeters.  This stage involves refinements of the organ systems—especially the lungs and brain—that are essential to life outside the womb. Fetal Stage  By the end of week 23, a small number of babies have attained viability, the ability to live outside the womb (Moore, Persaud, & Torchia, 2011). However, most babies born this early die, and those who do survive struggle for many months.  Remaining in the womb just one week longer, until the end of week 24, greatly increases a baby’s chances of survival.  The extra week probably allows time for lung function to become more efficient.  In addition, most brain structures are completely developed by the end of the 24th week. For these reasons, most experts accept 24 weeks as the average age of viability.  Viability is the ability of the fetus to survive outside the womb THEORIES OF DEVELOPMENT DEVELOPMENTAL PSYCHOLOGY  The foundational structures of all the body’s organ systems are formed during the embryonic stage.  Most of the formation and fine-tuning of the brain takes place during the fetal stage.​  Neurons, the specialized cells of the nervous system, begin developing during the embryonic stage in week 3.  The pace of neural formation picks up dramatically between the 10th and 18th weeks, a process known as neuronal proliferation.  Between the 13th and 21st weeks, the newly formed neurons migrate to the parts of the brain where they will reside for the rest of the individual’s life (Johnson, 2011).  While migrating, neurons consist only of cell bodies, the part of the cell that contains the nucleus and in which all the cell’s vital functions are carried out. The Fetal Brain  Once neurons have reached their final destinations in the fetal brain, they begin to develop connections called synapses, tiny spaces between neurons across which neural impulses travel from one neuron to the next.​  Several changes in fetal behavior signal that the process of synapse formation is underway, including alternating periods of activity and rest and the fetus beginning to yawn (Walusinski et al., 2005).  Synapse formation requires the growth of axons, which are tail-like extensions that can range from 1 to 200 millimeters within the brain, but can grow to be more than a meter long (e.g., between the spinal cord and the body’s extremities).  Dendrites are tentacle-like branches that extend out from the cell body and their development is thought to be highly sensitive to adverse environmental influences such as maternal malnutrition and defects in placental functioning (Dieni & Rees, 2003).  Simultaneously with neuronal migration, glial cells begin to develop, acting as the “glue” that holds neurons together to give shape to the brain’s major structures. As glial cells develop, the brain begins to assume a more mature appearance, observable using magnetic resonance imaging (MRI) and other modern technologies. THEORIES OF DEVELOPMENT DEVELOPMENTAL PSYCHOLOGY Sex Differences  Prenatal development is strongly influenced by maturational sequences that are the same for both males and females, resulting in only a few sex differences.  Early studies suggested that male fetuses, on average, are more physically active (e.g., DiPietro et al., 1996).  More recent findings indicate no sex differences in fetal activity levels (DiPietro et al., 2009).  Further research is needed to understand how sex differences in children’s activity levels are shaped in the womb (DiPietro et al., 2010; DiPietro, 2010, 2012).  Between four and eight weeks after conception, the male embryo begins to secrete the male hormone testosterone.  If testosterone is not secreted or is secreted in inadequate amounts, the embryo will be “demasculinized,” potentially developing female genitalia.  Female embryos do not appear to secrete any equivalent hormone.  The presence of male hormone at critical times (from maternal drugs or congenital adrenal hyperplasia) can “masculinize” female fetuses, resulting in male-appearing genitalia.  Female fetuses appear to be more sensitive to external stimulation and advance more rapidly in skeletal development (Groome et al., 1999; Tanner, 1990).  Female infants are about one to two weeks ahead in bone development at birth, despite newborn boys typically being longer and heavier.  Female superiority in skeletal development continues through childhood and early adolescence, with girls acquiring coordinated movements and motor skills earlier than boys.  The gap between sexes widens until the mid-teens when boys catch up and surpass girls in overall physical coordination.  