Roy P. Martin Stefan C. Dombrowski. Prenatal Exposures. Psychological and Educational Consequences for Children

Transcription

1 Prenatal Exposures

2 Roy P. Martin Stefan C. Dombrowski Prenatal Exposures Psychological and Educational Consequences for Children

3 Prof. Roy P. Martin University of Georgia Athens, GA USA (706) Prof. Stefan C. Dombrowski Rider University Lawrenceville, NJ USA (609) ISBN: e-isbn: DOI: / Library of Congress Control Number: Springer Science+Business Media, LLC All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY-10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. Printed on acid-free paper springer.com

4 Preface Approximately 2 percent to 3 percent of the population of the United States has been diagnosed with severe neurological disabilities (e.g., mental retardation, cerebral palsy, autism, chronic severe mental illness). A far greater percentage (10 percent to 20 percent) has less severe disabilities (e.g. learning disabilities, disorders of attention, episodic mental illness). These neurologically based afflictions result in enormous human suffering and social cost, placing a significant burden on even the most affluent countries in the world. For more than 100 years scientists in a wide range of disciplines (e.g., sociology, psychology, medicine, developmental biology) have attempted to determine the causes of these disabilities. Many factors have been isolated including genetics, nutrition, pollutants, inadequate caretaking and social factors linked to poverty. It is the belief of the authors of this book that one set of factors, those that alter the neurological development of the child during the fetal period, has not been given the attention that it deserves. The prenatal period of development is particularly sensitive to disruption because it encompasses a precisely timed period when organ systems are formed and rapid growth of neurological structures occurs. During no other period in the life course is the well-being of the individual so dependent on precisely timed biochemical events. As a result, an adverse prenatal exposure can impart immutable damage because of the sensitivity of the developing central nervous system during the prenatal period. A growing number of specialists are making important discoveries regarding the types of factors that perturb fetal neurological development. These researchers have, in some cases, documented long-term psychological, behavioral and educational sequelae. However, this research is scattered throughout research literatures of a variety of professions (medicine, epidemiology, developmental psychopathology, reproductive biology), is technically challenging for non-specialists and is not readily available to many that do not have access to research libraries or specialized computerized retrieval mechanisms. Thus, it is the purpose of this book to summarize the most important findings regarding prenatal exposures that have been associated with learning and behavior problems of children and adolescents. This volume is organized into five sections. The first introduces the main themes of the book and, in a separate chapter, presents an introduction to fetal development. This chapter was designed to set the stage for the understanding of how many v

5 vi Preface different types of perturbations result in long-term central nervous system damage that has a continued effect as the child matures. The second section is devoted to low birth weight, preterm birth and asphyxia. These are among the most widely researched markers or indicators that prenatal perturbations have occurred. The remaining three sections are devoted to detailed discussions of the research linking maternal illness, maternal drug use and maternal exposure to pollutants to long-term negative effects on child and adolescent development. We are particularly pleased to be able to summarize many recent findings in the area of air, water and household chemical pollutants as this volume is one of the first to include detailed reviews of this burgeoning area of scientific activity. It is our hope that having this body of knowledge compiled for the first time in one volume will aid researchers, practitioners and policy makers in elevating prenatal events to a more central position in the understanding of learning and behavioral pathologies of children and adolescents. A nuanced understanding of the role of prenatal events is particularly important in today s world, as the number of children with developmental anomalies is increasing, largely due to improved medical care. This book stands to fill a cross-disciplinary conceptual gap and serve as an important resource to the psychological, medical and educational community, setting the context for appropriate prevention and intervention activities that have the potential to foster the developmental well-being of children. November 2007 Roy Martin and Stefan Dombrowski Athens, GA Cherry Hill, NJ

6 Acknowledgments This book is dedicated to Janet, Greg and David, the immediate family who has to make the sacrifices of time and attention that a book such as this requires. Thanks for your generosity. In addition, thanks to Claudia (sister) and Claud (father) for your interest and emotional support. Also, Stefan, you have made this project possible; I would not have had the energy or enough ideas to do it without you. Finally, thanks to Susan Sullivan for proofing many of the chapters and helping to compensate for my lack of attention to grammar and punctuation. To all of you, I am very grateful. R.M. This book is dedicated to my children, Maxwell and Henry. I look forward to supporting your journey toward a vocation that brings you as much joy and satisfaction as I have found in mine. I would also like to acknowledge the love and support of my parents (Carl and Mary Lee), and my wife (Debbie). Finally, I owe a debt of gratitude to Roy P. Martin, my former major professor who inspired my academic career and remains a mentor to this day. S.D. vii

