When conception occurs, the tale of prenatal development begins. It is a long story that needs to be told, and can last up to 42 weeks before the ending is revealed. In the pages that between the books, there are many environmental and maternal influences the affects the ending of the story. For example, stress, drugs, alcohol, tobacco, prenatal care, exercise, nutrition, infectious disease, and environmental pollutions. Throughout this paper, there will be summarized scholarly journal articles that explain how environmental and maternal influences affect prenatal development.
The first article talks about the long term effects of stress in the brain in a gestational environment by Dr. Claudia Buss and et al. They begin by explaining the overview of the human brain development: The brain is developed from a single cell that is formed by the fusion of the ovum and sperm that forms a fertilized egg, which is also known as a zygote. The brain has multiple cell types and a lot of connections between these cells specify eventual form and function. Most of the brain growth happens in the first two years of life after birth. An infant's brain greatly increases in size because of the overproduction of connections, synapses, a d myelination. Then in later childhood and adolescence, the brain gets rid of unused axons, neurons, and synapse and this allow building brains for individual needs (Buss et. Al 2012).
After thoroughly explaining the human brain development, the article goes into the stress biology in human pregnancy: A lot of the hormonal and immune factors that influences growth and development are also involved in the stress response. Perhaps this is a reason that why stress has the possibility to impact prenatal development.
The article further elaborates that a mother's biological response to stress is dampened during gestation. Endocrine and immune markers may serve as signals of maternal stress and of nutrient and oxygen availability, obstetric complications such as preeclampsia and infection can sculpt brain development and alter neural outcomes. The understanding of potential mechanisms that shows maternal stress producing a long lasting change in fetal brain structure and function primarily comes from the study of animals. (Buss et. Al 2012) Many studies show that fetal exposure to inappropriate levels of biological stress and can occur during exposure to excess maternal stress or other adverse prenatal conditions, can cause detrimental effect and can interfere with long term brain development.
Dr. Claudia Buss et al (2012) further explores the correlation between stresses and the fetal brain development: Exposure to psychosocial stressors has a lot of effect on the developing brain. Sayings like 'Stress is bad for you and your baby', can inadvertently make pregnant women worry or get anxiety. Exposure to excessive psychosocial stressors like domestic violence or the death or serious illness of a loved one can negatively affect the fetal and infant neurodevelopment, which can include delayed mental and motor development, difficult temperament, and impaired cognitive performance. There is a link between the mother's emotional states during pregnancy and changes in the baby's brain structure. Babies born to mothers who had high levels of anxiety in their early second trimester had a region specific reduction in gray matter volume and impaired executive function in middle childhood.
All in all, healthy brain development can be promoted by supporting maternal health and well-being from the time of conception to the period of pregnancy. All children should be provided with a warm and enriched stress free environment in order to five them a fair chance of developing properly.
The next scholarly journal article is about the effects of prenatal alcohol exposure on child development by Dr. Joseph Jacobson and Dr. Sandra Jacobson (2003). They begin by discussing the serious consequences of drinking while pregnant: The most severe penalty for consuming alcohol while pregnant is fetal alcohol syndrome (FAS). FAS was first identified in the United Stated in 1973 when children were born to mothers who drank heavily during their pregnancy. The children were identified with distinctive set of facial abnormalities like short eyelid opening, flat midface, thin upper lip, and a flat or smooth groove between nose and upper lip. These children also displayed growth retardation and major cognitive and behavioral problems. Even though many FAS children are mentally retarded, with an IQ of less than 70, a large number of them can perform in the low average to average range on the IQ tests (Jacobson & Jacobson 2003).
The authors later continue to talk about fetal alcohol effects (FAE) and alcohol related neurodevelopmental disorder: There is a difference between FAS and FAE. Fetal alcohol effects is applies to children of mothers that were known to have drank heavily during their pregnancy and shows some, but not all the characteristics of fetal alcohol syndrome. The FAE children generally tend to have a slightly higher IQ score than the FAS children. Alcohol related birth defects are applied to those that had confirmed heavy prenatal alcohol exposure and one or more congenital abnormalities, which are usually cardiac, skeletal, renal, ocular, or auditory.
