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Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
Microsoft PowerPoint - Birth.Defects.Presentation
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Microsoft PowerPoint - Birth.Defects.Presentation

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  • 1. Understanding Birth Defects 1
  • 2. The mission of the March of Dimes is to improve the health of babies by preventing birth defects, premature birth and infant mortality. 2 The mission of the March of Dimes is to improve the health of babies by preventing birth defects, premature birth and infant mortality. Part of this mission is accomplished through programs of education such as this presentation. 2
  • 3. Birth Defects Every 3 1/2 minutes a baby is born with a birth defect in the United States. Over 150,000 babies are born with serious birth defects each year. In 2001, birth defects accounted for about 1 in 5 infant deaths in the United States. 3 Today’s topic is birth defects. Every 3 1/2 minutes a baby is born with a birth defect in the United States. This means that in the next hour, 16 babies will be born with a birth defect. In the United States, over 150,000 babies are born with serious birth defects each year. Overall, the incidence of birth defects is one in 20 births. Interaction: So, in your class of _______ (# of people in class), _____ people (ratio of 1:20) would have a child born with a birth defect. While most children with birth defects live, some birth defects cause death. In 2001, birth defects accounted for about 1 in 5 infant deaths in the United States. Birth defects are the leading cause of death in the first year of life. Retrieved April 20, 2005, from www.marchofdimes.com/peristats. 3
  • 4. There are many kinds of birth defects 4 Interaction: Have pictures of children with visible and non-visible birth defects on each desk. Ask: Who has a picture of a child with a birth defect? (Point out that not all birth defects are visible and there are many different types.) Ask: Do you know anyone with a birth defect? Ask: Do any of you know what types of birth defects are shown on this slide? What could be the impact of the defect on their lives? Many birth defects can be prevented and that is why we are here. There are many kinds of birth defects. Several thousand different birth defects have been identified. Some happen and we don’t know why. Others have known causes and are preventable. A birth defect is an abnormality (something wrong) with the body structure, function or metabolism that is serious enough to require the care of doctors and nurses. Many birth defects can cause permanent disabilities such as mental retardation, blindness, deafness, paralysis or other physical problems. 4
  • 5. Immunizations 5 Prenatal care is very important during pregnancy and in preventing birth defects. One reason to see a health care professional is to receive immunizations (shots) that could protect you and your baby. Diseases can also cause birth defects. Pregnant women and children are particularly vulnerable to infectious disease—that’s why it is critical to get immunized! 5
  • 6. Genetic Mutations Baby with Trisomy 13 Boy with Fragile X Syndrome 6 Ask: What is a mutation? Does anyone know how mutations occur in babies? Mutations in genes or chromosomes can cause birth defects. Some babies with mutations will not be able to live outside of the mother’s womb. Other mutations cause milder defects, that may not be noticed for many years. Sometimes the mutation is passed down to the baby from its parents but sometimes the mutation occurs (spontaneously) only in the baby when the sperm and egg join. The baby on the left has Trisomy 13, a severe and lethal condition. This baby has an extra #13 chromosome – often causing heart defects, vision problems, cleft lip/palate and other problems with organs. The boy on the right has fragile X syndrome, a less severe birth defect. This genetic mutation causes some characteristic facial and body features (large ears, narrow face) and learning problems. 6
  • 7. Which woman is pregnant? 7 Ask: Can any of you tell which of these women are pregnant? How can you tell? Do you think they know they are pregnant? Most women don’t find out that they are pregnant until at least a month after conception. Other people cannot see any outward changes on the woman during the first 1 to 3 months. Yet, there are critical changes going on in the baby’s development during this time period. 7
  • 8. Human Embryo at 4 Weeks 8 Here is a human embryo at four weeks. You can see that in the 28 days since the sperm has joined with the egg, incredible changes have taken place. The spine is growing, the brain and other organs are developing and the heart is beating. Interaction: Provide small Dixie cup with grain of rice, pinto bean and small ball/paperclip/etc about 1.5 inches long. Use to relate to actual size of embryo and fetus at early stages (crown to rump measurement). Stress that much is going on though it is very small. Size of embryo at 4 weeks since conception: 2-4mm/ 0.08-0.16 inches (grain of rice) Size of embryo at 6 weeks since conception: 14-20mm/0.56-0.8inches (pinto bean) Size of embryo at 8 weeks since conception: 31-42mm/1.25-1.68 inches (paper clip) 8
