1. Prenatal Development

2. 1 st time births American Mothers Getting Older 2012 average age of 1 st time moms: 25.8 yrs

5. Conception and Implantation Figure 3.3

6. Prenatal Development Stages Blastocyst – fluid filled sphere which floats in uterus for day or 2; then buries self in uterine wall Outer cluster of cells—trophoblast (support structures) Inner clusterInner cluster of cells—embryonic pole/disk Inner cluster

7. Copyright © 2012 Pearson Education, Inc. All Rights Reserved. Periods of Prenatal Development PeriodLength Key Events Zygote 2 weeks Fertilization Fertilization Implantation Implantation Start of placenta Start of placenta Embryo 6 weeks Arms, legs, face, organs, muscles all develop Arms, legs, face, organs, muscles all develop Heart begins beating Heart begins beating Fetus 30 weeks “Growth and finishing ” “Growth and finishing ”

8. Copyright © 2012 Pearson Education, Inc. All Rights Reserved. Table 3.3 Source: Moore & Persaud, 2008. Milestonesof Prenatal Development

9. Copyright © 2012 Pearson Education, Inc. All Rights Reserved. The Placenta and Umbilical Cord Figure 3.4

10. 9 week fetus

11. Prenatal Diagnostics a. Amniosentesis b. Chorionic Villus Sampling (CVS)

12. Premature infant born at 22 wk gestation age

14. 3-D Ultrasound Twins

15. Baby Born in Amnion

16. Fetus in uterus

17. Fetal surgery techniques IMAGES

18. Monkey fetus being reinserted into womb

19. Spina bifida as shown in 3D ultrasound ( on right)

21. Fetal surgery at 21 wks GA for spina bifida grasping reflex present

22. What other reflexes are important? Grasping, rooting, etc

23. Fetal Surgery

24. Prenatal Testing 1.Chorionic Villi Sampling 1.Chorionic Villi Sampling 8-13 weeks GA 2. Amniocentesis Around 16 weeks 3. Blood Testing 16-18 weeks AFP test—tests for Down Syndrome; multiple births; neural tube defects What if there are problemsWhat if there are problems? What if there are problems

25. Prenatal Testing What if there are problemsWhat if there are problems? What if there are problems

26. Copyright © 2012 Pearson Education, Inc. All Rights Reserved. Sensitive Periods in Prenatal Development Figure 3.5

27. Prenatal brain development

28. Fetal Alcohol Syndrome (FAS)

29. FAS developmentally…

30. Copyright © 2012 Pearson Education, Inc. All Rights Reserved. Prenatal Environmental Influences: Teratogens Teratogen Any environmental agent that causes damage during the prenatal period Any environmental agent that causes damage during the prenatal period Factors include: Dose Dose Heredity Heredity Other negative influences Other negative influences Age Age

31. Copyright © 2012 Pearson Education, Inc. All Rights Reserved. Prenatal Development and Later Health Low Birth Weight Greater chance of  Heart Disease  Stroke  Diabetes High Birth Weight Greater chance of  Breast cancer  Prostate and other cancers Steve LovegroveSteve Lovegrove | Dreamstime.comDreamstime.com

32. Copyright © 2012 Pearson Education, Inc. All Rights Reserved. Relationship of Birth Weight to Breast Cancer Risk in Adulthood Figure 3.6

33. Copyright © 2012 Pearson Education, Inc. All Rights Reserved. Teratogens Drugs Prescription Prescription Nonprescription Nonprescription Illegal IllegalTobaccoAlcoholRadiation Pollution eg. Prenatal PCBs: lower IQ and attention at age 11 eg. Prenatal PCBs: lower IQ and attention at age 11 Infectious disease © Absolute Family

34. Copyright © 2012 Pearson Education, Inc. All Rights Reserved. Fetal Alcohol Spectrum Disorder: Criteria for Diagnosis Table 3.4 Source: Loock et al., 2005.

35. Copyright © 2012 Pearson Education, Inc. All Rights Reserved. Effects of Some Infectious Diseases During Pregnancy Table 3.5 + = established finding; 0 = no present evidence; ? = possible effect that is not clearly established. Sources: Jones, Lopez, & Wilson, 2003; Kliegman et al., 2008; Mardh, 2002; O’Rahilly & Müller, 2001

36. Copyright © 2012 Pearson Education, Inc. All Rights Reserved. Maternal Factors in Healthy Prenatal Development  Exercise  Nutrition  Prevention and treatment  Emotional stress  Rh blood factor  Maternal age  Previous births © Ron Chapple Studios | Dreamstime.comRon Chapple StudiosDreamstime.com

37. Copyright © 2012 Pearson Education, Inc. All Rights Reserved. The Effects of Emotional Stress on the Developing Fetus Stress hormones cross the placenta, causing a dramatic rise in fetal heart rate and activity. Fetal neurological functioning can be permanently altered. Fetal neurological functioning can be permanently altered. Maternal emotional stress predicts anxiety, short attention span, anger, aggression, and overactivity among young children, above and beyond the impact of other risk factors. Stress-related prenatal complications can be greatly reduced when mothers receive support from family members and friends.

38. Father’s Mental Health Father’s Mental Health Norwegian study: Father’s psychological distress during fetus’ 2 nd trimester (18-19wks) linked to child’s socioemotional health at age 3

39. Copyright © 2012 Pearson Education, Inc. All Rights Reserved. Prenatal/Birth Complications Increase with Maternal Age Figure 3.7

40. Copyright © 2012 Pearson Education, Inc. All Rights Reserved. Expectant Mothers with Late or No Prenatal Care Figure 3.8

41. Reasons Women Delay Prenatal Care  Financial hardship  Situational barriers  Personal barriers  engaging in high-risk behaviors that they do not want to reveal  Low SES or ethnic minority  Group care is an alternative  Eg: Centering Pregnancy © Martin Novak | Dreamstime.comMartin NovakDreamstime.com

42. 28 -40 wks (or 26-38 wks post conception)