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4.1 What are the three stages of prenatal development, and what
happens during each stage?
4.2 What environmental influences can affect prenatal development?
4.3 What techniques can assess a fetus’s health and well-being, and
what is the importance of prenatal and preconception care?
Guidepost for Study 4.2 Lecture Topic 4.1, 4.2, 4.3, 4.4
What environmental influences can affect Choosing Sides 4.1
prenatal development? Knowledge Construction Activity 4.1,
4.2, 4.3, 4.4
Please check out the Online Learning Center located at http://www.mhhe.com/papaliaacw13 for further information
on these and other topics, as well as a variety of other teaching resources. There you can access downloadable
PowerPoints tailored to each chapter of the text. This site also contains useful teaching notes as well as images and
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3. EXPANDED OUTLINE
I. Prenatal Development: Three Stages
Gestation: The approximately 9-month or 266-day period of development between
conception and birth.
Gestational age: Age of an unborn baby.
Germinal, Embryonic, Fetal: Three stages of prenatal development when zygote grows into
an embryo and then a fetus.
Morphogens: Molecules which are switched on after fertilization and begin sculpting arms,
fingers, vertebrae, ribs, a brain, and other body parts.
Cephalocaudal principle: Principle that development proceeds in a head-to-tail direction;
upper parts of the body develop before lower parts of the trunk.
Proximodistal principle: Principle that development proceeds from within to without; parts
of the body near the center develop before the extremities.
C. Malnutrition
Dietary supplements may lessen the effects of maternal malnutrition.
E. Drug Intake
Medical Drugs
o Thalidomide: Tranquilizer that caused stunted or missing limbs, severe facial
deformities, and defective organs.
Alcohol
o Fetal alcohol syndrome (FAS): Combination of mental, motor, developmental
abnormalities, and disorders of the central nervous system.
Nicotine
Caffeine
Marijuana, Cocaine, and Methamphetamine
F. Maternal Illnesses
Acquired Immune Deficiency Syndrome (AIDS): Disease caused by human
immunodeficiency virus (HIV) that undermines effective functioning of the immune
system.
Perinatal transmission: The virus may cross over to the fetus’ bloodstream through the
placenta during pregnancy, labor of delivery, or after birth, through breast milk.
Fetal Welfare Versus Mothers’ Rights (See the Everyday World p. 106)
Toxoplasmosis: An infection caused by a parasite harbored in the bodies of cattle, sheep,
pigs, and cats.
H. Maternal Age
J. Paternal Factors
Outside environmental factors
Drug use
Paternal age
LECTURE TOPICS
The solution is more complex than simply supplementing the diets of malnourished
pregnant women and their newborn children. Fetally malnourished infants often are apathetic
and unresponsive and, when they are aroused, become irritable. These qualities put such children
at risk in another waythey often receive less interaction and emotional support from their
caregivers.
Zeskind and Ramsey maintain that fetally malnourished infants need both dietary
supplements and supportive-care environments to counteract the negative long-term effects of
fetal malnourishment. They tested this hypothesis in a longitudinal study in which fetally
malnourished 3-month-old infants were assigned to two conditions (early intervention and
nonintervention). In the early-intervention condition, the infants participated in a day care
program (8 hours per day, 50 weeks per year) that emphasized the acquisition of basic cognitive,
language, and social skills. The nonintervention groups did not attend this program. Nutrition
and medical care were the same for both groups. At regular intervals during the first three years,
the children were administered IQ and social-responsiveness tests and were observed interacting
with their mothers at home.
There were no differences in test scores at the beginning of the experiment, but the two
groups diverged greatly in their performances. The early-intervention group eventually exhibited
a nearly normal pattern of cognitive development, whereas the nonintervention groups exhibited
progressive declines in intellectual functioning. The mothers in the early-intervention group
became more responsive to their children, while the opposite occurred with mothers in the
nonintervention group. Emotionally, the children who attended the day care program at age 3
were less anxious, friendlier, and more self-assured than their counterparts in the nonintervention
group. These results show that the effects of fetal malnourishment are complex and may
compound over time. Both dietary and social interventions are necessary to overcome the
intellectual and social deficits that fetal malnutrition produces.
has also provided us with significant clinical information which is used by health care personnel
to make recommendations to couples planning pregnancies.
