2.  Nutrition  A balanced diet is important to the health of a growing fetus  Increase calories 10-20%  Proteins, vitamins and minerals are essential (supplement diet with prenatal vitamins)  Folic acid is a necessity to help the nervous system of the fetus develop. Without it the fetus could develop spina bifida (neural tube does not close properly = crutches or wheelchairs)  Without proper nutrition: premature birth, underweight, nervous system problems, vulnerable to illness

3.  Stress  Exposure to chronic stress = smaller than average, prone to behavioural and physical problems  Inability to pay attention  Stress reduces the flow of oxygen to the fetus while increasing its heart rate and activity level  Stress can weaken the woman’s immune system and make her susceptible to illness, which can damage fetal development  Women under stress are more likely to smoke or drink alcohol and are less likely to rest, exercise and eat properly

4.  Mother’s Age (Teen)  More problems during pregnancy, labour and delivery due to lack of resources and economic state and inadequate prenatal care  Incomplete education, poverty and marital difficulties can affect a child’s later development  Less likely to eat properly = less folic acid, which leads to higher incidences of spina bifida  They are still growing and fighting for nutrients – produces babies with a lower birth weight which can lead to higher incidences of SIDS (sudden infant death syndrome) and physical and intellectual delays

5.  Mother’s Age (35 and Older)  Older women have more difficulty getting pregnant  Women in their 30s are half as fertile as women in their 20s  After 35 the risk of a miscarriage increases dramatically  Half of all pregnancies among 40-45 year olds result in miscarriage  Chromosomal deficiencies  Higher blood pressure  Women in their 40s are more likely to give birth to children with Down Syndrome  Age of father may be linked to congenital malformations  Mutations of gametes  More likely to have children with Autism  Best ages are between 20 and 35

6.  Genetic Defects  Abnormalities that are hereditary  Down Syndrome: caused by 3 instead of 2 of the 21 st chromosomes – slanting eyes, broad hands, short broad skull, mental retardation  Phenylketnuria (PKU): deficiency of the enzyme necessary to convert protein – defective red blood cells  Sickle Cell Anemia: defective red blood cells  Diabetes: the pancreas doesn’t function properly (doesn’t metabolize sugar properly)  Tay-Sachs Disease: defective eyes, loss of weight, affects central nervous system and finally causes death  Hemophilia: blood does not clot, only found in males

7.  Teratogen: an agent that causes abnormal prenatal development

8.  Diseases  AIDS: frequent infections, neurological disorders, death (can be managed with medication)  Cytomegalovirus: deafness, blindess, abnormally small head, mental retardation  Genital Herpes: encephalitis, enlarged spleen, improper blood clotting (C-section necessary if active)  Rubella: mental retardation, damage to eyes, ears and heart  Syphilis: damage to the central nervous system, teeth and bones  Gonorrhea and Chlamydia: ear and eye infections, pneumonia, blindness  GET PROPER CARE!!!

9.  Drugs  Over the counter: aspirin can cause hemorrhaging  Prescription: check with your doctor – avoid accutaine  Alcohol: Fetal Alcohol Syndrome (FAS): brain injury, growth impairment, facial deformity, congenital heart defects, short attention spans, behavioural problems  Cocaine/Crack: pre-maturity, neonatal intoxication and withdrawal (jitteriness, excessive crying, irritable, inconsolable), cerbrovascular problems, learning disabilities, behavioural problems, ADD

10.  Drugs  Tranquilizers: baby may be intoxicated, withdrawal, lethargy, respiratory difficulties, difficulty regulating temperature, failure to suck effectively  Barbiturates: similar to FAS  Phencyclidine (PCP): intrauterine growth retardation, withdrawal, developmental delays  Narcotics: small, withdrawal, central nervous system damage, irritability, gastrointestinal dysfunction, respiratory distress  Marijuana: small birth weight, decreased psychomotor performance, decreased ability to perform skilled tests, learning disabilities, deformities  Smoking: low birth weight, prone to infections, increased mortality, at risk for cerebral palsy, malformation and developmental disabilities, high risk of SIDS

11.  Environmental  Polychlorinated Biphenyls (PCBs): cognitive deficits and disorders such as schizophrenia  Lead: mental retardation  Mercury: retarded growth, mental retardation, cerebral palsy  X-Rays: retarded growth, leukemia, mental retardation  Parasites: cat feces and undercooked food can cause toxoplasmosis (can be fatal – encephalitis, neurological disorders, damage to heart, liver, ears and eyes

12.  Ectopic Pregnancy: the egg attaches to the wall of the fallopian tube instead of the uterine wall (miscarriage, results in bleeding but can cause death)  Multiple Births: lack of space, preterm births  Rh Factor: factor found in red blood cells. Most people have it and are Rh positive though some are Rh negative. If a mother with Rh negative blood carries an Rh positive baby she will develop antibodies that will attack the blood cells of future fetuses. She will need a shot after each Rh positive baby to prevent the antibodies from forming

13.  Also called miscarriages  Usually it is nature’s way of eliminating an abnormal pregnancy  15% of pregnancies end in miscarriage  Usually occur in the first trimester  Baby dies 2-4 weeks before it is expelled  May need doctor assistance “D and C” (dialation and curettage) – walls of uterus are gently scraped

14.  Causes  Most frequently is chromosomal problems  Infections  Old or aged ovum  Defective implantation: placenta breaks loose due to lack of hormones  Ectopic pregnancy: implantation outside of uterus  Cord accidents: cord is torn off or twisted  Placenta Previa: placenta is low or may cover the cervix  Placenta Abruption: premature separation from uterine wall  Toxemia: the body doesn’t use protein correctly – swelling, puffy fingers and feet and can cause convulsions, still birth and maternal death  Hemorrhage: bleeding from placenta abruption or previa

15.  Genetic Counseling – hopefully avoid genetic disorders  Ultrasound: standard in prenatal care in Canada. Uses sound waves to generate a picture of the fetus. Can be used 4-5 weeks along.  Can predict due date, can see position of fetus and placenta  Can identify physical deformities  Can determine sex after 20 weeks

16.  Amniocentesis: a needle is inserted through the mother’s abdomen to obtain a sample of the amniotic fluid  Performed at 16 weeks  Analyzes the genotype of the fetus and can determine any genetic disorders  Chorionic Villus Sampling: a tube is inserted vaginally to obtain sample tissue from the placenta  Performed at 10 to 12 weeks  Analyzes the genotype of the fetus and can determine and genetic disorders  Miscarriages are slightly higher after these procedures

17.  If a problem is found in utero there are several options today.  Administer drugs or hormones to the fetus  (fetal hypothyroidism – thyroid is not producing enough hormones and can result in retarded mental and physical development but can be treated by injecting the hormones into the amniotic cavity)  Fetal Surgery: operate on the fetus while it is still in the uterus  When one twin is circulating the blood supply for both fetuses surgery can seal off the unnecessary blood vessels between them  Genetic Engineering: Highly experimental. In theory you could replace defective genes with synthetic normal genes