Boys are more vulnerable to prenatal problems; more males are conceived (120 to 150 male embryos for every 100 female ones) but more males are spontaneously aborted.  At birth, there are about 105 boys for every 100 girls.  Male fetuses appear to be more sensitive to factors such as marijuana and maternal stress, which may negatively impact prenatal development (Bethus et al., 2005; Wang et al., 2004). Prenatal Behavior  Centuries before scientists studied prenatal development, pregnant women noticed fetal responses to music and other sounds.  Techniques such as ultrasound imaging have provided researchers with significantly more information about fetal behavior.  Some researchers suggest that establishing norms for fetal behavior would aid health care providers in assessing fetal health and predicting postnatal problems (DiPietro et al., 2010; Nijhuis, 2003).  The number of research studies examining fetal behavior has increased significantly in recent years. Researchers have discovered that the fetus can distinguish between familiar and novel stimuli by the 32nd or 33rd week (Sandman et al., 1997).​  Evidence for fetal learning comes from studies indicating newborns remember stimuli to which they were exposed prenatally, such as their mother’s heartbeats, the odor of the amniotic fluid, and stories or music heard in the womb (Righetti, 1996; Schaal et al., 1998).  In a study, pregnant women read Dr. Seuss’s The Cat in the Hat daily for the last six weeks of their pregnancies. After birth, infants adapted their sucking patterns to listen to the familiar story and did not increase sucking for an unfamiliar story (DeCasper & Spence, 1986).  A study exposed full-term fetuses to either their mother’s voice or a female stranger’s voice, with the same poem read to each fetus. The fetuses showed different heart-rate patterns: an increase with their mother’s voice and a decrease with a stranger's, suggesting recognition of the mother’s voice (Kisilevsky et al., 2003).  Longitudinal studies show that very active fetuses, both males and females, tend to become very active children (DiPietro et al., 2008). Such children are more likely to be labeled “hyperactive” by parents and teachers. Conversely, less active fetuses are more likely to be intellectually delayed (Accardo et al., 1997). THEORIES OF DEVELOPMENT DEVELOPMENTAL PSYCHOLOGY ISSUES IN PRENATAL DEVELOPMENT  Prenatal development is not immune to outside influences.  Most problems discussed are very rare, many are preventable, and many need not have permanent consequences for the child.  In Canada, approximately 4% of babies are born with a congenital anomaly.​  A congenital anomaly is defined as an abnormal structure, function, or body metabolism present at birth that results in physical or mental disability or death (PHAC, 2012a). Genetic Disorders Many disorders appear to be transmitted through the operation of dominant and recessive genes (see Table 3.4 ). Autosomal disorders are caused by genes located on the autosomes (chromosomes other than sex chromosomes). The genes that cause sex- linked disorders are found on the X chromosome. NAME DESCRIPTION Recessive Genes Most disorders caused by recessive genes are diagnosed in infancy or early childhood.​ Phenylketonuria (PKU): o PKU is caused by a recessive gene that leads to problems digesting the amino acid phenylalanine. o Toxins build up in the baby’s brain and cause developmental delay. o PKU occurs in about 1 in every 10,000 babies (Nicholson, 1998). o If a baby avoids foods containing phenylalanine, he will not experience intellectual delays. o Milk is one of the foods that PKU babies cannot have, making early diagnosis critical. o Universal screening for PKU is conducted soon after birth in all Canadian provinces. o PKU is associated with ethnicity; Caucasian babies are more likely to have the disorder than infants in other groups. o West African and African American infants are more likely to suffer from sickle-cell Autosomal Disorders disease, a recessive disorder causing red blood cell deformities (Raj & Bertolone, 2010). o Sickle-Cell Disease: o In sickle-cell disease, the blood cannot carry enough oxygen to keep the body’s tissues healthy. o With early diagnosis and antibiotic treatment, over 80% of children diagnosed with the disease survive to adulthood (Raj & Bertolone, 2010). o Tay-Sachs Disease: o About 1 in every 3,000 babies born to couples of Eastern European Jewish