The effect of a teratogen depends on the dosage, the timing, the specifics of the influence,
and the buffers that may be in place for the fetus. For example, cigarette smoking contributes to
early miscarriage (spontaneous abortion). Chronic smoking contributes to the early shut down of
the placenta, thus compromising the ability of the placenta to supply oxygen and nutrition to the
fetus. This cumulative effect of cigarette smoking probably contributes to the likelihood of low
birth weight among infants of mothers who smoke. In childhood, children whose mothers
smoked during pregnancy have a greater-than-average chance of having asthma. By age four,
there are still effects of maternal use of tobacco, caffeine, aspirin, and alcohol on children’s
motor skills.
Prescribed medication can have teratogenic effects as well. While Prozac has not been
demonstrated to cause birth defects, third trimester use is associated with early (preterm) labor
and neonatal complications. Other medications, even ones as simple as aspirin, have the potential
to cause fetal damage.
Clinical recommendations currently lean toward the side of extreme caution. Substances
that might be harmful to a developing fetus should be avoided. However, in the case of
medications, including psychotropic drugs, caution and clinical judgment interact. In some cases,
the benefit of lower limitations of drug dosage might be accepted during the pregnancy. In such
cases, the benefit to the mother and the (limited) potential harm to the infant must be balanced in
determining how the mother should manage her medications during pregnancy.
The geographical distribution of birth defects is not an even one. There are hundreds of
known birth defect clusters, and about 50 of them are added each year. Of all the new clusters of
birth defects, only 3 or 4 are even investigated. Birth defects clusters are located in diverse areas
such as Port St. Lucie, Florida; Toms River, N.J.; and Woburn, Massachusetts, all of which have
a childhood cancer rate that is 2½ times the average. It was found that, in some areas, the high
rate of birth defects occurred only in a part of town where buried toxic wastes had infiltrated the
drinking wells. In Love Canal, New York, 56 percent of children born near the toxic dump were
mentally or physically disabled.
One of the thorniest problems in research on birth defects is that a teratogen can cause
many different birth defects, and any defect can be caused by a variety of teratogens. The typical
research procedure has been to use animal research to study teratogens, yet only twice has the
cause of human birth defects been found first in an animal. There is a tremendous need to
examine human populations. Another study involving Vietnam veterans and Agent Orange
showed that the highest rate of birth defects was found among offspring of the “Ranch Hand”
veteransthose who had sprayed the herbicide. As a country, we need to offer better public
education, put stronger warnings on drugs, do better basic research including fetal autopsies,
train our medical doctors on the topic (none of our medical schools has a teratology specialty),
and reduce environmental pollutants.
DISCUSSION TOPICS
INDEPENDENT STUDIES
CHOOSING SIDES
You are working in a bar; a woman customer comes in whom you suspect
may be pregnant. Can you ask her if she is pregnant? Should you serve her
if she says she is not pregnant, but you still suspect that she is? If she says
that she is pregnant, but still demands to be served, what do you do?
Gestational age
Tay-Sachs
Down syndrome
Spina bifida
Genetic disorders
Sickle-cell anemia
Multiple pregnancies
Students will find all aspects of this activity challenging and fun. It provides them with an
opportunity to experiment with common research methodology, learn some critically important
information, assess the educational level of peers, and share an experience with colleagues.
1. What kind of prenatal care do women receive and who delivers that care?
2. Where do women give birth?
When you have the answers to your questions, create a presentation for the class. Each group
should include a description of the health care available to pregnant women in their chosen
country. Care of impoverished as well as affluent women in that country should also be
considered.
Your instructor will use the information from each group to create a summary table on an
overhead transparency or whiteboard. When all of the information is presented, discuss
international differences.