  • 9. Human Embryo at 8 Weeks 9 Here is a picture of an embryo at 8 weeks. (Question on quiz relates to this info.) Ask: What parts of the baby can be seen in this picture? How many more weeks will it take for the baby to develop all its organs? Even more changes have taken place. The eyes are starting to develop and you can see the tiny arms and legs. All the organs have formed and are continuing to develop! This first few weeks of pregnancy are a period of time when severe damage can be done if a pregnant woman drinks alcohol, smokes, takes drugs, or lacks vitamins from poor nutrition. This is the period when many important organs are developing their internal structure and damage during the period can have long lasting effects. Consider Interaction here – Ask what organs might be affected – ask what substances might do to organs and what the long term outcome could be – e.g. brain, affected by alcohol causing delays in mental development – but let students come up with ideas as speaker will discuss details in a few slides. 9
  • 10. Drugs, alcohol and tobacco are dangerous in pregnancy... 10 Pregnancy, whether planned or surprise, brings with it important concerns about prescription and over the counter drugs as well as illegal drugs. Not every drug is a risk to the fetus but many are. Taking drugs whether legal or illegal, drinking alcohol and smoking while pregnant is risky. A woman who drinks, smokes or takes drugs during pregnancy is risking her baby’s life. Interaction – What things/drugs that a pregnant women takes might cause problems for the baby? What sorts of problems might you expect? (Suggestion: Have bottles of aspirin, and other over counter meds. Ask: Which of these might be harmful to the fetus. Answer: All could be harmful. Ask your health care provider before taking any type of medicines). 10
  • 11. Accutane in Pregnancy This sign means DO NOT take this drug if you are, or could be pregnant 11 One example of a prescription drug that can have serious effects on a baby is Accutane. Accutane, which is often used to treat acne, can cause significant damage to babies if the mother takes it during pregnancy. The woman may either not know she is pregnant or fail to tell the doctor, who prescribed the drug, that she is pregnant. Babies exposed to Accutane may have malformed ears. In some cases, they do not have any ear canals at all, resulting in deafness. The jaw may be deformed causing great difficulty sucking so feeding and weight gain are additional problems. There can also be problems with the central nervous system, deformities of the skull and face, heart and blood vessels, and the liver. Because some drugs can cause birth defects and we don’t always know which ones yet, pregnant women should be careful about all medications in pregnancy. 11
  • 12. Talk to your care provider before taking any over the counter medications during pregnancy 12 When a woman is pregnant she should not take over the counter drugs, like aspirin, Tylenol, Advil, cough or cold medicine, herbs or “natural” remedies without first asking the nurse or doctor. Even medicines you can buy without a prescription can pose a risk to the unborn baby. 12
  • 13. Many substances are harmful in pregnancy Energy drinks may contain Caffeine (typically the amount in 2.5 Cokes) Ephedrine (stimulant) Siberian Ginseng (stimulant) Green Tea (caffeine) Echinacea (herb) Ginkgo Biloba (herb) St. John's Wort (antidepressant) Kava Kava (traditional Polynesian sedative) 13 Many other substances can be harmful in pregnancy. Caffeine, certain herbs and chemicals can all cause damage to a developing fetus. Pregnancy is a time when we care for ourselves and our babies. A pregnant woman must choose wisely what she puts in her body. The consequences can be permanent. 13
  • 14. Drugs, smoking & alcohol can cause Premature Birth 14 Using drugs, alcohol and tobacco during pregnancy is one of the causes of premature birth and low birth weight. Preterm birth is defined as a live birth before 37 completed weeks. The babies shown above were born prematurely, some earlier than others. These babies were born weeks or months before they should have been. Because of this they can suffer many problems including brain bleeds, respiratory infections, heart problems, hearing loss, blindness and many other conditions. They can spend months in the hospital before they are ready to go home, if they survive. 14
  • 15. Baby born with Gastroschisis (Gastro-skee-sis) 15 Drugs, alcohol and smoking can also contribute to birth defects. One example, gastroschisis (gastro-ski-sis), is a birth defect in which the baby’s intestines and/or liver develop outside of the baby’s body. Cocaine and other stimulant drugs used during pregnancy can cause this defect. Ask: Who is under the age of 24? You all have one risk factor for having a child with gastroschisis. Gastroschisis is most common in women under 24 and in those who take illegal drugs. Some babies can be helped with surgery but some (12 %) of babies born with gastroschisis die at birth. 15
  • 16. Illegal Drugs in Pregnancy 16 In addition to the risks of low birth weight, prematurity, birth defects and developmental disabilities, babies whose mothers take illegal drugs while pregnant may be born addicted and suffer from withdrawal. These babies are agitated and irritable, difficult to relax and unable to suck. Withdrawal can be so severe that the babies need medication after birth. Even if a woman stops taking drugs before the baby is born, her child can have severe birth defects. Stopping is the best treatment. Better late than never! 16
