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Poor Prenatal Choices

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A series of the empirical research has demonstrated that poor prenatal choices could have both long and short-term effects on the developing child. The research has also shown that the prenatal exposure to Marijuana, tobacco, alcohol, and cocaine, along with and stress may lead to some negative cognitive and physical outcomes for an infant. This paper analyses the evidence for long-term and short-term effects of the fetal situation and the later antisocial conduct of children and possible interventions.

It is apparent that the infancy period is critical for later health and vulnerability of the developing child to diseases. The early stages in the formation of organs such as brain are susceptible to environmental influences. The study of epigenetics shows that changes accruing from pregnancy can last throughout the lifetime. To obtain the best outcomes for a child, the interventions should start from childhood. Epigenetic changes in the neural pathways may be hard to change once the brain has been formed. Though some neurodevelopment changes can be altered, the behavioral disorder or learning problems, all of which may culminate to the later antisocial and criminal demeanor and be hard to alter.

Studies have shown that the exposure to alcohol during infancy may result to changes in  neuro-physiological processing of stimulus and the recognition of memory (Burden et al., 2011). It has also been proven that the prenatal exposure to marijuana may result to altered visual responsiveness, the prevalence of startles and tremors and damages in the Central Nervous System (Smith et al., 2007). It is now evident that the emotional stress of the mother during infancy is crucial to the brain development and the later social demeanor of the child (Glover & Sutton, 2012). Cocaine has also been found to have adverse effects on the child both during infancy and after the child birth. In the recent study, cocaine has been found to cause premature births, respiratory distress, low birth weight, bowel infarctions and the increased risk of seizures (Keller & Abigail 2011). The empirical study done by Boutwell and Beaver (2010, p. 154) has demonstrated that the prenatal exposure of tobacco through smoking may be linked to negative outcomes such as low cognitive abilities, health problems and later behavioral problems in the child.

This paper has analyzed the evidence for long-term and short-term effects of these fetal situations and the later antisocial conduct of children and possible interventions through responding to the following questions:

  • Does the mother’s stress during infancy affect the developing child?
  • What are the effects of the prenatal usage of drugs on the developing child?
  • What are the possible interventions to poor prenatal choices?

Does the Mother’s Stress during Infancy Affect the Developing Child?

The impact of prenatal stress may be the least a visited factor in the list. Nevertheless, there has been an upsurge in the relevant literature on the issue. It may, therefore, prove worthy to give it the attention in the current paper.

There is the substantial evidence that if mothers are stressed during pregnancy, the child is most likely to encounter a range of neuro-developmental problems. The problems may be attributed to fetal programming. This is the concept that the environment in the Uterus during infancy can affect the fetal development with both short and long-term effects on the child. This may be linked to cardiovascular diseases. Many notable studies have shown the link between stress and low birth weights and the reduced gestation age (Glover & Sutton, 2012). Investigators focusing on the effect of stress on newly born infants have shown the poor performance by the neonatal Behavioral Assessment Scale (NBAS) implying that poor behavioral outcomes have been set on from the beginning. The studies on toddlers and infants born to stressed mothers have demonstrated that, as compared to stress free mothers, they experience more sleep problems, have a more difficult temperament, the lower or altered cognitive performance, and more fearfulness.

Approaches analyzing the link between the prenatal stress and neuro-developmental outcome in children rather than toddlers or infants have shown that children born to stress mothers experience more emotional difficulties, mostly anxiety and depression as compared to those born to the less stressed mothers. It has also shown that children associated with prenatal stress exhibit lower cognitive abilities or the altered cognitive function (Titterness & Christie, 2008). Nevertheless, there may be the inadequate consistency in the research on the time of gestation when the effect of stress has a maximal impact on the child. It is possible that both the early and late onset of stress have similar effects. There is a possibility that some stages in the gestation have these effects being felt most. Meanwhile, the study on conduct disorders and antisocial demeanor have demonstrated that the late pregnancy stage would be the most vulnerable to prenatal stress effects of the prenatal stress on the developing child (Rice et al., 2010).

What Are the Effects of Prenatal Usage of Drugs on the Developing Child?

The prenatal exposure to drugs and alcohol and smoking has adverse effects on the developing child. The most prevalent drugs abused by pregnant mothers include marijuana, cocaine, and tobacco.

Prenatal Exposure to Marijuana

Marijuana is the most commonly abused illicit drug among pregnant mothers. In the recent National Pregnancy and Health Survey done by the NIDA, have self-reported on marijuana usage among pregnant women recorded 2.9% prevalence. This was approximated to be three times more from the prevalence of crack/cocaine use (Fried & Smith, 2007). The long-term neuro-physiological effect of prenatal exposure to marijuana has been investigated among 18-22 year old. This was done through functional magnetic resonance imaging (fMRI). In this study, Fried and Smith (2007, p. 5) have carried a longitudinal provided a distinctive body of the information derived from each participant over 20 years. This entailed the prenatal drug history, a detailed behavioral performance from early life to early adulthood, and the past and current drug usage. This information has been analyzed to exhibit the potential exposure of the participants to marijuana. Thirty participants (15 non-exposed and 16 prenatally exposed) have gone through the fMRI for imaging of the neural activity. The data on cognitive performance would also be collected.