ancestry suffers from Tay-Sachs disease, another recessive disorder. o French Canadians in the Gaspé region of Quebec carry the gene for a severe form of Tay- Sachs disease at a rate 10 times that of the general population (Myerowitz & Hogikyan, 1987; Triggs-Raine et al., 1995). o A baby with Tay-Sachs is likely to be severely intellectually delayed and blind, with very few surviving past age 3 (Kaelbling, 2009). THEORIES OF DEVELOPMENT DEVELOPMENTAL PSYCHOLOGY Dominant Genes Usually diagnosed in adulthood Huntington’s Disease o Huntington’s disease causes brain deterioration and affects both psychological and motor functions. o The risk of Huntington’s in Canada is 1 in 10,000, and a child of a parent with Huntington’s has a 50% chance of developing the disease (Huntington Society of Canada, 2001). o A blood test can identify the Huntington’s gene, aiding individuals in making decisions about child-bearing and preparing for a serious disorder in adulthood. Most sex-linked disorders are caused by recessive genes.​ Red–Green Colour Blindness: o A fairly common sex-linked recessive disorder is red–green colour blindness. o People with this disorder have difficulty distinguishing between the colours red and green when they are adjacent. o About 7 to 8% of men and 0.5% of women have this disorder. o Most individuals learn ways to compensate for the disorder and live perfectly normal lives. Sex-linked Disorders Hemophilia: o Hemophilia is a more serious sex-linked recessive disorder. o The blood of people with hemophilia lacks the chemical components necessary for blood clotting. o As a result, when a person with hemophilia bleeds, the bleeding does not stop naturally. o Approximately 1 in 5,000 baby boys is born with this disorder, which is almost unknown in girls (Agaliotis, Zaiden, & Ozturk, 2009). Fragile-X Syndrome: o About 1 in every 4,000 males and 1 in every 8,000 females has fragile-X syndrome (Jewell, 2009). o This disorder involves an X chromosome with a “fragile,” or damaged, spot. o Fragile-X syndrome can cause developmental delay that worsens progressively as a child ages (Jewell, 2009). Chromosomal Errors A variety of problems can be caused by a child having too many or too few chromosomes, a condition referred to as a chromosomal error or chromosomal anomaly. Like genetic disorders, these are distinguished by whether they involve autosomes or sex chromosomes. NAME DESCRIPTION A trisomy is a condition in which a child has three copies of a specific autosome. Trisomy 21 (Down Syndrome): o The most common trisomy is trisomy 21, or Down syndrome, where the child has three copies of chromosome 21. Trisomies o The number of infants born with this anomaly has remained fairly constant in Canada, averaging one in 800 births (Mamayson, 2009). o Children with Down syndrome are intellectually delayed and have distinctive facial features. o They often have other health concerns such as hypothyroidism, hearing loss, or heart anomalies (Chen, 2010). o The risk of bearing a child with trisomy 21 is greatest for mothers over 35.​ o Among Canadian women aged 35 to 39, the rate of Down syndrome is about 1 in 350 births. o Among women 40 to 45, the rate climbs to 1 in 150 births. o For women above age 45, Down syndrome is present in almost one-quarter of all births (Health Canada, 2002a). THEORIES OF DEVELOPMENT DEVELOPMENTAL PSYCHOLOGY o These figures underestimate the true rates by 15 to 24% because they exclude spontaneous abortions and terminated pregnancies Other Trisomies: o Scientists have identified children with trisomies in the 13th and 18th pairs of chromosomes as well. o These disorders have more severe effects than trisomy 21. o Few trisomy 13 or trisomy 18 children live past the age of 1 year. o As with trisomy 21, the chances of having a child with trisomy 13 or 18 are also influenced by maternal age. A second class of anomalies is associated with the sex chromosomes. Klinefelter’s Syndrome (XXY): o The most common anomaly is an XXY pattern, called Klinefelter’s syndrome, occurring in 1 or 2 out of every 1000 males. o Affected boys usually look normal but have underdeveloped testes and very low sperm production as adults. o Most are not intellectually delayed, but many have language and learning disabilities. o At puberty, these boys experience both male and female changes, such as penis enlargement and breast development. Turner’s Syndrome (X0): o A single-X pattern (X0), called Turner’s syndrome, may also occur. o Individuals with Turner’s syndrome are anatomically female but show stunted growth Sex Chromosome and are usually sterile. Anomalies o Without hormone therapy, they do not menstruate or develop breasts at puberty. o About one-quarter have serious heart anomalies. o These girls often perform poorly on tests that measure spatial ability but usually perform at or above normal levels on tests of verbal skills.  