  • 17. Marijuana in Pregnancy 17 Ask: Is it safe to smoke pot during pregnancy? Pot and pregnancy don’t mix. Marijuana use can reduce fertility in both men and women, making it difficult to conceive. If you are pregnant, you need to know that marijuana crosses the placenta and can affect your baby. Marijuana use during pregnancy has been linked to low birth weight in the baby and withdrawal-like symptoms including excessive crying, and tremors (shaking). Some studies suggest that children exposed to marijuana while in the womb are at increased risk of attention disorders and learning problems later in life. http://www.marchofdimes.com/pnhec/159_4427.asp 17
  • 18. Smoking in Pregnancy 18 Smoking in general is harmful to everyone. Women, who are pregnant, are especially at risk because they are responsible for two lives: theirs and their baby’s. Women should avoid smoking while they are pregnant, and other people should not smoke when they are near pregnant women. It is important to avoid 2nd hand smoke. Tobacco smoke contains more than 2500 chemicals including ammonia, benzene, formaldehyde and arsenic. Many of these items are known as familiar household cleaning products. (Suggestion for props: Show bottles of household cleaners—Would you like to ingest this? Poor into empty baby bottle for dramatic effect. Point: When you smoke your baby is also getting all these chemicals). Smoking nearly doubles a woman’s risk of having a low-birthweight baby. Low birthweight can result from poor growth before birth, preterm delivery or a combination of both. Smoking may also cause other complications in pregnancy that can be dangerous to the mother and baby. However, the good news is that if a woman quits smoking by the end of the first trimester of pregnancy, the risk of low birthweight is no higher than a non-smoking woman. After birth, babies whose parents smoke also have a higher rate of chest colds, bronchitis and pneumonia than babies with non-smoking parents. 18
  • 19. Alcohol in Pregnancy 19 Drinking while pregnant is just like feeding your baby alcohol in its bottle. Alcohol in the mother goes directly to the developing baby and alcohol stays in the baby’s system longer than the mother’s system. Alcohol can cause many problems including birth defects. One in 250 babies born in the US are damaged by alcohol. There is no way to tell how much is safe. Babies born to mothers who had one night of heavy drinking while pregnant may be affected as well as babies whose mothers drank frequently throughout their pregnancy. 19
  • 20. Fetal Alcohol Syndrome 20 Fetal Alcohol Syndrome affects many children whose mothers drank alcohol during pregnancy. These babies are born small at birth and may have distinctive facial features, including a flattened area between the nose and lip, narrow upper lip, small eyes, narrow forehead and a small head. These children also suffer from mild to severe mental retardation. Children with Fetal Alcohol Effect (fetal alcohol spectrum disorder), a milder disease than FAS, may not have facial changes, but their brain is affected. They may have trouble with school work and social relationships. 20
  • 21. 21 Heavy alcohol consumption can decrease brain size. This top picture is a view of two human brains. One is a normal infant brain at 6 weeks. The one on the right is a view of an infant with fetal alcohol syndrome. You can see that the fetal alcohol brain is smaller and looks irregular. The folds in the brain tissue are different than the normal brain. In the second picture you can see that a baby’s brain can be affected by alcohol without causing changes in her appearance. Some effects of alcohol do not show up until a child is much older and enters school. No amount of alcohol is safe in pregnancy! 21
  • 22. Premature Babies are at Risk for Many Health Problems 22 Ask: When you think of premature babies, what are some words that come to mind? Do you know anyone who has had a premature baby? What types of problems did the baby have? Although drug and alcohol use are one thing that may increase the risk of premature birth, often doctors don’t know exactly why a baby is born prematurely. Babies born too soon are often born too small. But these premature infants are not just small - many organs are not fully developed when they are born and they are at risk for many health problems including long term breathing problems, heart problems, cerebral palsy, and developmental disabilities. They need special care in the hospital and may not be able to go home for many weeks or months. Very premature and small babies may not survive. 22
  • 23. Who is at risk for preterm birth? 23 Ask: What conditions put a mother at risk for preterm birth? Interaction: Write ideas on blackboard. A woman is at high risk for preterm delivery if she has had pervious preterm birth, is pregnant with twins or triplets (or more) or has certain uterine or cervical abnormalities. Other factors besides smoking, alcohol or illegal drug use also increase the risk of preterm birth including: being a teenage mom, being older than 35, getting late or no prenatal care, domestic violence, lack of social support and working long hours with long periods of standing. Certain medical conditions can also increase the risk of prematurity – infections, diabetes, high blood pressure, being underweight or obese before pregnancy, and having a short time between pregnancies. 23
