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Learning objectives: Prenatal

development
¨ Describe the changes that occur during the
three periods of prenatal development and
brain formation.
Prenatal Development ¨ Explain the effects of teratogens and other

maternal and paternal factors on the

developing fetus.
¨ Identify the types of prenatal assessments and

discuss common complications of pregnancy.

Ms. Pam Santos

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Prenatal development: Germinal Figure 2.5

period Germinal period
¨ Begins with conception
¨ Ends when fertilized egg implants in uterine wall
¤ Fertilized egg = Zygote

¨ 2 weeks long
¨ Cell division occurs (mitosis)
¤ After five days of mitosis = 100 cells = blastocyst
n Inner layer = Embryonic disk (becomes the embryo)
n Outer layer of cells = Trophoblast (becomes the support
system which nourishes the developing organism)

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Prenatal development: Embryonic Figure 2.6

period The embryo (6-7 weeks gestational age)
¨ From 3-8 weeks after conception
¨ Blood vessels from trophoblast form placenta
¤ Structure attached to the uterus

¤ Provides nourishment and oxygen from the mother to the

developing embryo
¤ Connected to embryo via the umbilical cord

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Prenatal development: Embryonic

Prenatal development: Fetal period
period (continued)
¨ Major structures (organs, limbs, brain) start to develop ¨ From 9 weeks post-conception until birth
¤ Vulnerable to damage from harmful agents ¨ Major structures continue to develop
¨ Growth occurs in two patterns ¨ Growth
¤ Cephalocaudal – From head to tail ¨ Age of viability = First chance of survival outside uterus
¤ Proximodistal – From the midline outward (24 weeks)

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Figure 2.8
Prenatal brain development
Prenatal development age milestones
¨ Stem cells produced along neural plate
¨ Neural groove appears during 3rd week
¤ Eventually turns into neural tube

¤ Neural tube becomes brain and spinal cord

¨ Neurogenesis (formation of neurons) mostly completed

after five months of gestation
¤ Neurogenesis in hippocampus may be lifelong

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Prenatal brain development

(continued)
¨ Gray matter
¤ Regions of the brain that contain cell bodies

¤ Responsible for movement and cognitive activity

¨ White matter
¤ Axons that form neural pathways
¤ Covered with myelin – Fatty substance that aids neurotransmission
¤ Connects gray matter areas

¤ Conducts neural impulses

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Figure 2.9
Teratogens
Critical periods of prenatal development
¨ Environmental factors that can contribute to birth defects
¨ Effects depend on:
¤ Timing of the exposure – Earlier is usually worse

¤ Number of teratogens – Teratogens may interact

¤ Amount of exposure – More is usually worse

¤ Genetics – Sex, genetic vulnerability
¤ Being male or female – Males are more likely to experience
damage due to teratogens than are females

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Figure 2.10
Specific teratogens: Alcohol
Fetal alcohol spectrum disorders
¨ Leading preventable cause of intellectual disability Fetal Alcohol Spectrum Disorder Facial Features
Facial Feature Potential Effect of Fetal Alcohol
¨ Possible outcomes: Head size Below-average head circumference
¤ Cognitive and behavioral problems

¤ Fetal death Eyes Smaller than average eye opening,

skin folds at corners of eyes
¤ Fetal Alcohol Spectrum Disorders
Nose Low nasal bridge, short nose
Midface Smaller than average midface size

Lip and philtrum Thin upper lip, indistinct philtrum

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Specific teratogens: Legal and illegal

Specific teratogens: Tobacco
drugs
¨ Includes all nicotine delivery methods (vaping, gum, patch) ¨ Both prescription and over-the-counter medications
and secondhand smoke ¨ Difficult to determine effects of illegal drugs
¨ Possible outcomes: ¤ People may use more than one drug
¤ Low birth weight, premature birth, miscarriage ¤ People may have other unhealthy behaviors

¤ Ectopic pregnancy (fertilized egg implants itself outside of ¨ Possible outcomes:

the uterus)
¤ Problems with brain development
¤ Placenta previa (placenta lies low in the uterus and covers all
¤ Low birth weight, stillbirth, miscarriage
or part of the cervix)
¤ Neonatal abstinence syndrome
¤ Placenta abruption (placenta separates prematurely from
the uterine wall)

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Specific teratogens: Pollutants Specific teratogens: Diseases

¨ Lead, pesticides, mercury, radiation, BPA ¨ Toxoplasmosis – Caused by a parasite

¨ Possible outcomes in raw meat, cat feces, dirt
¤ Problems with brain development ¤ Possible outcomes: Premature birth,

n Learning problems
stillbirth, brain/eye defects
n Sensory impairment ¨ Sexually transmitted diseases
¤ Miscarriage, low birth weight, premature birth ¤ Possible outcomes:

n Transmission of STD
n Premature birth, miscarriage, stillbirth,
ectopic pregnancy

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Specific teratogens: Diseases

Specific teratogens: Maternal age
(continued)
¨ Rubella (German measles) ¨ Over 35 – Associated with increased risk of:
¤ Mostly preventable through vaccination ¤ Genetic disorders, prematurity, miscarriage, stillbirth

¤ About half of infected people have no visible symptoms ¤ Diabetes and high blood pressure

¤ Possible outcomes: ¨ Older mothers typically more confident and stable

n Vision and hearing problems ¨ Teenage – Associated with increased risk of prematurity
n Intellectual disability
and low birthweight
n Heart defects
¤ Often have poor nutrition and medical care