Neither Klinefelter’s nor Turner’s syndrome is associated with the mother’s age.  However, older mothers are more likely to produce normal-appearing girls with an extra X chromosome and boys with an extra Y chromosome.  Females with an XXX pattern, occurring in about 1 in every 1000 female births, are usually of normal size but develop more slowly than their peers.  Many of these females have poor verbal abilities, score low on intelligence tests, and do more poorly in school than other groups with sex chromosome anomalies.  Approximately 1 in 1000 boys has an extra Y chromosome.  Most are taller than average with large teeth and experience normal puberty.  They have no difficulty fathering children.  It is a myth that an extra Y chromosome causes below-average intelligence and high aggression. THEORIES OF DEVELOPMENT DEVELOPMENTAL PSYCHOLOGY Teratogens: Maternal Diseases  Teratogens are substances such as viruses and drugs that can cause congenital anomalies  Deviations in prenatal development can result from exposure to teratogens, agents that cause damage to an embryo or fetus.  Each organ system is most vulnerable to harm when it is developing most rapidly (Moore, Persaud, & Torchia, 2011).  Most organ systems develop most rapidly during the first eight weeks of gestation, making this the period of greatest risk for teratogen exposure  Several viruses can pass through the placental filters and attack the embryo or fetus. NAME DESCRIPTION o Rubella causes a mild reaction in adults but may be deadly to a fetus. Rubella (German Measles) o Most infants exposed to rubella during the embryonic stage show some degree of hearing impairment, visual impairment, and/or heart anomalies (Ezike & Ang, 2009). o CMV is in the herpes group and is transmitted through contact with body fluids, including saliva and breast milk. o As many as 60% of women carry CMV, but most have no recognizable symptoms. o A recent Canadian study found that 0.2 to 2.4% of babies whose mothers are infected with CMV become infected prenatally Cytomegalovirus (CMV): o The highest risk for the fetus occurs when the mother is infected during pregnancy; about 10% exhibit serious symptoms, including deafness and intellectual delay (Ontario Hospital Association, 2009; Vaudry et al., 2009). o Another 5 to 17% of infected newborns may later develop varying degrees of abnormality. o HIV, the virus that causes AIDS, can be passed directly from mother to fetus. o The virus can cross the placenta, enter the fetus’s bloodstream, or be transmitted through HIV breast milk. o The rate of HIV infection among pregnant women in Canada is estimated at about 2 per 1000. o Studies show that 6 in 10 HIV-positive women intend to become pregnant. o Treatments have been shown to lower the risk of transmission from HIV-positive mothers to their children. o Infants who acquire HIV typically become ill within the first two years of life (Springer, 2010) and may have compromised immune systems, thus requiring restrictions on exposure to viruses and bacteria.  Other STDs, including syphilis, genital herpes, and gonorrhea, can cause various congenital anomalies. o The bacterium causing syphilis is most harmful during the last 26 weeks of prenatal Other Sexually development, leading to eye, ear, and brain anomalies. Transmitted Diseases o Genital herpes is usually transmitted during birth, with one-third of infected babies dying (STDs): and another 25 to 30% suffering blindness or brain damage. o Surgical delivery is often advised for babies born to women with herpes. o Gonorrhea can cause infant blindness and is typically transmitted during birth, resulting in newborns receiving special ointment to prevent damage from the infection. THEORIES OF DEVELOPMENT DEVELOPMENTAL PSYCHOLOGY Teratogens: Drugs  Any drug, including those deemed safe (e.g., antibiotics), can be teratogenic.  Doctors ask women of child-bearing age about potential pregnancy before prescribing medication.  Unless absolutely necessary for the woman's health, it is recommended to avoid drugs during pregnancy.  