1. Prenatal Influences on Healthy Development
Chapter 6
Prenatal Influences on Healthy Development
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Key Terms
allele
Apgar score
attachment
bonding
chromosome
dizygotic
dominant gene
ectopic pregnancy
en face
engrossment
fetal alcohol syndrome
fetus
gene therapy
genetic code
genetic counseling
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Key Terms (cont.)
genome
gestation
monozygotic
multifetal
mutated
neonatal
sibling rivalry
syndrome
viable
virus vector
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4. The Human Genome Project
Involved gene mapping, which determined the makeup of human genes
The completion of the project in 2001 resulted in the identification of all human genes
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Heredity
genome
chromosome
genetic code
allele.
dominant gene
mutated
syndrome
See Figures 6-1 and 6-2.
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Genetic Counseling
Communication between a geneticist and parents to discuss an infant's risk of inheriting genes that could result in an abnormality
Therapeutic genes can repair defective DNA
Suicide genes can be programmed to destroy defective genes
Pure genes can replace a missing gene
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Gene Therapy
Placing a therapeutic gene on the back of a virus vector:
Virus enters specific cells in the body
Carries the new gene into the cell that has a missing or defective gene
Ethical, social, and legal aspects
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8. Screening Procedures and Therapies
Screen individual patients for the existence of some specific genetic problems without looking at DNA
Some adult-onset diseases can be diagnosed before symptoms appear
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ELSI
Ethical, legal, and social implications of gene therapy
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Fetal Development
Occurs when sperm penetrates the ovum as it enters the upper portion of the woman's fallopian tube
Sperm lives for up to 5 days, but the ovum lives for only 24 hours after ovulation
Zygote
Ectopic pregnancy
Fetus
Gestation
Viability
See Table 6-1.
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Twins
Multifetal
Dizygotic
Monozygotic
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12. The Prenatal Phase: Critical Periods
Many occur during the first trimester of pregnancy (first 3 months) when basic structures are developing.
Inadequate nutrition
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13. Exercise During Pregnancy
Important to maintain levels of health and fitness during pregnancy
Benefits include improved energy level, mood, sleep, and muscle tone, as well as decreased risk of gestational diabetes.
Simple modifications may be needed
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Toxins
Exposure to toxins during fetal development can cause abnormalities, illness, or miscarriage
Maternal ingestion of substances such as alcohol can interfere with cell growth in the developing fetus
Fetal alcohol syndrome is characterized by mental retardation and abnormal facial features
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15. Maternal Adaptations During the Prenatal Phase
Three phases of parental development
Response to discovering that conception has occurred
Reality of pregnancy becomes evident with fetal movement and ultrasound
Plans for the actual birth of the baby
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The Birth Process
Childbirth is a normal physiological process that affects the health of the mother and the fetus
Labor and delivery are often a family affair
A woman can choose to deliver the baby in a traditional hospital setting, in a freestanding private birthing center, or at home
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17. The Birth Process (cont.)
Dilation and effacement
Descent and birth of the baby
Birth of the placenta
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The Newborn Infant
Physiological changes occur in the infant's body to enable it to adjust to life outside the uterus after the umbilical cord is cut
Infant is dried and placed in a pre-warmed bed, and the head is covered to minimize heat loss until the infant can stabilize its own body temperature
Bonding and attachment between parents and newborn
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Apgar Score
Assessed at 1 minute and minutes after birth
A rating of heart rate, respiration, muscle tone, color, and reflex response
Score from 0 to 10 estimates the condition of the infant
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20. The Transition to Motherhood
Hormonal changes, changes in self-image, and reorganization of tasks
Mood swings are common; postpartum blues
See Table 6-2.
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21. Rubin’s Psychological Changes After Birth
Phase 1 - “Taking in.”
Phase 2 - “Taking hold.”
Phase 3 - “Letting go.”
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22. Fathers or Significant Others
Engrossment
Roles and responsibilities may change
Changes in sleep patterns and routines and the onset of new financial burdens can be stressful for some fathers or partners
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Siblings
Sibling rivalry
Initial relationship between a newborn and a sibling is established by the parents’ interaction with each child
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Grandparents
Culture and physical distance in living arrangements influence the role of grandparents
Most helpful if they assume the role of home manager by preparing meals, shopping, and helping with household tasks
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25. The Influence of Culture
Although the beliefs and practices of the family may be different than those of the health-care provider, these differences must be respected and considered.
Cultural perception may also affect the accuracy of pain assessment
See Cultural Considerations (p. 88)
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26. Developmental Tasks and Responses of the Neonate
Feeding patterns and habits
First trust experience
Sleeps 15 to 20 hours daily
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27. Development of Intelligence
Intelligence involves the ability to learn from experience and to adapt to the environment and its challenges
Psychometric variables and complex system variables
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28. Play Activities and Neonatal Development
A developmental task of the neonate is to learn how to focus on and follow objects as they move across the field of vision
Piaget's sensorimotor stage of cognitive growth
The best time to interact with the neonate is during the quiet-alert state of responsiveness
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