Teratology is the study of abnormalities of physiological development in organisms during their life span. It is a sub-discipline in medical genetics which focuses on the classification of congenital abnormalities in dysmorphology caused by teratogens. Teratogens are substances that may cause non-heritable birth defects via a toxic effect on an embryo or fetus. Defects include malformations, disruptions, deformations, and dysplasia that may cause stunted growth, delayed mental development, or other congenital disorders that lack structural malformations. The related term developmental toxicity includes all manifestations of abnormal development that are caused by environmental insult. The extent to which teratogens will impact an embryo is dependent on several factors, such as how long the embryo has been exposed, the stage of development the embryo was in when exposed, the genetic makeup of the embryo, and the transfer rate of the teratogen.
A birth defect is an abnormal condition that is present at birth, regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities can range from mild to severe. Birth defects are divided into two main types: structural disorders in which problems are seen with the shape of a body part and functional disorders in which problems exist with how a body part works. Functional disorders include metabolic and degenerative disorders. Some birth defects include both structural and functional disorders.
Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person who is exposed to alcohol during gestation. FASD affects 1 in 20 Americans, but is highly mis- and under-diagnosed.
Low birth weight (LBW) is defined by the World Health Organization as a birth weight of an infant of 2,499 g or less, regardless of gestational age. Infants born with LBW have added health risks which require close management, often in a neonatal intensive care unit (NICU). They are also at increased risk for long-term health conditions which require follow-up over time.
Maternal deprivation is a scientific term summarising the early work of psychiatrist and psychoanalyst John Bowlby on the effects of separating infants and young children from their mother. Although the effect of loss of the mother on the developing child had been considered earlier by Freud and other theorists, Bowlby's work on delinquent and affectionless children and the effects of hospital and institutional care led to his being commissioned to write the World Health Organization's report on the mental health of homeless children in post-war Europe whilst he was head of the Department for Children and Parents at the Tavistock Clinic in London after World War II. The result was the monograph Maternal Care and Mental Health published in 1951, which sets out the maternal deprivation hypothesis.
Prenatal stress, also known as prenatal maternal stress, occurs when an expectant mother is exposed to psychosocial or physical stress. This can be brought on by daily events or environmental hardships.[1] [2] According to the Developmental Origins of Health and Disease (DOHaD), a wide range of environmental factors a woman may experience during the perinatal period can contribute to biological impacts and changes in the fetus that then cause health risks later in the child's life. Health risks include impaired cognitive development, low birth weight, mental disorders, and gender specific deficits in the offspring.
Attachment-based therapy applies to interventions or approaches based on attachment theory, originated by John Bowlby. These range from individual therapeutic approaches to public health programs to interventions specifically designed for foster carers. Although attachment theory has become a major scientific theory of socioemotional development with one of the broadest, deepest research lines in modern psychology, attachment theory has, until recently, been less clinically applied than theories with far less empirical support. This may be partly due to lack of attention paid to clinical application by Bowlby himself and partly due to broader meanings of the word 'attachment' used amongst practitioners. It may also be partly due to the mistaken association of attachment theory with the pseudo-scientific interventions misleadingly known as attachment therapy. The approaches set out below are examples of recent clinical applications of attachment theory by mainstream attachment theorists and clinicians and are aimed at infants or children who have developed or are at risk of developing less desirable, insecure attachment styles or an attachment disorder.
Christine Dean FRCPsych is an English psychiatrist consulting at the Priory Hospital, Roehampton, the British Association of Performing Arts Medicine (BAPAM), The Helen Bamber Foundation, in her private practice and as a medical member of the Mental Health Review Tribunals, Ministry of Justice.
Daniel S. Schechter is an American and Swiss psychiatrist known for his clinical work and research on intergenerational transmission or "communication" of violent trauma and related psychopathology involving parents and very young children. His published work in this area following the terrorist attacks on the World Trade Center in New York of September 11, 2001 led to a co-edited book entitled "September 11: Trauma and Human Bonds" (2003) and additional original articles with clinical psychologist Susan Coates that were translated into multiple languages and remain among the first accounts of 9/11 related loss and trauma described by mental health professionals who also experienced the attacks and their aftermath Schechter observed that separation anxiety among infants and young children who had either lost or feared loss of their caregivers triggered posttraumatic stress symptoms in the surviving caregivers. These observations validated his prior work on the adverse impact of family violence on the early parent-child relationship, formative social-emotional development and related attachment disturbances involving mutual dysregulation of emotion and arousal. This body of work on trauma and attachment has been cited by prominent authors in the attachment theory, psychological trauma, developmental psychobiology and neuroscience literatures
Thyroid disease in pregnancy can affect the health of the mother as well as the child before and after delivery. Thyroid disorders are prevalent in women of child-bearing age and for this reason commonly present as a pre-existing disease in pregnancy, or after childbirth. Uncorrected thyroid dysfunction in pregnancy has adverse effects on fetal and maternal well-being. The deleterious effects of thyroid dysfunction can also extend beyond pregnancy and delivery to affect neurointellectual development in the early life of the child. Due to an increase in thyroxine binding globulin, an increase in placental type 3 deioidinase and the placental transfer of maternal thyroxine to the fetus, the demand for thyroid hormones is increased during pregnancy. The necessary increase in thyroid hormone production is facilitated by high human chorionic gonadotropin (hCG) concentrations, which bind the TSH receptor and stimulate the maternal thyroid to increase maternal thyroid hormone concentrations by roughly 50%. If the necessary increase in thyroid function cannot be met, this may cause a previously unnoticed (mild) thyroid disorder to worsen and become evident as gestational thyroid disease. Currently, there is not enough evidence to suggest that screening for thyroid dysfunction is beneficial, especially since treatment thyroid hormone supplementation may come with a risk of overtreatment. After women give birth, about 5% develop postpartum thyroiditis which can occur up to nine months afterwards. This is characterized by a short period of hyperthyroidism followed by a period of hypothyroidism; 20–40% remain permanently hypothyroid.
