PREGNANCY More Established Reproductive Technologies: Artificial Insemination: Artificial Insemination: Introducing sperm into woman’s vagina or uterus by artificial means single woman single woman husband low sperm count husband low sperm count husband dead husband dead husband infertile: donor sperm husband infertile: donor sperm

PREGNANCY More Established Reproductive Technologies (Cont’d): IVF: in vitro fertilization: IVF: in vitro fertilization: test tube or Petri dish is used to mix gametes; once dividing, surgically implanted into woman’s uterus can use both parents’ gametes can use both parents’ gametes one parent plus donor’s one parent plus donor’s can be implanted in surrogate’s uterus (“rent-a-womb”) can be implanted in surrogate’s uterus (“rent-a-womb”)

PREGNANCY Testing the Conceptus for Abnormalities: amniocentesis (11-14 weeks) amniocentesis (11-14 weeks) CVS: chorionic villus sampling (villi) (6-8 weeks) CVS: chorionic villus sampling (villi) (6-8 weeks) ultrasound (12-16 weeks) fetoscopy blood test

PREGNANCY TERATOGENS: anything that causes birth defects (teratos = monster) anything that causes birth defects (teratos = monster) Critical vs. sensitive periods Critical vs. sensitive periods Maternal Diseases: Maternal Diseases:Rubella Toxoplasmosis (cat’s feces, raw meat) CMVAIDS

PREGNANCY TERATOGENS (Cont’d): Radiation Radiation Chemicals: Chemicals: absorbed through lungs or skin High Temperature: High Temperature: hot bath General Environmental Pollution: General Environmental Pollution: what we eat, drink, breathe, touch e.g. phthalates: alter boys’ genitals alter boys’ genitals found in: found in:perfumes nail polish flooring hard plastics paintsadhesives

PREGNANCY Drugs: prescription, e.g. DES, thalidomide prescription, e.g. DES, thalidomide OTC OTC “recreational”, illegal “recreational”, illegal caffeine caffeine aspirin, etc. aspirin, etc. TERATOGENS (Cont’d):

PREGNANCY Smoking: Smoking:nicotine CO: CO: 200 times more affinity to Hgb than oxygen oxygen supply compromised (5% less) decreases sperm motility: lower fertility lower fertility less progesterone: miscarriages miscarriages placental problems higher morbidity and mortality from 9/1000 to 33/1000 from 9/1000 to 33/1000 higher rates of cleft palate and hare lip

PREGNANCY TERATOGENS (Cont’d): Alcohol: Alcohol: FASD (fetal alcohol spectrum disorder) brain abnormalities: brain abnormalities: learning difficulties ADDH mental retardation, etc. possible damage to eyes, ears, immune system, internal organs, joints, limbs possible damage to eyes, ears, immune system, internal organs, joints, limbs low birth weight low birth weight increased prematurity, miscarriage and stillbirth risk increased prematurity, miscarriage and stillbirth risk

PREGNANCY TERATOGENS (Cont’d): Alcohol: Alcohol: FASD (fetal alcohol spectrum disorder) (Cont’d) growth retardation growth retardation facial and cranial malformations facial and cranial malformations dose and timing related dose and timing related no safe dose no safe dose there is no cure for FASD there is no cure for FASD leading cause of preventable mental retardation leading cause of preventable mental retardation

PREGNANCY TERATOGENS (Cont’d): All drug effects: Dose Related: Dose Related: Interactions: hard to tell main effects Interactions: hard to tell main effects Possible effects: miscarriage miscarriage stillbirth stillbirth low birth weight low birth weight irritability, hard to soothe irritability, hard to soothe shorter attention span (learning) shorter attention span (learning) tremors tremors digestive difficulties digestive difficulties

PREGNANCY TERATOGENS (Cont’d): THERE ARE NO TOTALLY SAFE DRUGS! Most vulnerable: Most vulnerable: brain, CNS learning problems learning problems ADHD ADHD Most common mechanism: Most common mechanism: oxygen deprivation

PREGNANCY TERATOGENS (Cont’d): Maternal stress: Maternal stress: acute or chronic (worse) adrenaline, corticosteroids: adrenaline, corticosteroids: compromise oxygen supply for infant after birth: digestive problems digestive problems low birth weight low birth weight irritability irritability

PREGNANCY TERATOGENS (Cont’d): Maternal age: Maternal age: no more obstetrical complications (if healthy) increased Down’s syndrome Other effects of these variables: Other effects of these variables: affect maternal-infant interaction abuseneglectrejection

PREGNANCY Maternal Nutrition: First trimester: First trimester: usually not an issue – special cases Second trimester: Second trimester:quality Third trimester: Third trimester: quality and quantity Important: Important: Folic acid: prevents neural tube defects (eg. spina bifida)

PREGNANCY Maternal Nutrition (Cont’d): Infant Optimal Weight: Infant Optimal Weight: 7½ - 8 lbs. (European stock) Low Birth Weight: Low Birth Weight: 5½ lbs. or 2,500 g

Low Birth Weight Definition Low Birth Weight: Infant weighs less than 5.5 pounds (2500 g) Infant weighs less than 5.5 pounds (2500 g) Premature: Infant is born at less than 38 weeks gestation Infant is born at less than 38 weeks gestation

Causes of LBW There is no one cause for LBW, but some include: maternal smoking; drinking; drugs maternal smoking; drinking; drugs maternal diabetes maternal diabetes lack of adequate prenatal care lack of adequate prenatal care poor nutrition poor nutrition infection infection unknown causes unknown causes Even healthy mothers with good prenatal care may give birth to a LBW infant (placental problems)

Risks for the LBW Infant Health heart & lung heart & lung vision vision hearing hearing motor problems motor problems developmental problems developmental problemsEnvironmental abuse abuse attachment problems attachment problems Later Deficits learning difficulties learning difficulties health problems may persist into adulthood health problems may persist into adulthood There is no way to predict which problems, if any an infant may have may have

Chromosomal disorders Many congenital disease are caused by chromosomal mutations. These disorders result from errors during meiosis. Gametes are formed that have either too few or too many chromosomes. 20Nondisjunction%20Meiosis%20II.htm 20Nondisjunction%20Meiosis%20II.htm

Trisomy Trisomy is the condition in which the offspring inherit an extra copy of a chromosome. The most common type is called Downs Syndrome. Sufferers of this disease have three copies of Chromosome 21.

Monosomy Sometimes the offspring only receive a single copy of a chromosome, which leads to a monosomy. Monosomy of X chromosome is called turner syndrom.

Partial monosomy Sometimes offspring receive two copies of each chromosomes, but one of the copies is incomplete. The disease Cri-du-chat results from the partial monosomy of chromosome 5. One copy of the chromosome is missing it’s short arm.