The rest of the article examine the cognitive and behavioral effects of prenatal exposure to alcohol in more detail: They discuss the inconsistent correlation between hyperactivity and FAS. Hyperactivity was rated as least severe among problems by parents of FAS children in recent studies. Sustained attention is the ability to remain alert and focused over time and is usually measured by timed observance or continuous performance tests. Also, focused attention is assessed. Focused attention is the ability to maintain attention in the presence of distraction. Poorer focused attention has been found with children associated with alcohol related neurodevelopmental disorder. Socio-emotional function was also assessed. It was said that prenatal alcohol exposure is associated with increased levels of irritability during infancy. Also, the most noticeable problem was the failure to consider the consequences of ones actions, lack of responsiveness to social cues, and poor interpersonal relationships. All the data indicates that prenatal alcohol exposure is associated with intellectual deficits, attention problems, and cognitive flexibility (Jacobson & Jacobson 2003).
The next article is by Dr. Krisa Van Meurs (1999) and it is about the effects of cigarette smoking during pregnancy, and how it will affect the developing fetus. Cigarette smoke has over 1000 different compounds. The two main compounds that are alleged to causing adverse effects on developing fetus during pregnancy are carbon monoxide and nicotine. Nicotine is another toxin that is found in cigarettes. It has cardiovascular and central nervous system effects on one's body. Nicotine is known to cross the placenta and reaching levels in the amniotic fluid and fetus that is more than those of the mother. Cigarettes can have adverse effect on women even if she is not pregnant. Several studies have shown that smoking can decrease fertility in women and men like ovulations and decreased sperm motility. Also, nicotine can cause spontaneous abortion because it is a potent vasoconstrictor reducing uterine and placental blood flow. There can also be placental problems due to the use of cigarettes. For example, placental abruption, this is the premature detachment of the normal implanted placenta. Also, placenta previa, is the implantation of the placenta in the lower part of the lower uterine segment. Both can cause a pregnancy to end prematurely, which will result in a low birth weight of a baby. Low birth weights are one of the clear signs of smoking while pregnant. Sadly, there is a 33% increase in perinatal and neonatal mortality in smoking women primarily due to the low birth weight (Meurs 1999). In addition, behavioral deficits like attention deficit hyperactivity disorder have been linked to children of smoking mothers during their pregnancy. The use of cigarettes is highly discouraged while pregnant, and mothers should think of all the adverse effects it can have on their unborn child (Meurs 1999).
Proper nutrition is a vital for a healthy pregnancy. Dr. Kathleen Abu-Saad and Dr. Drora Fraser (2010) wrote an article about maternal nutrition and the birth outcomes. The article is very extensive and thorough, but there is one section of this that requires all attention. The authors write about specific nutritional requirements during pregnancy. They explain how malnutrition is a result of a poor dietary intake (Saad & Fraser 2010). Also, energy is the main nutritional factor of gestational weight gain. Throughout the whole pregnancy, extra energy is required for the growth and maintenance of the fetus, placenta, and maternal tissues. It is recommended by the United Nations University, the Food and Agriculture Organization and the World Health Organization, the during pregnancy, women should increase they energy intake by 85 calories a day in the first trimester, by 285 calories in the second trimester, and by 475 in the third trimester. Also protein is essential during pregnancy for both the mother and the fetus (Saad & Fraser 2010). . Essential fatty acids are also beneficial to both the mother and the fetus. Omega 3 fatty acids may result in an increased duration of gestation and can also improve fetal growth. Furthermore, nutritional iron deficiency is highest in populations that are experiencing peak growth rates, like infants, young children, and pregnant women. There is a great risk if developing iron deficiency during pregnancy, especially in low SES women and ethnic minority groups. There is strong evidence that iron deficiency in the first trimester of pregnancy results in decrement in fetal growth and is generally more damaging to pregnancy outcome than iron deficiency anemia in the second and third trimesters. Iron supplements should be taking during the early parts of pregnancy in order to reduce premature births. It should then be continued throughout the whole pregnancy, all the way till the baby starts to breastfeed. The last nutrient that was talked about was folate. Folate is an essential nutrient and it is critical to fetal development because it is a cofactor for many essential cellular reactions, including DNA and nucleic acid synthesis. Folic acid is needed for the rapid tissue growth and the growth of the placenta and fetus. Lack of ample folate has been connected to low birth weight and preterm birth. Maternal nutrition plays a very vital role in fetal growth and birth outcomes (Saad & Fraser 2010). .