¤ More likely to drink, smoke, and use drugs

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Specific teratogens: Maternal factors

Specific teratogens: Maternal factors
(continued)
¨ Gestational diabetes – Body can’t manage glucose ¨ Rh disease – Type of anemia in baby
appropriately ¤ Rh is protein found in blood (most people Rh+)

¤ Associated with prematurity, stillbirth, difficult birth due to ¤ If mother is Rh- and fetus is Rh+:
large baby size, breathing problems n Mother’s immune system may react to Rh protein
¨ Hypertension – Too much pressure on artery walls n Produce antibodies to destroy fetus’ red blood cells
¤ Associated with prematurity and low birth weight ¤ Can be prevented by treating mother in pregnancy
¨ Both diabetes and hypertension endanger mother’s health ¤ Can be treated with transfusion in baby after birth

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Specific teratogens: Maternal factors Table 2.4

(continued) Weight gain during pregnancy
¨ Weight gain – Should be about 25 pounds !"#$%&#'()(#*#+(*,-+$# !"#$%&#'()(#&24()'(.I+-# !"#$%&#'()(#%5()'(.I+-# !"#$%&#'()(#%0(6(#
'(.I+-#0("%)(# 0("%)(#1)(I2*23$## 0("%)(#1)(I2*23$## 0("%)(#1)(I2*23$##
¤ Too much increases risk of diabetes, hypertension, difficult 1)(I2*23$##
birth # # # #
•! I*.2#789:8,06## •! I*.2#7@9<A,06## •! I*.2#;7978#,06## •! I*.2#;;97A,06##
¤ Too little suggests baby isn’t growing properly •! ;9<=,06#.2#-+(#".)6-# •! ;9<=,06#.2#-+(#".)6-# •! ;9<=,06#.2#-+(#".)6-# •! ;9<=,06#.2#-+(#".)6-#
-).>(6-()#*24#;,0#1()# -).>(6-()#*24#*#,.--,(# -).>(6-()#*24#*#,.--,(# -).>(6-()#*24#,(66#
¨ Stress '((?#.2#-+(#6(3%24# >%)(#-+*2#;,0#1()# >%)(#-+*2#=,0#1()# -+*2#=,0#1()#'((?#.2#
*24#-+.)4#-).>(6-()6## '((?#-+()(*"-()## '((?#.2#-+(#6(3%24# -+(#6(3%24#*24#-+.)4#
¤ High stress increases prematurity/low birth weight risk # # *24#-+.)4#-).>(6-()6## -).>(6-()6##
# #
¤ Poor stress management (e.g., alcohol use) B%-+()6#%"#-'.26#2((4#-%#I*.2#>%)(#.2#(*3+#3*-(I%)$C##
#

¤ Possibly associated with attention and anxiety problems #

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Specific teratogens: Maternal factors

Specific teratogens: Paternal factors
(continued)
¨ Depression – Feelings of sadness and worthlessness that ¨ Age over 40 associated with increased risk of:
interfere with daily function ¤ Miscarriages, autism, birth defects, achondroplasia (bone

¤ Increased risk of: growth disorder) and schizophrenia

n Prematurity and low birthweight ¨ Men more likely to smoke
n Poor emotional and attentional control
¨ Men more likely to encounter environmental hazards (e.g.,
¤ Many medications are possible teratogens chemicals) at work
¤ Baby blues – Feelings of sadness lasting about a week after
birth
¤ Postpartum depression – Longer-lasting depression starting
in first month after birth

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Prenatal assessment Prenatal ultrasound

¨ Ultrasound – Sound waves used to examine the fetus
¤ Look for structural defects, growth problems, multiple fetuses

¤ Check age, location of placenta, heart rate

¤ Typically done 16-20 weeks into pregnancy

¤ May also be used to check fetal position during other tests

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Prenatal assessment (continued) Infertility

¨ Amniocentesis – Sample amniotic fluid ¨ Infertility – Inability to conceive within 12 months

¨ Chorionic villus sampling – Sample placenta ¤ Affects 10-15% of couples in the US

¨ Both used to check for genetic defects ¤ Male factors the cause in about 1/3 of these – usually low
sperm production
¨ Recommended for:
¤ Female factors the cause in about 1/3 of these
¤ Mothers over 35
n Failure to ovulate
¤ Early tests suggest a problem
n Pelvic inflammatory disease – Infection of reproductive
¤ Family history of genetic problems organs, often caused by STD

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Reproductive technology Potential complications of pregnancy

¨ In vitro fertilization (IVF) ¨ Ectopic pregnancy – Zygote implants in the fallopian

¤ Remove eggs and fertilize outside the body tube instead of the uterus
¤ Reinsert fertilized egg in the uterus ¨ Preeclampsia (toxemia) – Increased blood pressure and
¨ Gamete intra-fallopian tube transfer (GIFT) leakage of protein in urine
¤ Accounts for about half of maternal deaths in US
¤ Implant both sperm and ova into the fallopian tube
¤ Eclampsia – When preeclampsia causes seizures
¨ Zygote intra-fallopian tube transfer (ZIFT)
¤ Sperm and ova are fertilized outside of the body
¨ Spontaneous abortion (miscarriage)
¤ Zygote implanted in the fallopian tube ¤ Usually caused by chromosomal abnormalities
¨ May not be covered by insurance

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