Prenatal and Neonatal

Prenatal Development

• Prenatal development lasts approximately 38 weeks from conception to birth.

• Three periods of development:

▫ Zygote

▫ Embryo

▫ Fetus

Zygote Period

• The zygote is formed at conception and continues to develop for the first two weeks.

• The zygote travels from the fallopian tube to the uterus and implants itself in the uterine wall.

• After 2 weeks, the placenta begins to grow and is attaches to the zygote via the umbilical cord.

Embryo Period

• The embryo period begins at the end of the second week and ends at the end of the eighth week.

• First half of this period:

▫ The ectoderm, mesoderm, and endoderm layers develop.

▫ The heart begins to pump.

• Second half of this period:

▫ Facial features, arms, legs, fingers, and toes form.

▫ Can respond to touch.

Fetus Period

• The fetus period begins in the ninth week and continues through birth.

• At the beginning of this period:

▫ Organs, muscles, and the nervous system organize.

▫ The lungs expand and contract.

▫ The external genitals are distinguishable.

▫ The fingernails, toenails, tooth buds, and eyelids develop.

Fetus Period (continued)

• 18 Weeks - Fetal movements are felt by the mother.

• 20 Weeks - The fetus can hear sounds and react to them.

• 24 Weeks - All the brain neurons are developed.

• 25 to 38 Weeks – The fetus has a chance for survival outside the womb. This is called the age of viability.

Prenatal Health Issues

• Teratogens - environmental substances that cause damage during prenatal development

▫ Medications

▫ Drugs, cigarettes, and alcohol

▫ Radiation and pollution

▫ Infectious disease

• Other health issues can include:

▫ The mother’s nutrition and stress level

▫ Rh blood incompatibility

▫ The mother’s age and previous pregnancy experiences

Medications

• Almost all medications that are taken by the mother can reach the embryo or fetus through the bloodstream.

• Medications can cause:

▫ Low birth weight

▫ Lower intelligence later in life

▫ Death

• Mothers must consult doctors before taking any medications.

Illegal Drugs

• Fetuses exposed to illegal drugs in

the womb are at risk of: ▫ Low birth weight

▫ Numerous defects

▫ Death

• If the fetus manages to survive through birth, the baby is likely born with a drug addiction.

Cigarettes

• Cigarette smoking while pregnant can cause:

▫ Low birth weight

▫ Cancer in childhood

▫ Miscarriage

▫ Death

• Second-hand smoke can also put children at risk

Alcohol

• Fetal alcohol syndrome (FAS) is a serious effect caused by the mother consuming alcohol during pregnancy.

• Children with FAS may have:

▫ Mental retardation

▫ Poor attention

▫ Hyperactivity,

▫ Facial abnormalities

▫ Slow growth

Radiation

• Pregnant women should avoid exposure to radiation, including medical X-rays.

• Exposure to radiation can cause:

▫ Miscarriage

▫ Poor physical growth

▫ Brain damage

▫ Cancer

Pollution

• Some environmental pollution dangers include mercury, lead, and PCBs.

• Exposure to pollutants can cause:

▫ Brain damage

▫ Mental retardation

▫ Low birth weight

Infectious Disease

• Infectious disease can be difficult for pregnant mothers to evade.

• Common illnesses such as the cold and flu are essentially harmless to the fetus as long as the mother is well-rested and continues to get nutrients.

• Serious infectious disease can cause:

▫ Birth defects

▫ Low birth weight

▫ Miscarriages

Non-Teratogen Prenatal Health Issues

• Pregnant women must be certain to get proper nutrition. The level of malnutrition of the mother is directly linked to brain weight in the child.

• Pregnant women should also try to remain stress-free. Anxiety can have harmful effects on the fetus.

Non-Teratogen Prenatal Health Issues (continued)

• Rh blood incompatibility between the mother and fetus can cause: ▫ Mental retardation

▫ Heart damage

▫ Death

• Blood tests and vaccines are given to prevent illness or injury resulting from Rh incompatibility.

Neonatal Development

• The first four weeks of life are called the neonatal, or newborn, stage.

• In this stage, special attention is given to:

▫ Parent-child bonding

▫ Reflexes

▫ Temperament

▫ States of arousal

▫ Sensory capabilities

The Apgar Scale

• The Apgar scale rates newborns in the following areas: ▫ Appearance

▫ Pulse

▫ Grimace

▫ Activity

▫ Respiration

• Apgar scores: ▫ 7 to 10 – Healthiest

▫ 4 and 6 – Need assistance with breathing or other vital signs

▫ 0 and 3 – Need serious emergency medical attention

Bonding

• Bonding is a parent’s deep affection and concern for the newborn.

• Parents and children develop a special bond that allows the infant to grow and develop with confidence.

• Some parents instantly bond, while other parents bond over the first few weeks.

Reflexes

• Reflexes are expected, automatic responses to specific stimulants.

• Newborn reflexes include:

▫ Rooting reflex

▫ Sucking reflex

▫ Palmer reflex

• Most of these reflexes should disappear as the baby grows and develops.

Sensory Capabilities

• Touch – most important sense for newborns

• Taste – prefer sweet over salty

• Smell – respond to good and bad smells

• Sound – special interest in the human voice

• Vision – least developed sense in a newborn

Newborn States of Arousal

• Newborns continually cycle through five states of arousal:

▫ Regular sleep – deep sleep with little movement

▫ Irregular sleep – light sleep with body movement

▫ Drowsiness – waking up or falling asleep

▫ Quiet alertness – awake and attentive

▫ Waking activity and crying – uncoordinated movements and irregular breathing

Neonatal Health Issues

• The transition from the womb into the world does not occur smoothly.

• Neonatal health issues include:

▫ Premature birth

▫ Respiratory issues

▫ Sudden Infant Death Syndrome

Premature Birth

• Premature birth is used to describe infants that are preterm or small-for-date.

▫ Preterm babies are born 3 weeks or more before the 38-week due date.

▫ Small-for-date babies weigh less than expected compared to their length of time in the womb.

• With proper care and special attention, many premature babies go on to lead normal, healthy lives.

Respiratory Issues

• In respiratory distress syndrome, a baby’s air sacs collapse, which makes breathing very strenuous

• Respiratory distress syndrome can occur in premature or full-term babies.

• Babies with respiratory distress syndrome are attached to respirators until they can breathe comfortably on their own.

SIDS

• Sudden Infant Death Syndrome (SIDS) occurs when an infant dies during sleep.

• Death occurs with no trauma to the child and no indication from the child, such as crying, prior to death.

• No cause, cure, or prevention has been found for SIDS.