The results showed no significant performance in the differences between control and exposed participants. The analysis of the data using multiple regressions has showed that the neural activity in the middle frontal and left inferior gyri among non exposed participants exceeded the exposed participants significantly. There were also the less activity middle frontal and right inferior gyri. This would be interpreted to mean that marijuana exposure during infancy alters memory processing and neural functioning in a young adulthood.

Other researchers have found the significant differences in sleep patterns and the integrity of the Central Nervous System while comparing babies with the prenatal exposure to marijuana to those unexposed ones to marijuana. The effects of marijuana exposure on the CNS may be found at older ages, whereby the 48 months-old children exhibit lower scores in both memory and verbal domains (Day et al., 1993).

Cocaine abuse is not only a significant problem to the general population, but also to the expectant women. Cocaine easily crosses the placenta and metabolizes in the fetus. Therefore, the unborn baby may be exposed to large amounts of cocaine for long durations (Keller & Abigail, 2011). In human beings, the most likely effects of cocaine exposure to the fetus include: the premature birth, respiratory distress, cerebral infarctions, small head circumference, low birth weight, and the risk of seizures. Some of behavioral effects entail irritability, crying and being over-reactive to the environmental stimuli. These effects may be short term in the sense that the babies recover within a month. Nevertheless, they do not experience a full recovery. There may not be the quite life threatening effects of the prenatal exposure to cocaine. However, long-term effects remain as explicated.

In 2011, Keller and Abigail (p. 223) have focused on the prenatal exposure of cocaine to the unborn offspring. They have used a rat model to explain neuro-anatomical, neuro-chemical, and behavioral changes ensuing from the parental cocaine exposure. Since it has been established that cocaine blocks the inactivation of neurotransmitters serotonin and dopamine, they have focused on serotonin and brain dopamine pathways. In this model, they have found neuro-chemical changes that prevail from birth and recede as the rat has grown. The same effects have been translated to infants. However, the found neuro-chemical and behavioral changes prevailing from birth and could provide an insight into the long-term effects. The research had the aim of translating the results and deriving pharmacological interventions to the long-term effects of the prenatal cocaine exposure. The long-term effects include high susceptibility to drug addiction, depression, schizophrenia, seizures and Parkinson’s disease.

In another study, Richardson et al. (2007) have carried a longitudinal analysis of effect of prenatal exposure to cocaine. They have investigated the effects from one through ten years of age using a repeated measures’ growth curve. The method of study was through interviews conducted on the women attending prenatal clinics, at the end of each trimester. The aspects of focus were the general drug usage, particularly alcohol, marijuana, tobacco, crack and cocaine. A cross sectional analysis has showed that babies exposed to cocaine in the first trimester were smaller than those unexposed at 7 and 10 years; but not at 1 or 3 years (Richardson et al., 2007). The further analysis has showed that growth curves for the two groups of children diverged further with those exposed to cocaine growing at a slower rate. This study has further proved that the exposure of infants to cocaine had a lasting effect on the child development.

Prenatal Exposure to Tobacco

A large set of studies has proved that smoking during pregnancy may be harmful to both the fetus and the mother. Smoking exposes the infant to nicotine. This substance alters the neurological development and may increase the risk for neurological conditions (Blood-Siegfried, 2010). The studies have established a positive link between maternal prenatal smoking and the sudden infant's death syndrome (SIDS); nicotine heightens neurotransmitter functions in adults but have a desensitizing element on these functions in the prenatally exposed children and infants. The desensitizing element results into abnormal responses throughout the child’s lifespan. The nicotine replacement drugs may be used by expectant women. Nevertheless, they may not be adequate to mitigate the outcomes of nicotine exposure to the infant. They even have added more damage to the neurological development of fetus.

Prenatal Exposure to Alcohol

The fetal alcohol syndrome (FAS) describes a set of facial anomalies identified with children whose mothers engage into drinking during pregnancy, occasioned with the prenatal and postnatal retardation in growth as well as behavioral problems (Burden et al., 2011).

Alcohol has adverse effects on the fetus. Although a wide range of researches may be conducted on the cognitive performance discrepancies of alcohol exposure to the infant, not much emphasis has been laid on how the neuro-physiological processes behind these discrepancies may be affected. According to Burden et al., Event Related Potentials (ERPs), that exhibit some task-specific occurrences in the brain electrical activities, provide a methodology for examining constituents of cognitive processes at the neutral level. In their study, they have utilized a record of ERPs from 217 children during two different tasks, i.e. the continuous recognition memory and Go/No- go response. The children would be classified into either Controls (CON) or alcohol-exposed (ALC). This depends on whether the mother has recorded indulgence in drinking during pregnancy or not.

