Topic 2

Question 1

teratogen

Answer 1

any agent that can cause a birth defect or negatively alter cognitive or behavioral outcomes of the individual

• severity/damage is greatly influence by dose, genetic susceptibility, maternal state, and time of exposure
• difficult to identify due to numbers and defects occurring later in life

Question 2

General results of exposure to teratogens

Answer 2

• initial growth spurt=greatest susceptibility. Eyes and CNS vulnerable throughout pregnancy
• embryonic period: major structural abnormalities
• fetal period: minor abnormalities and functional defects like stunted growth/problems with organ functioning

Question 3

types of teratogens

Answer 3

• nonpsychotropic drugs
• infectious maternal disease
• chronic medical conditions
• psycotropic drugs

Question 4

Rubella

Answer 4

• contagious, similar to measles
• pink rash, swollen lymph nodes, mild fever
• vaccination is a live attenuated virus: not for months -1 to 9 of pregnancy
• congenital damage in first trimester: death, deafness, growth retardation, cataracts, glaucoma, cognitive deficits, etc. (eyes are very susceptible)

Question 5

Tetnus

Answer 5

vaccination is not a live virus-therefore safe during pregnancy.

Question 6

Varicella

Answer 6

• chickenpox
• live virus vaccine
• congenital varicella syndrome similar to regular varicella

Question 7

Toxoplasmosis

Answer 7

3 ways of transition of parasite toxoplasma gondii

1. cat litter/fetus ( cat is primary host)
2. food-uncooked infected meat
3. congenital: if mother consumes uncooked infected meat
   - -mental retardation, abnormal motor abilities, visual impairment

Question 8

Pregnancy and diet

Answer 8

• raw fish (harmful bacteria)
• swordfish (mercury levels). fetus: developmental delays, brain damage
• deli meats (listeria). fetus: blood poisoning, infection
• hot dogs (listeria)
• soft cheese (listeria)
• unpasteurized honey
• raw meat (coliform bacteria, toxoplasmosis and salmonella)

Question 9

What is the most common teratogen?

Answer 9

ALCOHOL

Question 10

Why does having diabetes classify a pregnancy as high-risk?

Answer 10

Because the metabolic condition of the fetus has been compromised. It is hard to regulate insulin levels and blood sugar levels. If fetus environment fluctuates then motor development will be affected.

Question 11

Diabetes Mellitus

Answer 11

fetal hyperinsulinemia may result in

• macrosomia (birth weight above 90th percentile for gestational age)
• inhibition of maturation of lung surfactant
• muscle weakness/cardiac arrhythmias
• permanent neurological damage

Question 12

Macrosomnia

Answer 12

• linked to obesity later in life
• CNS deformities
• congenital anomalies (heart defects)
• musculoskeletal deformities
• respiratory distress syndrome
• traumatic birth injury

Question 13

Dependency Ratios

Answer 13

# of individuals likely to be "economically dependent" on the support of others
-determined by age structure and provides an indication of the social support structures required for population

Question 14

Youth Dependency Ratio
Elderly Dependency ratio
Total Dependency ratio

Answer 14

• ratio of youth (0-14) per 100 of working age (15-64)
• ratio of elderly (65+) per 100 of working age
• ratio of youth+elderly per 100 working age

Question 15

Where is investment needed if dependency ratios are high?

Answer 15

total:if high, working class and economy face a support burden
youth-education, early childcare
elderly-pension, healthcare

Question 16

fertility rate

Answer 16

avg no of children that would be born if all women lived to the end of their childbearing years and bore children according to the given rate

Question 17

Replacement rate

Answer 17

how many children are needed to replace a country’s population

Question 18

Replacement Fertility Rates

Answer 18

no mortality in childbearing years:
-developed countries: 2.1
less developed countries: 2.5-3.3
(0.1 and 0.5 buffers are for death, those who choose not to/cannot have children, and increased male vs female births)

Question 19

Replacement Fertility Rate trends

Answer 19

if 2.1, growth=0

if 2.1, growth increases and median age decreases

Question 20

Birth rate

Answer 20

avg. annual no of births per 1000 persons
-determines rate of population growth
depends of level of fertility and structure of population
does not factor in migration

Question 21

death rate

Answer 21

avg annual no. of deaths per 1000 persons

-indicates current mortality impact on population’s growth

Question 22

giving birth over 35

Answer 22

increased likelihood:

• pre-existing hypertension
• pre-eclampsia
• gestational diabetes
• placenta previa
• Caesarian section
• young-for-date infant
• small-for-gestational age infant
• chromosomal/congenital abnormality

