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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
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Prenatal Risk FactorsPrenatal Risk FactorsPSY 417PSY 417
Maternal StatusMaternal Status Maternal NutritionMaternal Nutrition
– ProteinProtein– Folic AcidFolic Acid
Maternal DiseasesMaternal Diseases– HIVHIV– DiabetesDiabetes
Prenatal Infections: STORCHPrenatal Infections: STORCH SyphilisSyphilis ToxoplasmosisToxoplasmosis RubellaRubella CytomegalovirusCytomegalovirus HerpesHerpes
TeratogenTeratogen ““toxic” agents that cause toxic” agents that cause
deficits/malformations in the fetusdeficits/malformations in the fetus AAgent that can produce a permanent
alteration of structure or function in an organism exposed during embyronic or fetal life.
Example of a MalformationExample of a MalformationAgent OrangeAgent Orange
ThalidomideThalidomide
There is no such thing as a teratogenic agent.
Many agents can produce a teratogenic
effect under some circumstances.
Nature of the agentNature of the agent
Factors That Influence Factors That Influence TeratogenicityTeratogenicity
Dose Route Frequency of exposure Duration of exposure
Gestational timingGestational timing
Factors That Influence Factors That Influence TeratogenicityTeratogenicity
Concurrent exposures Concurrent illness Genetic susceptibility
– Mother– Fetus
TimingTiming
Multifactorial42%
Unknown37% Chromosomal
3%
Monogenic8%
Teratogens10%
Baird et al. AJHG 42:677, 1988
Birth Defects in Childhood
Teratogens
Birth Defects in Childhood
Birth Defects Caused By Teratogenic Exposures Are
Preventable.
AlcoholAlcohol Fetal Alcohol Syndrome (FAS)Fetal Alcohol Syndrome (FAS)
– confirmed maternal drinking during confirmed maternal drinking during pregnancypregnancy
– pattern of facial featurespattern of facial features– growth retardationgrowth retardation– evidence of CNS disturbanceevidence of CNS disturbance
Fetal Alcohol Effect (FAE)Fetal Alcohol Effect (FAE)
Mechanism of TransmissionMechanism of Transmission
FAS: Brain developmentFAS: Brain development
Facial Features: Facial Features: DysmorphologyDysmorphology
CigarettesCigarettes Low birth weightLow birth weight CNS deficits - LD, AttentionCNS deficits - LD, Attention SIDSSIDS Respiratory problemsRespiratory problems Increased risk for cancerIncreased risk for cancer
CigarettesCigarettes
CocaineCocaine No addictionNo addiction Crack baby mythCrack baby myth PrematurityPrematurity Growth retardation - SGAGrowth retardation - SGA Poorer reflexesPoorer reflexes
Other TeratogensOther Teratogens Radiation - genetic mutations, Radiation - genetic mutations,
malformed organsmalformed organs Aspirin - enamel defectsAspirin - enamel defects
Other TeratogensOther Teratogens RubellaRubella Norman GreggNorman Gregg
– An Australian opthamologistAn Australian opthamologist– In early 1940s, saw many blind infantsIn early 1940s, saw many blind infants– Surveyed his colleagues in SydneySurveyed his colleagues in Sydney– Found 78 blind infants visited doctors that yearFound 78 blind infants visited doctors that year– 68 had been exposed to rubella68 had been exposed to rubella– Published 1941 paper about rubella and infant Published 1941 paper about rubella and infant
blindnessblindness
Rubella continuedRubella continued Norman GreggNorman Gregg
– 1941 paper reported widely in popular press1941 paper reported widely in popular press– When it came out, Gregg got two phone callsWhen it came out, Gregg got two phone calls– Mothers who had rubella during first trimesterMothers who had rubella during first trimester– Infants were not blind but deafInfants were not blind but deaf– Sent others to check the historical recordsSent others to check the historical records– Outbreaks of rubella had regularly been followed Outbreaks of rubella had regularly been followed
by epidemics of infant blindness and hearing by epidemics of infant blindness and hearing problemsproblems
– Thus, learned that rubella is a teratogenThus, learned that rubella is a teratogen– Today – vaccine.Today – vaccine.