Both groups of children may have exhibited to the comparable performance on the tasks issued. However, the ALC group has exhibited an altered neuro-physiological response linked to the preliminary visual processing of stimuli. The tests on memory tasks have elicited the lower FH400 amplitude to new events for the ALC group. This would be named as the familiarity effect. They have also registered the lowered amplitude regarding the late positive component. This would be attributed to impairments in the memory retrieval. The finding here has showed that even if two groups exhibited comparable results in equal tasks, prenatal exposure to alcohol would be linked to the altered neuro-physiological processing of responses and the altered memory recognition. This would be translated to mean that prenatal alcohol exposure results into inefficiency in the initial retrieval of the meaning of the certain stimulus, low allocation of attention to the task, and the poor processing of conscious and explicit recognition (Burden et al., 2011).

Though the studies have demonstrated facial impairments and alterations of growth as the major effects of prenatal alcohol exposure, the effects of ethanol, a main component of alcoholic beverages may be the most noteworthy as it affects the brain leading to adverse effects on the neurobehavioral development (Glover & Sutton, 2012). A deeper focus on ethanol shows that its effects extend throughout the gestation when the cortex and among other brain structures. The effects of ethanol on the infants are dose-dependent; in the event of unusually high repeated dosages, there is the 5-10% risk for a fetal alcohol syndrome (Ornoy et al., 2010). Conducting the disorder in adolescence may be increasingly associated with the alcohol exposure in infancy. According to Disney et al. (2008), he has found that even a drink or two per day during the first trimester of pregnancy could significantly contribute to the adolescent conduct disorder. Thus, the evidence should add more to the notion that prenatal alcohol exposure has some negative long-term and short-term effects.

A body of research may have substantiated drugs and the substance abuse as a major threat to the proper development of a child. Poor prenatal choices still continue to be a significant area of concern in social and demographic studies. Nevertheless, much emphasis should be laid on mitigation measures to these problems.

What Are the Possible Interventions to Poor Prenatal Choices?

All these findings pose significant implications. There is a wide variety of strategies and possible mitigation measures. Reducing stress, illegal drug consumption, alcohol use and smoking among expectant mothers, all contributes significantly to lowering effects of poor prenatal choices. The risk of these children being affected by the attention deficit hyperactivity disorder (ADHD), learning difficulties, conduct disorders and later antisocial demeanor would be lowered. Some of specific interventions include:

Treating for Stress during Pregnancy

The implication here should be an improvement of the emotional care of expectant mothers. Though the physical care of pregnant women may have improved in the recent century, it is evident that depression, anxiety and emotional abuse on them go undetected by obstetricians (Alder et al., 2011). Obstetricians and midwives ought to be trained on how to detect stress symptoms and administer appropriate solutions. Depressed mothers would need counseling or a talking therapy including the cognitive behavioral therapy. Antidepressants would also serve for the severely depressed women.

Reducing Alcohol, Tobacco and Substance Abuse

It would be crucial to encourage pregnant women to abandon or at least reduce the smoking and alcohol intake. This may prove to be difficult though. Most women have basic concepts of effects of prenatal tobacco and alcohol and the substance abuse to unborn babies. The best approach to this problem should be education and regular screening of women at their child-bearing age (Keegan et al., 2010). Teaching older children about the potential risk of engaging in drug and substance abuse to their future offspring could also go a long way in reducing the addiction during pregnancy. Such education could help prevent them from either initiating indulgence or continuing with drug abuse. Formal education at schools about fetal programming and the effects of drug abuse should also be instigated. This way, some of evils associated with drugs could be reduced.


It has been established that the mother’s stress and depression, alcohol abuse, and indulgence in drug abuse can be detrimental to the growth and developments of a child. Various implications of poor prenatal choices are evident in this paper. The first implication is that prenatal alcohol, smoking and stress, all heighten the risk of the child showing criminal or antisocial demeanor. The second implication is that interventions during pregnancy to lower the use of maternal alcohol, smoking and stress may be indicated. The third implication is that in the advent of poor prenatal choices, policy makers and medical experts should seek some measures to mitigate the associated problems. The mitigation measures include the reduction of smocking, avoiding alcoholic drinks during pregnancy and also the treatment of stress among pregnant women. Since various approaches have been found hard to implement, a more effective solution may inculcate the formal education about fetal programming and the effects of drug usage and alcohol abuse on the developing child. Preventive measures would be found more effective than the pharmacological intervention of the problems posed by poor prenatal choices.

Nevertheless, some of the concepts addressed in this paper may elicit the need for the further research; for instance, it has been found that the little consistency exists in studies about the time of gestation when the effect of stress has a maximal impact on the child. It may be possible that both early and late onset of stress have similar effects. There may be a possibility that there are some stages in the gestation when these effects could be felt most of all. Meanwhile, the study on conduct disorders and antisocial demeanor has demonstrated that the late pregnancy stage would be the most vulnerable to prenatal stress effects on the developing child. The clarification of mother’s stress issue on the prenatal development; and later demeanor during adolescence, should imply the need for the further research.

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