7 Contents Section A Introduction Chapter 1 Themes and Purpose Etiology of Childhood and Adolescent Psychopathology The Underestimated Importance of the Prenatal Environment Summary Chapter 2 Prenatal Central Nervous System Development Prenatal CNS Development First Trimester Development Cell Proliferation Cell Migration Cell Differentiation Myelination Cell Death (Apoptosis) Summary Section B Perinatal Mediators and Markers of Disturbances of Fetal Development: Introduction Chapter 3 Low Birth Weight and Prematurity: Effects on Child Development Outcomes Definitions Outcomes Historical Account of Adverse Outcomes Outcomes of Low Birth Weight Pathophysiological Basis of LBW Conclusion and Future Research Directions ix

8 x Contents Chapter 4 Pre- and Perinatal Anoxia and Hypoxia Hypoxia and the Preterm Infant Mechanisms by Which Hypoxia Produce Neurological Damage Perinatal Hypoxia/Anoxia and Developmental Outcomes Health Outcomes Neurological Outcomes Learning and Behavior Outcomes Summary and Conclusions Section C Maternal Illness: Introduction Chapter 5 Prenatal Infections Influenza Influenza s Association with Congenital Anomalies Influenza s Association with Affective Disorder Influenza s Association with Schizophrenia Other Prenatal Infections Congenital Rubella Measles/Mumps Varicella-Zoster (Chicken Pox) Cytomegalovirus infection (CMV) Herpes Simplex 2 (HSV-2) Toxoplasmosis Syphilis Summary Etiological Hypotheses Neurodevelopmental Hypothesis The Immune Response to Infection Cytokine Effects Indirect Effects via Hyperthermia Autoimmune Response The Heat Shock Response Conclusion Chapter 6 Maternal Chronic Illness Maternal Diabetes Mellitus Maternal Obesity Circulatory Diseases Occurring During Pregnancy Maternal Hypertension Maternal Heart Disease Pulmonary Diseases: Asthma Summary and Conclusions

9 Contents xi Chapter 7 Nutrition Protein-Energy Malnutrition Iron Deficiency Vitamin Deficiences Vitamin A Vitamin B Complex Vitamin C Vitamin D Vitamin E Summary and Conclusion Chapter 8 Maternal Stress Definition The Psychobiology of Stress: A Brief Overview The Sociology of Stress Prevalence of Stress or Distress Occurring During Pregnancy Effects of Pregnancy Distress on Offspring: Introduction Animal Studies Human Research: Effects Observed During the Prenatal Period Etiological Mechanism Timing of Stressors During Gestation Methodological Issues Summary and Conclusions Section D Maternal Use of Recreational Drugs Chapter 9 Maternal Smoking During Pregnancy Smoking During Pregnancy Outcomes Experimental Animal Studies Human Obstetrical and Fetal Outcomes Effects During Infancy Effects Assessed During Childhood Adolescence and Adulthood Secondhand Smoke Exposure Occurring During Prenatal and Postnatal Life Summary and Conclusions Hypotheses about Causal Mechanisms Physiological/Biological Explanations Psychosocial and Environmental Explanations The Motivation to Smoke Summary and Conclusion

10 xii Contents Chapter 10 Gestational Exposure to Alcohol Fetal Alcohol Syndrome Effects of Mild to Moderate Alcohol Use During Pregnancy Cognitive Ability and Neuropsychological Outcomes Neuropsychological Sequelae Learning and Memory Fine and Gross Motor Skills Behavioral Outcomes Attention and Activity Related Deficits Aggression and Conduct Problems Social Skills Deficit Alcohol and Drug Use Summary Mechanisms of Teratogenesis and Resulting Brain Morphology Summary and Conclusion Chapter 11 Maternal Use of Illicit Drugs Marijuana Growth Indicators Behavioral Outcomes Cognitive Outcomes Mechanisms Summary Cocaine Growth Outcomes Cognitive Outcomes Behavioral Outcomes Mechanisms of Teratogenesis Summary Opiates Outcomes Mechanisms of Teratogenesis Summary Amphetamine/Methamphetamine Methamphetamine Amphetamine Mechanism of Teratogenesis Summary and Conclusion

11 Contents xiii Section E Pollutants and the Development of the Human Fetus: An Introduction Chapter 12 Air and Water Pollution Air Pollution Carbon Monoxide (CO) Sulfur dioxide (SO 2 ) Nitrogen dioxide (NO 2 ) Ozone (O 3 ) Particulate Matter Combined Effects of Various Air Pollutants Outcome Studies for Pregnant Women Summary Water Pollution Agricultural Pollutants Industrial Waste Water Treatment Spot Sources of Pollution Summary: Water Pollution Chapter 13 Heavy Metals and Household Chemicals Heavy Metal Pollution Mercury Poisoning Lead Exposure Cadmium Various Chemical Exposures Found in Home Products Polychlorinated biphenyls Fluorine-based Coatings Pthalates Flame-Retardant Chemicals Acrylamide Volatile Organic Compounds Summary Section F Historical Perspective and the Future Appendix: Brief Medical Dictionary Related to Pregnancy References Subject Index