  • 24. Cerebral Palsy 24 These children have cerebral palsy, a condition in which a person’s muscles do not work properly and they may not be able to walk or feed themselves. Many cases of cerebral palsy are caused by premature birth or maternal infections that lead to brain injury in the baby. 24
  • 25. Prenatal Care 25 Ask: What is prenatal care? Why is prenatal care important? What are some reasons why a woman might not get prenatal care in the 1st 3 months of pregnancy? How could she deal with these ‘obstacles’? It is very important for women to get prenatal care from a doctor, midwife or nurse beginning in the first 3 months of pregnancy. The provider will teach their patients about pregnancy, answer questions that the women or her partner may have and check for infections or health problems that could affect the mom or baby. They will monitor the pregnancy to make sure that everything is going well. If there are any problems, the provider can take the next steps to deal with the problems appropriately. Note: In Washington: Healthy Mothers, Healthy Babies is an organization offering resources for prenatal care and support for mom and or dad. 25
  • 26. Sexually Transmitted Infections Eye infection in newborn Congenital systemic from Chlamydia herpes infection 26 Ask: What are some STIs? How does a person get an STI? What risks do STIs have on babies? How can you prevent harm to your baby? Sexually transmitted infections can cause miscarriage, tubal pregnancy, premature birth, stillbirth, birth defects and newborn illness and death. It is important for a pregnant woman to find out if she has an STD so that she and her baby can be treated properly In the picture on the right, you can see a baby with a herpes infection. In the adults, genital herpes can cause painful itch blisters in the genital area, but many women who have herpes do not have any symptoms. A small number of women with herpes can pass it on to their infants. The risk of passing it along to the infant is highest if the woman gets herpes while she is pregnant. If the infant becomes infected with herpes, it can cause a very serious infection that can lead to brain damage, blindness, hearing loss, liver damage, and developmental disabilities in the baby. The baby on the left has an eye infection from Chlamydia, which is passed to the baby as it travels through the birth canal. 26
  • 27. Sexually Transmitted Infections Disease Effects Treatment Chlamydia Miscarriage, premature birth, Antibiotics can cure Chlamydia pneumonia or eye infection in the baby Gonorrhea Miscarriage, premature birth, Antibiotics can cure Gonorrhea eye, joint or blood infections in baby Syphilis Fetal or infant death, brain Antibiotics can cure, and baby damage, blindness, hearing usually won’t be affected if treated loss by 4th month of pregnancy Genital Skin sores, severe infection No cure, but medicines can treat can cause brain damage, sores. Doctors can do c-section if Herpes blindness, hearing loss and there are vaginal sores at time of mental retardation in baby delivery 27 Briefly describe table: disease, effects and treatment. At an early prenatal visit a woman should be offered screening for certain STIs, such as HIV (the virus that causes AIDS), chlamydia, gonorrhea, hepatitis and syphilis. The best way to avoid becoming infected with STIs prior to or during pregnancy is to abstain from sex, use a condom, limit your number of sexual partners and/or maintain a monogamous relationship. The best way to avoid injury to the unborn child is to get tested for STIs and to let your provider know about any genital infections or sores that you have had in the past so that you and your baby can be treated appropriately. 27
  • 28. HIV • Women who learn that they carry the virus can get treatment for HIV • Treatment with antiviral medication dramatically reduces the chance that she will pass HIV on to her babies 28 120,000-160,000 women in the United States are living with HIV. The CDC and the March of Dimes recommend that all pregnant women be offered counseling and testing for HIV. Women who learn they carry the virus can get treatment for HIV to help protect themselves and their babies. New antiviral treatments can reduce the chance of passing HIV from a mother to child to less than 2%. Without treatment, the risk of passing HIV from a mother who is infected to her baby is 25%. HIV testing is offered at prenatal care. Many teenage cases are picked up for the first time at prenatal screening. 28
  • 29. Baby at 30 weeks gestation 29 This is a picture of a baby at 30 weeks gestation… 2 months away from a normal full term birth. Around the baby, you can see the umbilical cord; this is what brings the nutrients to the baby from the mother. The baby doesn’t eat like you and I do at this state, but relies on the mother for vitamins, minerals and calories to grow. So what the mom eats, or doesn’t eat, impacts the baby. 29
  • 30. Anorexia and Pregnancy 30 This is a picture of a baby born to a woman who has anorexia, an eating disorder where the woman restricts what she eats or excessively exercises. The woman did not gain enough weight during pregnancy to provide enough nutrition for both herself and her baby. Ask: How many pounds should the average woman gain during pregnancy? (25-35 lbs.) Because she didn’t gain weight, her baby did not gain weight either. As you can tell, this baby has very little fat on it’s body. It may have permanent problems including poor brain development due to the lack of nutrition. 30
