Prenatal Risk Factors

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Prenatal Risk Factors. PSY 417. Maternal Status. Maternal Nutrition Protein Folic Acid Maternal Diseases HIV Diabetes. Prenatal Infections: STORCH. Syphilis Toxoplasmosis Rubella Cytomegalovirus Herpes. Teratogen. “toxic” agents that cause deficits/malformations in the fetus - PowerPoint PPT Presentation

Text of Prenatal Risk Factors

  • Prenatal Risk FactorsPSY 417

  • Maternal StatusMaternal NutritionProteinFolic AcidMaternal DiseasesHIVDiabetes

  • Prenatal Infections: STORCHSyphilisToxoplasmosisRubellaCytomegalovirusHerpes

  • Teratogentoxic agents that cause deficits/malformations in the fetusAgent that can produce a permanent alteration of structure or function in an organism exposed during embyronic or fetal life.

  • Example of a MalformationAgent Orange

  • Thalidomide

  • There is no such thing as a teratogenic agent.

  • Many agents can produce a teratogenic effect under some circumstances.

  • Factors That Influence TeratogenicityNature of the agentDoseRouteFrequency of exposureDuration of exposure

  • Factors That Influence TeratogenicityGestational timingConcurrent exposuresConcurrent illnessGenetic susceptibilityMotherFetus

  • Timing

  • Multifactorial42%Unknown37%Chromosomal3%Monogenic8%Teratogens10%Baird et al. AJHG 42:677, 1988Birth Defects in Childhood

  • TeratogensBirth Defects in Childhood

  • Birth Defects Caused By Teratogenic Exposures Are Preventable.

  • AlcoholFetal Alcohol Syndrome (FAS)confirmed maternal drinking during pregnancypattern of facial featuresgrowth retardationevidence of CNS disturbanceFetal Alcohol Effect (FAE)

  • Mechanism of Transmission

  • FAS: Brain development

  • Facial Features: Dysmorphology

  • CigarettesLow birth weightCNS deficits - LD, AttentionSIDSRespiratory problemsIncreased risk for cancer

  • Cigarettes

  • CocaineNo addictionCrack baby mythPrematurityGrowth retardation - SGAPoorer reflexes

  • Other TeratogensRadiation - genetic mutations, malformed organsAspirin - enamel defects

  • Other TeratogensRubellaNorman GreggAn Australian opthamologistIn early 1940s, saw many blind infantsSurveyed his colleagues in SydneyFound 78 blind infants visited doctors that year68 had been exposed to rubellaPublished 1941 paper about rubella and infant blindness

  • Rubella continuedNorman Gregg1941 paper reported widely in popular pressWhen it came out, Gregg got two phone callsMothers who had rubella during first trimesterInfants were not blind but deafSent others to check the historical recordsOutbreaks of rubella had regularly been followed by epidemics of infant blindness and hearing problemsThus, learned that rubella is a teratogenToday vaccine.