Antenatal depression, also known as prenatal or perinatal depression, is a form of clinical depression that can affect a woman during pregnancy, and can be a precursor to postpartum depression if not properly treated. It is estimated that 7% to 20% of pregnant women are affected by this condition. Any form of prenatal stress felt by the mother can have negative effects on various aspects of fetal development, which can cause harm to the mother and child. Even after birth, a child born from a depressed or stressed mother feels the affects. The child is less active and can also experience emotional distress. Antenatal depression can be caused by the stress and worry that pregnancy can bring, but at a more severe level. Other triggers include unplanned pregnancy, difficulty becoming pregnant, history of abuse, and economic or family situations.
In psychology, limbic imprint refers to the process by which prenatal, perinatal and post-natal experiences imprint upon the limbic system, causing lifelong effects. The term is used to explain how early care of a fetus and newborn is important to lifelong psychological development and has been used as an argument for alternative birthing methods, and against circumcision. Some also refer to the concept as the human emotional map, deep-seated beliefs, and values that are stored in the brain's limbic system. When a fetus or newborn experiences trauma, the brain will register trauma as normal affecting the newborn into adulthood. However, when a fetus or newborn does not experience trauma, the brain will develop healthy coping mechanisms that work effectively into adulthood.
Cannabis consumption in pregnancy is an important public health issue. Research has found possible or likely associations between cannabis use and a risk of adverse outcomes in respect of cognitive development, mental health, physical health, and lactation.
Frances A. Champagne is a Canadian psychologist and University Professor of Psychology at the University of Texas at Austin known for her research in the fields of molecular neuroscience, maternal behavior, and epigenetics. Research in the Champagne lab explores the developmental plasticity that occurs in response to environmental experiences. She is known for her work on the epigenetic transmission of maternal behavior. Frances Champagne's research has revealed how natural variations in maternal behavior can shape the behavioral development of offspring through epigenetic changes in gene expression in a brain region specific manner. She won the NIH Director's New Innovator Award in 2007 and the Frank A. Beach Young Investigator Award in Behavioral Neuroendocrinology in 2009. She has been described as the "bee's knees of neuroscience". She serves on the Committee on Fostering Healthy Mental, Emotional, and Behavioral Development Among Children and Youth in the United States.
Julia Rucklidge is a Canadian-born clinical psychologist who is the director of Te Puna Toiora, the Mental Health and Nutrition Research Lab at the University of Canterbury in New Zealand. Her research has centered on mental health and nutrition.
Arline Geronimus wrote about the weathering hypothesis the early 1990s to account for health disparities of newborn babies and birth mothers due to decades and generations of racism and social, economic, and political oppression. It is well documented that people of color and other marginalized communities have worse health outcomes than white people. This is due to multiple stressors including prejudice, social alienation, institutional bias, political oppression, economic exclusion, and racial discrimination. The weathering hypothesis proposes that the cumulative burden of these stressors as individuals age is "weathering", and the increased weathering experienced by minority groups compared to others can account for differences in health outcomes. In recent years, social scientists investigated the biological plausibility of the weathering hypothesis in studies evaluating the physiological effects of social, environmental and political stressors among marginalized communities. The weathering hypothesis is more widely accepted as a framework for explaining health disparities on the basis of differential exposure to racially based stressors. Researchers have also identified patterns connecting weathering to biological phenomena associated with stress and aging, such as allostatic load, epigenetics, telomere shortening, and accelerated brain aging.
Fetal programming, also known as prenatal programming, is the theory that environmental cues experienced during fetal development play a seminal role in determining health trajectories across the lifespan.
Shubulade Smith, also known as Lade Smith is a British academic and consultant psychiatrist at the South London and Maudsley NHS Foundation Trust (SLaM). She is a senior lecturer at King's College, London and Clinical Director at the NCCMH and forensic services at SLaM, and is currently serving as the first black President of the Royal College of Psychiatrists.
COVID-19 infection in pregnancy is associated with several pregnancy complications. However, pregnancy does not appear to increase the susceptibility of becoming infected by COVID-19. Recommendations for the prevention of COVID-19 include the same measures as non-pregnant people.
Louise Clare Kenny is a British physician who is Professor and Executive Pro-Vice-Chancellor at the University of Liverpool. She was elected an Commander of the Order of the British Empire in the 2022 New Year Honours.
