Recap question from last time

In lecture last time, we talked about two examples of

disruptions to the development of sex organs in humans.
In Congenital Adrenal Hyperplasia, children have the sex
chromosomes ______ but external genitalia that resembles
____.
In Androgen Insensitivity Syndrome, children have the sex
chromosomes ______ but genitalia that resembles
____.
 Prenatal developmental and
preterm birth
Jenny Richmond
PSYC2061

Reading: White 4th edition

https://tinyurl.com/2061questions Chapter 2: pg 51-60
 Outcomes
◻ By the end of this lecture you should be
able to..
⬜Describe the changes that occur during
each stage of prenatal development
⬜Explain the limit of viability for preterm
birth
⬜Understand the rationale behind
interventions that are used with preterm
infants
Fertilization!
The Germinal Period:
The First 14 days
◻ Zygote travels towards
uterus
⬜Divides and forms
blastocyst
⬜16 to 64 cells
 The Embryonic Period
3rd to 8th week
◻ The blastocyst implants in the
uterine wall
◻ Layers of cells differentiate to
become
⬜Ectoderm (outer layer)
■ Nervous system, skin, hair
⬜Mesoderm (middle layer)
■ Muscles, bones, and circulatory
system
⬜Endoderm (inner layer)
■ Digestive system, lungs, urinary
tract and other vital organs
Embryology 101
Placenta

Embryo
Amniotic sac

Umbilical cord
4 weeks
6 weeks
8 weeks
 The Fetal Period:
The Last 7 Months

◻ A period of rapid growth and refinement of

organ systems
◻ Fetus more responsive

◻ Behavior becomes increasingly regular and

integrated
◻ Fetuses become viable between 22-28
weeks
12 weeks
18 weeks
6 months
◻ Fetus is capable of
responding to light
◻ Able to hear sound
⬜Sound level in the
uterus is 75db
⬜The mother’s voice
and heartbeat are best
heard
7 months
◻ Third trimester!
◻ Fetus begins
putting on weight
in the form of fat
just beneath the
skin
8 months
The Newborn Infant
 Check your understanding

Put the following stages of prenatal

development into chronological order
⬜Fetal period
⬜Germinal period
⬜2nd trimester
⬜Embryonic period
 The Preterm infant

◻ Born at 36 weeks
or earlier
◻ Low birth weight
(<2500 g)
 Preterm birth in Australia
◻ 7% of all birth < 37 weeks
◻ Certain groups at higher risk

⬜Indigenous mothers
⬜Young mothers (less than 20 years)
⬜Older mothers (older than 40 years)
⬜Multiple birth
⬜First time mothers

Tracy et al., (2007)

 Limit of viability

◻ The limit of viability

⬜The age at which infants have a 50% chance
of surviving their first year
Gestational age Died in NICU Died before 2 years Died or profound
impairment
22 weeks 95% 95% 98%
23 weeks 74% 74% 84%
24 weeks 44% 44% 57%
25 weeks 24% 25% 38%

From Tyson et al., (2008) NE. J.Med

 Predicting outcome

◻ Need to consider
⬜Birth weight
⬜Gender
⬜Multiple or
singleton
⬜Steroids

At 23 weeks:
- relatively heavy girl, singleton + steroids = 80% chance of survival
- relatively small boy, twin + no steroids = 20% chance of survival

From Tyson et al., (2008) NE. J.Med

 What is the NICU like?
◻ Preterm NICU environment video (6min)
⬜Secret Life of the Brain

◻ 16:20
 Interventions
◻ Adapting the neonatal intensive care unit
(NICU) environment
⬜Containment and lighting (86% US NICU)
 Interventions

◻ Kangaroo care (98% US

NICU)
⬜Skin-to-skin contact
⬜Accelerates development
of regulatory processes
■ Sleep development
■ Better feeding/growth
■ Earlier discharge

Feldman & Eidelman (2003)

 Interventions

◻ Tactile-kinesthetic stimulation (massage)

(38% US NICU)
⬜Benefits for preterm
■ Stimulates growth
■ Decreases stress behaviors
■ Earlier discharge

Tiffany Field Ph.D.

University of Miami
 Take home message

◻ Prenatal Development occurs sequentially

⬜ Germinal ⇨ Embryonic ⇨ Fetal

◻ Preterm birth represents a major anomaly in

the fetal environmental
⬜Outcome is multi factorial; it is not solely
determined by gestational age
⬜Research into interventions has changed NICU
practices and improved outcomes for infants
Questions- come to Q&A

https://tinyurl.com/2061questions