Sorting out drug effects on prenatal development is challenging due to multiple drug use and accompanying factors like maternal stress, lack of social support, and poverty. NAME DESCRIPTION  Prescription o The thalidomide tragedy in the 1960s involved a tranquilizer that caused serious limb malformations in fetuses (Vogin, 2005). o Prescription drugs for anxiety and depression have shown teratogenic effects (Calderon- Margalit et al., 2009). o Benzodiazepines are linked to preterm delivery, low birth weight, and other complications. o Selective serotonin reuptake inhibitors (SSRIs) are associated with preterm deliveries among women starting treatment after the first trimester. o Some pregnant women must take medications for health conditions that endanger Prescription and Over-the- themselves or their unborn child. counter Drugs o Anti-seizure medication is essential for pregnant women with epilepsy. o Other necessary medications may include treatments for heart conditions, diabetes, and asthma. o Physicians weigh medication benefits against potential teratogenic effects to minimize risks.  Over-the-counter o Most people take over-the-counter medications casually without consulting a doctor. o Many OTC drugs, such as acetaminophen, are safe for pregnant women unless taken in excess (OTIS, 2005). o Pregnant women should discuss all medications, vitamins, and supplements with their doctors at the start of pregnancy to ensure safety. THEORIES OF DEVELOPMENT DEVELOPMENTAL PSYCHOLOGY  Infants of mothers who smoke are about 150 grams lighter at birth on average  Smoking during pregnancy is associated with higher rates of miscarriage, stillbirth, premature birth, and low-birth weight babies  Smoking rates during pregnancy are declining, but younger women (33%) are more likely Tobacco to smoke than older women (13%).  Approximately 36% of younger women and 13% of older women are exposed to second- hand smoke during pregnancyThe rate of smoking among Aboriginal women during pregnancy is roughly double that of non-Aboriginal women  Alcohol can adversely affect prenatal development before and after conception  Heavy drinking or alcoholism increases the risk of delivering infants with fetal alcohol syndrome (FAS). Alcohol  Children with FAS are generally smaller with distinctive facial features and may have developmental delays  (The term Fetal Alcohol Spectrum Disorders (FASD) encompasses a continuum of effects from alcohol consumption during pregnancy, including milder effects known as fetal alcohol effects (FAE).  Alcohol consumption rates during pregnancy in Canada are decreasing, with 14% reporting drinking and 5% admitting to drinking throughout pregnancy (Dell & Roberts, 2006).  Both younger and older Canadian women are likely to consume alcohol, but the safest choice for pregnant women is to abstain entirely.  Both heroin and methadone can cause miscarriage and premature labour  60 to 80% of babies born to heroin-addicted women are also addicted, experiencing withdrawal symptoms Psychotropic Drugs  Cocaine use during pregnancy is linked to various developmental problems, but separating its effects from poverty and other substance abuse is challenging  Marijuana use during pregnancy has mixed results; some studies show small reductions in birth weight, but THC has not been confirmed as a human teratogen Second-hand smoke exposure should also be considered, as cannabis is excreted in breast milk. Teratogens: Other Harmful Influences on Prenatal Development Other factors that can adversely affect prenatal development include the mother’s diet, her age, and her physical and mental health. NAME DESCRIPTION  Specific nutrients, such as folic acid (found in beans and spinach), are vital for prenatal development.​  Inadequate folic acid is linked to neural tube anomalies, including spina bifida.  Insufficient folic acid can have negative effects early in pregnancy; therefore, women who could become pregnant should consume 400 micrograms daily. Diet  Adequate caloric and protein intake is essential to prevent malnutrition during pregnancy.  Malnutrition, especially in the final trimester, increases the risk of low-birth-weight infants and potential intellectual difficulties in childhood.  Prenatal malnutrition is also linked to the development of mental illnesses in adulthood.  Maternal malnutrition primarily affects the developing nervous system, with studies showing patterns of reduced brain weight and cognitive capacity.  