  • 31. Nutrition 31 Women should eat healthy foods like fruits and vegetables, low-fat protein and whole grains and limit fats and sweets during pregnancy. Pregnancy is not a time for radical diets or “low-carb” experiments. Exercise is also healthy for mothers and babies! The difficulty and level of activity can be modified as the pregnancy progresses and the baby gets bigger. 31
  • 32. Foods in Pregnancy 32 However, there are a few things that pregnant women should avoid eating due to risk of infection or injury to her unborn child. Make sure that all meats and eggs are fully cooked to avoid bacterial infection (this means no raw cookie dough or runny eggs). Raw fish or sushi can also be harmful. Some deep sea fish contain high levels of mercury (that can affect brain development) so pregnant women shouldn’t eat shark, mackerel, swordfish and tilefish at all and they shouldn’t eat more than 6 oz per week of white tuna or tuna steak. The EPA/FDA recommends that a pregnant woman can eat up to 12 oz per week of other seafood that is lower in mercury. Soft, unpasturized cheese, packaged meat and deli meat can cause a form of food poisoning (listeriosis) that is especially dangerous during pregnancy. Pregnant women can protect themselves by avoiding hot dogs, smoked meats and deli meats unless they are reheated until steaming hot. 32
  • 33. 33 Eating properly before and during pregnancy is very important. There are certain vitamins and minerals that are necessary for a healthy baby. Ask: What do you think is the most important vitamin to take? One particularly important vitamin is Folic Acid (or folate). It is recommended that all women of childbearing age take a multi-vitamin with 400 micrograms of folic acid every day. Ask: What kind of birth defects do you think are prevented by taking this vitamin? When should you start taking it? Folic acid also protects against certain birth defects of the brain and spine. Dried beans and legumes, oranges and orange juice, peanuts and leafy green vegetables all contain folate. Synthetic (manufactured) folic acid is added to grain products, including flour, rice, pasta, cornmeal, bread and cereals. These foods are considered “fortified” with folic acid. Potential interaction – pass out 3 or 4 different types of vitamins and have students find the one with 400+ mcg of folate. 33
  • 34. Spina Bifida 34 A lack of folic acid during pregnancy can cause serious birth defects such as spina bifida. Spina bifida happens when the spine fails to close during the first 22 days of pregnancy. That’s right! The spine is formed by day 22 of pregnancy. As you can see, there is a hole in the sac covering the spinal cord and a defect in the bony spine in the same area. This effects the child’s nervous system. It can cause problems with the child’s ability to use his legs go to the bathroom normally. Taking a multi-vitamin with folate everyday before pregnancy can help prevent spina bifida. If a woman waits to take vitamins until after she knows she’s pregnant, it may be too late to prevent this birth defect! 34
  • 35. Dad’s Responsibilities Help your partner make healthy choices: Avoid Alcohol Avoid tobacco smoke Eat nutritious foods Avoid unsafe drugs Don’t let her clean the cat litter box Avoid dangerous household products Remind her to take vitamins with folate Make sure she gets prenatal care 35 Fathers are a very important support for their pregnant partners. They can do many things to help their partners stay healthy and have a healthy baby. Ask: What can fathers and friends do to encourage healthy pregnancy? •Dads can help their partner avoid alcohol, and could even consider avoiding alcohol themselves to help mom stay away from alcohol. •They should stop smoking, second hand smoke isn’t good for the mother or the baby. •Help mom eat healthy foods and avoid risky foods •Help her avoid unsafe drugs and medications •They should take over cleaning the cat’s litter box, and help her avoid other cat feces to avoid exposure to toxoplasmosis – an infection that can cause serious problems for a developing baby •They can also make sure that she stays away from dangerous household products like paint, paint thinner, solvents and pesticides.. •They can help her to remember to take a multivitamin with folate before she becomes pregnant and can make sure that she gets good, timely prenatal care. •Note: Friends are an important support system and can participate in these same tasks. 35
  • 36. Make wise choices now for a healthy baby later 36 The lifestyle and health-related choices a young woman makes now effect not only her present health, but also her long-term health and the health of the children she may have sometime in the future. Habits, good or bad, are hard to break. Make wise choices now. The health of your future children may depend on it. Wrapping up the session: Do you have any questions? And now for the exam/quiz – provide prizes/candy for completing and returning quiz and survey. Please let us know how we did and fill out this survey. 36
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