CHAPTER 4

PRENATAL AND BIRTH

 LEARNING OBJECTIVES
By the end of this chapter, students should be able to:
• define prenatal development
• identify the phases of prenatal development
• describe potential problems in prenatal development
• explain the birth defects and types of birth defects
• descsribe the tools to measure neonatal health and
responsiveness.
 Prenatal development
- Definition – development that occurs between
the moment of conception and the beginning
of the birth.
- Conception occurs when a single sperm cell
from the male unites with an ovum (egg)
 Phases of prenatal development
• 266-280 days:
– Germinal period: first 2 weeks after conception, zygote
created

– Embryonic period: occurs from 3 to 8 weeks after

conception

– Fetal period: begins 2 months after conception and lasts

until birth
 Potential problems in prenatal
development
– Teratogens
– General risk factors
 Teratogens: Diseases, Drugs
and Environmental Hazards
• Teratogens – external agents such as diseases, drugs and chemical
that can harm the developing organism
• Many disease pass through the placenta directly and attack the
fetus.
– AIDS (infections neurological disorders, death)
– Cytomegalovirus (deafness, blindness, retardation)
– Genital herpes (enlarge spleen, improper blood clotting)
– Rubella (Mental retardation, eyes, ear and heart)
– Syphilis (CNS damage, teeth, bones)
• Potentially dangerous drugs.
– Alcohol (fetal alcohol syndrome)
– Aspirin (lower IQ, attention and motor skill)
– Caffeine (low birth weight, low tone)
– Cocaine (retarded growth)
– Marijuana (low birth weight, less motor control)
– Nicotine (retarded growth, cognitive impairments)
 General Risk Factors
1.Stress
• Prolonged stress create problems:
– Fetus underweight.
– Bleeding
– Miscarriage
2.Mother’s Age
 40 and higher risk of Downs
 If adequate care, pregnancy
can be normal from teens till
late 30’s
 But teens less likely to get
adequate care.
 Older – less likely to get
pregnant.
3.Fetal Alcohol Syndrome
•is a pattern of physical and mental defects
that can develop in a fetus in association
with high levels of alcohol consumption during pregnancy
•Mother drinks heavily during pregnancy
•Effects to the baby:
– Mental retardation
– Learning disability
– alcohol interferes with brain development
– heart defects
– poor motor development
3/1,000 babies have FAS.
4. Environmental Hazards
•Environmental hazards are treacherous
because we’re often unaware of their presence.
– Lead (mental retardation)
– Mercury (retarded growth, cerebral pains, mental
retardation)
– X-ray(retarded growth, leukemia, mental
retardation)
5. Ectopic Pregnancy
• The fertilized egg
continues to develop
in the fallopian tube
instead of moving into
the uterus.
6. Miscarriage
The natural ending of a pregnancy before
the embryo or fetus can survive outside the
womb.

7. Stillbirth
The natural ending of a pregnancy after 20
weeks.
• The loss happens by accident and is not
the fault of the father or mother.
7. Premature baby
Baby that is born before their development is
complete.
Pregnancy is less than 36 weeks.
Weighs less than 2.5 kg (last month of pregnancy is when they
gain most of their weight).
Small size and incomplete development can make them
vulnerable to infection, lung ailments, etc.
8. Low Birthweight Baby
•Baby is full term (or near full term) but
weighs less than 2.5 kg.
•Usually occurs because of poor prenatal
care (lack of medical care or poor prenatal
environment).
•Baby may have more long term issues than
a premature.
 9. Gestational Diabetes
• A form of diabetes that occurs only during
pregnancy.
• If left untreated during pregnancy, can cause
baby to be heavier than is normal or healthy.
• Can usually be controlled by a special diet or
may require medication.
• Usually goes away after baby is born.
 10. Preeclampsia
• Characterized by high blood
pressure and the presence of
protein in the mother’s urine.
• Can prevent the baby from getting
enough blood, which provides
oxygen and food.
• May require rest, medication, or an
early delivery.
 Birth Defects
Birth abnormality that affects the structure or
function of the body(definition of birth defects)
Types of birth defects:
– Spina Bifida
– Hydrocephalus
– Cerebral Palsy
– Cleft Lip or Palate
– Down Syndrome
 Spina Bifida
• Spina bifida is a birth defect where there
is incomplete closing of the backbone and
membranes around the spinal cord.
 Hydrocephalus
• Hydrocephalus is a brain condition that gets its name
from the Greek word for water (meaning "hydro")
and head (meaning "cephalus").

It occurs when cerebral spinal fluid (CSF) — the clear,

water-like fluid that surrounds and cushions
the brain and spinal cord — is unable to drain from
the brain.
 Hydrocephalus
Without treatment
children rarely
survive.
Surgical removal of
the excess fluid
increases chances of
survival and normal
development.
 Cerebral Palsy
• Caused by injury to the brain
before, during, or after birth -
A group of disorders that affect
movement control include -
lack of coordination,
difficulty in speech, and
paralysis (loss of muscle
function for one or more
muscles sometimes also a loss
of feeling (sensory loss) in the
affected area.
 Cleft Lip / Palate
Birth defect that
develops when
the face does
not grow
together during
prenatal
development.
 Down
Syndrome
 Chromosomal error
 extra chromosome
21 (they don’t
know why there is
an extra one)
 mother’s age will
increase the risk
 father may also be
a carrier
 Causes of Birth Defects
• Environmental causes
– nutritional imbalance of mother’s
diet
– any disease or infections the
mother may have during pregnancy

• Heredity – the result of inheriting the

same defective gene from both
parents.
Can birth defects be prevented?
• Avoid environmental hazards
• Appropriate exercise
• Proper nutrition
• Nutritional supplements – Folic Acid
– Helps protect your unborn baby against birth
defects of the brain and spinal cord (neural
tube defects).
 Transition from Fetus
to Newborn
• Measuring neonatal health and responsiveness:
– Apgar Scale: assessed at 1 minute and 5 minutes after
birth
• evaluates heart rate, body color, muscle tone, respiratory effort
and reflex irritability
• 10 is highest, 3 or below indicates an emergency
• Measuring neonatal health and responsiveness:
– Brazelton Neonatal Behavioral Assessment Scale (NBAS):
• Typically performed within 24–36 hours after birth
• Assesses newborn’s neurological development, reflexes, and
reactions to people and objects
– Low scores can indicate brain damage or other difficulties
– Neonatal Intensive Care Unit Network Neurobehavioral
Scale (NNNS):
• Provides a more comprehensive analysis of newborn’s behavior,
neurological and stress responses, and regulatory capacities
• Assesses the “at-risk” infant