Canadian weight-gain guidelines recommend specific weight gain during pregnancy based on BMI; following dietary guidelines can help maintain necessary weight gain.  Increasing numbers of women are postponing their first pregnancy until their 30s; about half of Canadian births are to women aged 30 and older.  The average age for childbirth in Canada has risen to 29.3 years, with 18.0% of births to women aged 35 and older. Age  Older mothers generally have uncomplicated pregnancies, but risks increase with age, including low birth weight and congenital anomalies.  Teenage pregnancies show higher rates of congenital anomalies and are associated with inadequate prenatal care and nutrition.  Preventative measures are necessary to address lifestyle factors that contribute to negative outcomes for mothers and babies. THEORIES OF DEVELOPMENT DEVELOPMENTAL PSYCHOLOGY  Conditions like heart disease, diabetes, lupus, hormone imbalances, and epilepsy can negatively affect prenatal development.  Fetal-maternal specialists work to manage pregnancies of women with chronic illnesses to support the health of both mother and fetus. Chronic Illnesses  For example, diabetes can make blood sugar control difficult, potentially harming the fetus's nervous system or growth.  Specialists balance the mother's medication needs with fetal safety in conditions like epilepsy.  Recent immigrants to Canada show fewer chronic health issues and lower rates of prenatal complications compared to long-term residents.  Maternal emotions can significantly impact prenatal development; distressed mothers' fetuses are at higher risk for emotional and cognitive disorders later in childhood. Maternal Mental Health  Stressful states like anxiety and depression may alter body chemistry and affect hormones that influence fetal development.  Maternal stress is associated with reduced fetal growth, and the effects of maternal depression can similarly slow development.  The impact on fetal growth may be due to emotional state or indirect effects like reduced maternal nutrition and immune response.  Providing social support and counseling during home visits can improve prenatal and infant health, especially for at-risk families. Teratogens: Mutagenic, Environmental, and Epimutagenic Teratogens are classified into three broad categories: mutagenic, environmental, and unknown. Much of the "unknown" category is suspected to comprise epigenetic factors, and a single teratogen may fit into more than one category. NAME DESCRIPTION  Composed of mutagens, which cause alterations (mutations) to genomic DNA.  Exposure to mutagens (e.g., radiation, biological, or chemical toxins) can lead to germinal mutations, affecting conception and embryo/fetal development. Mutagenic Teratogens  High X-ray exposure can cause infertility, and if conception occurs, it may result in failure to implant or miscarriage.  Embryos exposed to mutagens may develop somatic mutations, leading to congenital anomalies that can be transmitted to future generations.  Environmental agents cause direct, nonheritable effects on prenatal development by damaging cells or disrupting normal cell processes.  These agents may interfere with normal cell proliferation in the embryo, hindering the formation of tissues like neurons, muscles, and bones. It is the increase in cell numbers by Environmental Teratogens means of cll growth and cell division.  They can disrupt cell migration, which is critical for cells to reach their genetically predetermined locations (e.g., neural cells in the brain). It is the movement of cells to their predetermine destinations in the body.  Environmental teratogens can also result in cellular structural and functional abnormalities, such as the destruction of cells impacting neural networks.  Mutagens account for about 15 to 25% of congenital anomalies, while environmental factors account for another 10%.  More than two-thirds of congenital anomalies remain unaccounted for, with many suspected to be epigenetic in nature. Epimutagenic Teratogens  Epimutagens cause alterations (epimutations) to epigenetic structures without changing genomic DNA.  Teratogenic damage is generally limited to one generation, as acquired epimutations are typically reset after conception, although some can be passed to future generations.  