Determinants of prenatal health and development Key SKILLS explain the determinants of health and individual human development and their impact during the prenatal stage of the lifespan using relevant examples Describe a specific health issue affecting the prenatal stage of the lifespan and draw informed conclusions about personal, community and government strategies or programs to optimise prenatal health and development.

 Bodyweight  Excess maternal bodyweight and obesity can lead to an increase risk of gestational diabetes, pre-eclampsia, infection, haemorrhage and caesarean delivery.  The babies of women who are obese have higher rates of stillbirth and neonatal deaths.  22.4% of women  who gave birth in 2010 were obese.  It is to be expected that a woman’s Body Mass Index (BMI) will increase during pregnancy, with the increase in blood volume and the weight of the baby, placenta and additional fluid. Impact of biological determinants

Genetics includes all of the things that are inherited from parents via DNA at the moment of conception. These include: Inherited characteristics – body type, potential for height, basal metabolic rate, hair colour and eye colour. Sex – whether or not the individual is male or female. Genetic disorders – either genetically inherited diseases such as haemophilia, cystic fibrosis or phenylketonuria (PKU) or other genetic disorders that may be the result of chromosomal abnormality. These are not inherited from the parents as such, but rather are the result of incorrect cell division eg. Down syndrome

 Parental smoking Smoking tobacco during pregnancy is known to be detrimental to the growth and development of the foetus. Passive smoking can also affect the foetus. Tobacco smoking reduces the oxygen supply and blood flow to the foetus via the placenta, nicotine will increase its heart rate and reduce the movements that it is practising to assist it to breathe after birth. Impact of behavioural determinants

 Increases risk of low birth weight  Need for resuscitation  Increase risk of SIDS  increase risk of cleft lip and/or cleft palate and may impact on intellectual development.  increase risk of ectopic pregnancy, miscarriage and pre-term birth. Smoking during pregnancy

 Nearly 14% of women who gave birth in 2010 reported smoking in the first 20 weeks of their pregnancy, and 9.5% reported smoking after 20 weeks of pregnancy.

 alcohol crosses the placenta, and it can be detrimental to foetal health  Binge-drinking in particular is potentially dangerous, especially in the first trimester of pregnancy.  It can cause: birth defects, brain damage, low birth weight,damage the baby’s central nervous system, causing mental retardation, growth deficiencies and facial abnormalities depending on the time and extent of the exposure to alcohol, increase the risk of miscarriage, premature birth or stillbirth. Alcohol and drug use during pregnancy

 associated with heavy alcohol consumption during pregnancy  where a child has problems with growth and learning, and has distinctive facial features and structural abnormalities due to alcohol exposure during pregnancy  consumption-can-affect-your-baby/# Foetal alcohol syndrome (FAS)

Vaccinations

 Folate is a B group vitamin that is important in protecting against neural tube defects such as Spina bifida during foetal development.  It is recommended that women trying to become pregnant consume 400 micrograms of folate per day, and should continue to consume that amount during the first three months of pregnancy.  Food source: green leafy vegetables, cereals, fruits and grains. Maternal nutrition prior to and during pregnancy

 increases in nutrients equate to two extra serves of fruit, half a serve of meat, fish, nuts or legumes and possibly one extra serve of vegetables.  Need to ensure adequate calcium intake

 ensure food is prepared and stored safely to avoid the risk of infection from listeria, salmonella and toxoplasmosis  should avoid when pregnant include: soft cheeses such as ricotta and camembert, soft serve ice-cream, cold meats, raw seafood and pre-packaged salads.  Listeria can grow in the fridge so pregnant women should avoid foods that have been prepared and stored for more than 12 hours.  Listeria is serious as it can cross the placenta to the foetus and result in miscarriage, stillbirth or premature birth Foods to avoid

Impact of social determinants

 higher education and literacy impacts positively on health  more likely to have more antenatal health checks, consume adequate levels of folate  less likely to drink alcohol or smoke during their pregnancy Parental education

 increases access to goods and services such as nutritious food and healthcare  Low socio economic tend to have less access to adequate nutrition, less access to health services, poorer housing, less safety and more stress. Parental income

 Barriers to adequate access to healthcare may include culture, language, knowledge and cost.  All Australians have the right to free or low cost medical or hospital care but knowledge and resources to access these services may be a challenge for some women.  Centres that supply antenatal healthcare may provide advice on nutrition and monitor the health of the mother and baby, such as her blood pressure, blood glucose levels and weight gain, and provide advice about avoiding exposure to harmful substances. Access to healthcare

 Tobacco smoke in the home  A non smoking pregnant woman is more likely to give birth to a baby with a low birth weight if she is exposed to passive smoking in the home.  Babies that have been exposed to tobacco smoke in the home may also be at higher risk of SIDS Impact of the physical environment

 There can be several barriers to people having access to healthcare services, such as geographical location and transport Access to healthcare