Infant Toddler Development Training
Module 6, Lesson 1
Problems Arising in Embryonic and Fetal Development
Problems with development often have their origin in the developing embryo and fetus and often the embryo or fetus self-aborts due to a defect. However, there are survivals through the embryonic stage of 5 -10 weeks when most organ systems are developing and these surviving embryos and then fetuses are born with malformations such as cardiac lesions.
There are fetal conditions that affect subsequent growth. Some of these conditions include infants who:
- are small for gestational age or low birth weight
- have genetic conditions with growth problems as a characteristic of a syndrome
- have infections from teratogens, foreign substances that can cause malformations in the developing embryo or fetus or can affect growth and development
As discussed in Module 1 of the ITDS series, risk factors during pregnancy can affect the outcome of an infant. During pregnancy, the placenta functions as the primary funnel of nutrients to the fetus. Nutrients actively pass from mother to fetus as the metabolic system of the mother regulates the nutrition for the fetus. Thus, a mother's nutritional status is very important to the health and well being of the baby. The growth issues become more obvious as the fetus grows.
Toxemia or pre-eclampsia and pregnancy induced hypertension can produce vascular changes in the placenta which can result in starving the fetus of adequate nutrients and can produce a newborn that is small for gestational age (SGA). Babies who are small for gestational age are at risk for growth, developmental, and behavioral problems. They are more at risk than infants who are appropriate for gestational age (AGA) to develop hypertension and diabetes as adults.
Influence of Teratogens
The Central Nervous System (CNS) is very susceptible to influences of teratogens such as alcohol, drugs, or environmental pesticides, etc. because the CNS takes much longer than most organs to develop. A teratogen may also be a medication or prescription drug taken by the mother during her pregnancy, especially in the first trimester. Also infections in the mother can pass to the developing fetus and cause problems. These include such things as rubella (German measles), rubeola (measles), varicella (chicken pox), toxoplasmosis, herpes simplex, cytomegalovirus (CMV), syphilis and human immunodefiency virus (HIV).
Amniotic Fluid Implications
Another factor that can influence the outcome for the infant includes the amount of amniotic fluid. Too much fluid (hydramnios or polyhydramnios) may be an indicator for problems such as neuromuscular diseases or obstruction of the gastrointestinal tract. Examples of the latter include imperforate anus, duodenal atresia, gastroschisis, omphalocele, or tracheo-esophageal fistula. Too little fluid (oligohydramnios) may also indicate the presence of problems for the growing fetus. This can be associated with an obstruction of the urinary tract, renal agenesis, immature lung development, and intrauterine growth retardation (IUGR).
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