Studies indicate a mother’s diet can produce lasting changes across generations, which may impact future grandchildren independent of their parents' diets. THEORIES OF DEVELOPMENT DEVELOPMENTAL PSYCHOLOGY Birth and the Neonate Once gestation is complete, the fetus must be born—an event that holds some pain for the mother as well as a good deal of joy for most parents. Birth Choices In most places around the world, tradition dictates how babies are delivered. However, in industrialized countries, especially in Canada, hospital deliveries became routine in the second half of the 20th century. Today, though, parents have several choices as to who will attend their baby’s birth, whether medication will be used to manage the physical discomforts of labour and delivery, and where the birth will take place. NAME DESCRIPTION  Regulated health care profession in most provinces and territories in Canada.  Involves assessing, supervising, and caring for women during pregnancy, labour, and postpartum. Midwives  Midwives are licensed to conduct deliveries and care for newborns.  To become a midwife, one must graduate from a recognized midwifery education program.  Analgesics can be administered during labour to reduce pain.  Sedatives or tranquillizers may be used to alleviate anxiety.  Anaesthesia (general or local) is typically administered later in labour to block pain.  Drugs given during labour pass through the placenta and may affect newborn behavior.  Infants of mothers who received drugs are usually more sluggish, gain less weight, and sleep more in the initial weeks.  No consistent long-term effects of analgesics or tranquillizers have been observed beyond Drugs during Labour and the first few days. Delivery  New mothers should consider the short-term effects of drugs on their babies but recognize that these will wear off, likely not affecting the long-term relationship.  Natural Childbirth: Many women choose to avoid drugs altogether, referred to as natural childbirth or the Lamaze method. o Relies on psychological and behavioral methods of pain management rather than pain- relieving drugs. o Key components include: o Selecting a labour coach (often the baby's father or a supportive person). o Participating in prepared childbirth classes to mentally prepare for labour and delivery. o Using relaxation and breathing techniques to manage contractions and focus away from pain.  In most industrialized countries, women typically deliver in specialized maternity clinics.  In Canada, there are four main alternatives for childbirth: o Traditional hospital maternity unit. o Birth centre or birthing room within a hospital, offering a homelike setting. Location of Birth o Free-standing birth centre, attended by a midwife, located apart from hospitals. o Home birth with a trained birth attendant present.  Approximately 98.5% of babies in Canada are born in hospitals.  Home deliveries are suitable for uncomplicated pregnancies with good prenatal care; complications rates are comparable to hospital deliveries when conditions are met. THEORIES OF DEVELOPMENT DEVELOPMENTAL PSYCHOLOGY The Physical Process of Birth Labour is divided into three stages.​ Stage 1: Dilation and Effacement:  Cervix must dilate (open) like a camera lens and efface (flatten).  The cervix must reach approximately 10 centimetres for delivery.  Duration can vary widely, lasting anywhere from 3 to 20 hours for first-time mothers. Phases of Stage 1:  Early (Latent) Phase: o Contractions are relatively far apart and not very uncomfortable.  Active Phase: o Begins at 3 to 4 centimetres of dilation and continues until 8 centimetres. o Contractions become closer together and more intense.  Transition Phase: o Last phase of dilation from 8 to 10 centimetres. o Contractions are closely spaced and strong, often causing the most pain. o Transition is typically the shortest phase of stage 1. Stage 2: Delivery:  Begins when the mother feels the urge to push after the transition phase.  The birth attendant confirms full dilation before encouraging pushing.  Baby’s head moves past the cervix into the birth canal and out of the mother's body.  Women generally find this stage less distressing because they can assist with pushing.  Typically lasts less than one hour, rarely exceeding two hours. Stage 3: Afterbirth:  Involves the delivery of the placenta and other materials from the uterus.  Usually a brief stage in the overall process of labour. NAME DESCRIPTION  Most infants are delivered head first; 3 to 4% have breech presentations (feet or bottom first).  In Canada, breech infants are primarily delivered via Caesarean section (C-section). Caesarean Deliveries Indications for a C-section include:  Fetal distress during labour.  Labour that does not progress in a reasonable time.  