According to Beth Lewis et al (2008), women with low risk pregnancies should partake in moderate intensity exercise during their pregnancy. Unfortunately, only a little over 15% of all pregnant women exercise during their pregnancy. One of the reasons that may women do not exercise is because they believe that it would be too risky. Overall, evidence show that exercise during pregnancy is safe and perhaps even reduces the risk of preeclampsia and gestational diabetes. However, women who were inactive before they got pregnant should take things very slowly. This doesn't mean they do not have to exercise at all, but they should definitely take things a little easier and cautiously. In January 2010, the American Journal of Obstetrics and Gynecology presented research on the subject of fetal growth measures and exercise participation. The results show that while pregnant mother who exercise tend to have smaller babies, the difference is so small, that it is practically insignificant. In addition, research indicates that women who exercise during pregnancy experience fewer side effects of pregnancy like insomnia, anxiety, and somatic complaints than women who do not exercise. There was study conducted with women who exercised at a level 1 (exercise that does not include vigorous walking at least 3 times a week for at least 20 mins) or a level 2 (exercising at least 3 times a week for 20 mins, with vigorous walking). The women who exercised at a level 2 reported fewer symptoms like heartburn, nausea, round ligament pain, and leg cramps. During the last trimester, they reported fewer common discomforts associated with pregnancy like, swelling, leg cramps, fatigue, and shortness of breath than sedentary women. Therefore, the mother is overall more comfortable, and less stressed, which is great for the developing fetus (Lewis et al 2008).
The last article is about the impact of maternal infection on fetal growth. There are several infections with are transmitted across the placenta, and are associated with decreased birth weight. The most important of these are syphilis and HIV (Tomkins et al). Prevention of infectious diseases is the key to a healthy mother and baby. There are several ways to prevent maternal, placental and fetal infections. First, the general public and health professionals need to know how to recognize a lot of the symptoms. Also, the promotion of lifestyles that prevent the development of infections can be used. Many times, improving housing, water supply, and sanitation and facilities for hygiene will reduce maternal infection, along with behavioral change to limit the spread of sexually transmitted diseases. Often times, antibiotic are being used for reproductive tract infections according to symptom complexes, rather than microbiological diagnosis because of the lack of laboratory facilities. Women's idea of their health status and of their pregnancy is a reflection of their cultural background and their role and status with their family and they community. In some communities, it might not be acceptable to complain about their complications during their pregnancy. It might also be taboo a when it comes to reproductive tract infections (Tomkins et al). When it comes to genital or pelvic examination at local 'STD clinics', the service might be poor. With inadequate privacy, and a lack of information exchange and an absence of integration with other services like child health and contraceptive services. All in all, getting treatment for any type of infection while a mother pregnant is extremely important for the welfare of the mother and the baby. Having untreated infections can be detrimental to both the mother the fetus (Tomkins et al).
In conclusion, there are numerous environmental and maternal influences that affect the well-being of the mother and the baby during the prenatal stages. As the long journey from conception to birth occurs, there are many obstacles that can be along the way. It is important to get educated on all the information that can influence maternal in fetal health. Once the facts are gathered, it is everyone's responsibility to ensure it is implemented.
Buss, C., Entringer, S., Swanson, M. J, & Wadhwa, P. D. (2012). The Role of Stress in Brain Development: The Gestational Environment's Long Term Effects on the Brain. The DANA Foundation. Retrieved June, 14, 2013 from http://www.dana.org/news/cerebrum/detail.aspx?id=37188
Jacobson, J. L, & Jacobson, S. W. (2003). Effects of Prenatal Alcohol Exposure on Child Development. National Institute on Alcohol Abuse and Alcoholism. Retrieved June, 14 2013 from http://pubs.niaaa.nih.gov/publications/arh26-4/282-286.htm
Meurs, Krisa V. (1999). Cigarette Smoking, Pregnancy and the Developing Fetus. Standford Medical Review.Retieved June, 14 2013 from http://med.stanford.edu/medicalreview/smrp14-16.pdf
Saad, K. A, & Fraser D. (2010). Maternal Nutrition and Birth Outcomes. Oxford Journals. Retrieved June, 14 2013 from http://epirev.oxfordjournals.org/content/32/1/5.full#ref-117
Lewis, B., Avery, M., Jenning, E., Sheewood, N., Martinson, B. A, Crain, L. (2008). The Effect of Exercise During Pregnacy on Maternal Outcomes: Practical Implications of Practice. Medscape News. Retreived June, 15 2013 from http://www.medscape.com/viewarticle/580466_8
Tomkins, A., Murray, S., Rondo, P., & Filteau, S. (n.d). Impact of Maternal Infection on Foetal Growth and Nutrition. SCN News. Retrieved June 15, 2013 from http://www.unsystem.org/SCN/archives/scnnews11/ch08.htm#TopOfPage
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