Question 23

Pre-eclampsia

Answer 23

pregnancy induced hypertension

cure=giving birth

Question 24

Gestational Diabetes

Answer 24

high risk population: aboriginal

• pregnancy induced
• difficult to regulate (fluctuating environment is bad for fetus)
• mother+child increased factor to develop type 2 diabetes later

Question 25

Placenta Previa

Answer 25

when the placenta is covering the vaginal canal causing it to come out first-usually causes death of child

Question 26

gestational age | conceptional age

Answer 26

-40 weeks-from day 1 of last mentrual cycle to birth of infant (ovulation assumed to take place 2 weeks later) -38 weeks-from time of fertilization to birth full term=2weeks before to 2 weeks after

Question 27

3 Periods of pregnancy

Answer 27

1. Germinal (0-2 wks) - problems result in miscarriage 2. Embryonic (2-8) - most critical for development (organs) 3. Fetal (8-40)

Question 28

Germinal

Answer 28

-At conception, a one-cell zygote is created (fertilized egg). Cell division begins. By day 3, becomes a blastocyst. -Blastocyst enters uterus and attaches to uterine wall (implantation into endometrium). *Chemicals signify the presence of the blastocyst so mother’s body does not attack as a foreign body.

Question 29

Embryonic

Answer 29

begins as blastocyst attaches to uterine wall (becomes embryo) ~1in by 8th week

Question 30

4 weeks

Answer 30

structures that form the face and neck are becoming evident. heart and blood vessels continue to develop. lungs, stomach, and liver start to develop. home pregnancy test is now positive

Question 31

5 weeks

Answer 31

The plate that will become the heart has developed. The foundations for the brain, spinal column and nervous system has been established. skeleton is also forming. The embryo has a distinct organization that has a top, bottom, left, right, front and back.

Question 32

6 weeks

Answer 32

Facial features are visible, including a mouth and tongue. The eyes have a retina and lens. The digestive system starts forming, starting with the first cells of the stomach and the intestine. There are small indentations in the head, ready for the development of facial features, eyes, and ears. The outline of the jaw starts to form.

Question 33

8 weeks

Answer 33

Eyelid folds are forming. The baby's eyes are still very wide apart on the sides of the head, but will eventually center The tip of the nose is present. On an ultrasound you can see that the aortic and pulmonary valves of the heart. The tubes that lead from the throat to lungs are branching and the torso is getting longer and beginning to straighten out. -definite elbows, arms, toes, fingers.The baby is protected by the amnionic sac, filled with fluid. Inside, the child swims and moves.

Question 34

Myogenic Movement

Answer 34

- possible at end of embryonic period - occur through local stimulation of individual muscles with no nervous/external stimulation - striated muscles are innervated with alpha motorneurons

Question 35

Fetal Period

Answer 35

Period of rapid growth in size and further cell differentiation, leading to functional capacity - greatest growth rate from 8-16 weeks - greatest weight increase last month

Question 36

hyperplasia | hypertrophy

Answer 36

- increase in no of cells | - increase in size of individual cell

Question 37

ultrasound

Answer 37

- determine due date - confirm fetal viability - determine location - confirm location of placenta - No. of fetuses - major physical abnormalities - asses growth - check for movement/heartbeat - determine sex

Question 38

Neurogenic Movements

Answer 38

- appear at 20 weeks (conceptional) - generated by CNS when myelination begins (16-20 weeks) 1. completed when child is 4 2. influences neural conduction and motor capabilities

Question 39

Importance of movement in Utero

Answer 39

- facilitates development of neural pathways - ensures there are no adhesions in skin - shapes skeletal system by producing mechanical influences on the bones and joints - essential for post-natal movements

Question 40

Arthrogryposis

Answer 40

joint contractures that develop prenatally and appear at birth due to limited mobility causes: insufficient room, atrophic muscles, malformed CNS and spinal chord, abnormally developed bones, joints, or joint linings

Question 41

exercise and pregnacy

Answer 41

-no evidence that moderate to low intensity will result in adverse effects Importance: -lowers risk of gestational diabetes and pre-eclampsia -helps with excessive gestational weight gain

Question 42

Low birth weight (small-for-date)

Answer 42

less than 5.5lbs very low less than 3.3lbs -mostly occurs in young and old mothers -means infant has experience intrauterine growth retardation

Question 43

Causes of Low Birth weight

Answer 43

diet, drugs, smoking, infections, disease, social class, multiple births -50% of very low birth weight infants develop developmental delay or disability

Question 44

Young -for-Date (pre-term)

Answer 44

expected birth weight for gestational age before 37 weeks | -infant mortality has decreased due to neonatal care, but incidence of preterm birth is increasing

Question 45

Causes of preterm infants

Answer 45

drugs, smoking, maternal age, weight gain, history of miscarriage, adverse social/economic conditions, peridontal disease -developmental delay and disability in motor skill