Fetus too large for vaginal delivery.  Maternal health complications aggravated by vaginal delivery (e.g., cardiovascular disease, spinal injury) or dangerous to the fetus (e.g., herpes).  C-sections are often life-saving for both mother and infant.​ Controversy Surrounding C-sections:  Some physicians agree on the necessity of C-sections, but the procedure is controversial.  Critics argue they are often performed unnecessarily, raising concerns about increased risks and health care costs.  C-section rates in Canada increased from about 5% in the late 1960s to over 21% by 2001, among the highest globally.  The Society of Obstetricians and Gynaecologists of Canada advises against C-sections on demand and recommends informed discussions on risks and benefits between women and doctors. Fetal distress may occur during birth, indicated by sudden changes in heart rate, with common causes including:  Pressure on the umbilical cord, potentially leading to anoxia (oxygen deprivation), which Birth Complications can result in death or brain damage.  Quick surgical intervention can prevent long-term effects from distress. Other complications during birth may include:  Shoulder or hip dislocations, fractures, and temporary facial paralysis due to nerve THEORIES OF DEVELOPMENT DEVELOPMENTAL PSYCHOLOGY compression.  Most complications are not serious and resolve with little or no treatment. Indicators for C-section:  A sudden increase or decrease in the labouring woman’s blood pressure may necessitate a C-section.  Prolonged stage 1 labour exceeding 24 hours may require surgical delivery if the infant's head position prevents sufficient pressure on the cervix.  Most women need about a month to recover after childbirth.  Women experience various hormonal changes essential for nursing and returning to their normal menstrual cycle.  Some may experience postpartum depression, but most women recover quickly, both physically and emotionally, after pregnancy and birth. Assessing the Neonate A baby is referred to as a neonate during the first month of life. Apgar Scale Assessment:  Health of babies born in hospitals, birthing centres, and most home deliveries is assessed with the Apgar scale (Apgar, 1953).  The baby receives a score of 0, 1, or 2 on each of five criteria.  Maximum score of 10 is unusual immediately after birth, as most infants are somewhat blue in fingers and toes.  At a second assessment, usually five minutes after birth, 85 to 90% of infants score 9 or 10.  Score Interpretations:  Score of 7 or better: baby is in no danger.  Score of 4, 5, or 6: baby needs help establishing normal breathing patterns.  Score of 3 or below: baby is in critical condition. Standard Screening Procedures:  Expanded across Canada to include detection of rare metabolic disorders in newborns (Dyack, 2004).  New tandem mass spectrometry technology runs multiple tests efficiently and cost-effectively.  Allows for presymptomatic detection of inborn metabolic anomalies, enabling early treatment measures and better outcomes. Brazelton Neonatal Behavioral Assessment Scale:  Used to track a newborn’s development over the first two weeks following birth (Brazelton & Nugent, 1995).  Health professionals examine the neonate’s responses to stimuli, reflexes, muscle tone, alertness, cuddliness, and self- soothing ability after being upset.  Scores on this test can help identify children who may have significant neurological problems. THEORIES OF DEVELOPMENT DEVELOPMENTAL PSYCHOLOGY MGA WALA SA BOOK: Prenatal Development  Neonate - 1 month old Predisposed Behavior o having or showing an inclination or tendency toward a specified condition, opinion, behavior, etc., beforehand: Many studies show how genes interact with the environment to cause disease in predisposed individuals. Behavioral Genetics  Scientific study of the interplay between genetic and environmental contributions to behavior. NAME DESCRIPTION a) Passive Genotype-Environment Correlation o Occurs when children passively inherit both the genes and the environments their family provide. b) Evocative Genotype-Environment Correlation Genotype Environment Refer to how the social environment reacts to individuals based on their inherited results Correlation c) Active Genotype-Environment Correlation occur when individuals seek out environments that support their genetic tendencies. Factors Affecting Prenatal Risk a) Timing of the Exposure b) Amount of exposure c) Number of teratogens d) Genetics e) Being male and female