Читать книгу Lifespan Development - Tara L. Kuther - Страница 195

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The vagina is a muscular canal that connects to the uterus. At the lower end of the uterus is the cervix, a neck-like passageway. Extending from either side of the uterus are the fallopian tubes. Near the end of each tube are ovaries, which contain the corpus luteum and follicles.

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Ovulation starts in the ovary, which includes the corpus luteum and developing follicles. When the mature follicle bursts, it releases the ovum into the fallopian tube. The sperm then fertilizes the ovum in the fallopian tube. Cell division then begins. A morula develops and then turns into the blastocyst. The blastocyst then enters the uterus, andit implants into the endometrium.

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Following are the barriers reported and the percentage of mothers who reported each barrier as being a factor:

Lack of money or insurance for visits: 38.7%

Couldn’t get appointment when desired: 37.8%

Didn’t know when she was pregnant: 37.1%

Didn’t have a Medicaid card: 36.4%

Doctor or health plan did not start as early as desired: 24.1%

Mother was too busy: 19.7%

Lacked transportation to clinic or doctor’s office: 13.9%

Didn’t want anyone to know about pregnancy: 13.9%

Could not take time off work or school: 9.8%

Needed child care for other children: 7.9%

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For each educational level listed, three percentages are reported, in this order:(1) percentage of mothers who first received prenatal care during the first trimester, (2) percentage who first received care during the second trimester, and (3) percentage who first received care during third trimester or who received no care.

Less than high school diploma: 58.5, 30.1, 11.4

High school diploma or GED: 68.6, 24.2, 7.2

Some college or associate’s degree: 76.1, 19.0, 4.9

Bachelor’s degree or higher: 86.1, 11.2, 2.7

Total: 74.1, 19.9, 6.0

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Graph 1: First trimester

Non-Hispanic White: 82.3%

Non-Hispanic Asian: 80.6%

Hispanic: 72.0%

Non-Hispanic Black: 66.6%

Non-Hispanic American Indian or Alaska Native: 63.0%

Non-Hispanic Native Hawaiian or other Pacific Islander: 51.9%

Graph 2: Late or no care

Non-Hispanic White: 4.3%

Non-Hispanic Asian: 5.4%

Hispanic: 7.7%

Non-Hispanic Black: 10.0%

Non-Hispanic American Indian or Alaska Native: 12.5%

Non-Hispanic Native Hawaiian or other Pacific Islander: 19.2%

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This graphic shows gestational age in weeks and identifies:

1. Which congenital anomaliesare present

2. Which body systems are most sensitive to teratogens

3. Common sites of action of teratogens

Gestation is broken down into three developmental periods.

Weeks 1 to 2: During this period, the zygote divides, implantation occurs, and a bilaminar embryo develops. The fetus is not susceptible to teratogenesis during this time. Death of the embryo and spontaneous abortion are common.

Weeks 3 through 8: This is the main embryonic period.

Weeks 9 through 38: This is the fetal period.

In general, congenital anomalies are most likely to present earlier in pregnancy. During this time, the body systems of a fetus or embryo are less sensitive to teratogens. Times when body systems are most sensitive to teratogens and are thus most likely to develop defects are tied to times when particular body systems are developing.

Periods when major congenital anomalies begin to present are as follows:

Neural tube defects and mental retardation: Weeks 3 to 16

Truncus arteriosus and atrial septal defect: Weeks 3 to 6

Amella or meromella: Weeks 4 to 5

Cleft lip: Weeks 5 to 6

Low-set malformed ears and deafness: Weeks 4 to 9

Microphthalmia, cataracts, and glaucoma: Weeks 4 to 9

Enamel hypoplasia and staining: Weeks 6 to 8

Cleft palate: Weeks 6 to 9

Masculinization of female genitalia: Weeks 7 to 9

Periods when the embryo or fetus is highly sensitiveare listed here by body system:

Central nervous system: Weeks32 to 38

Heart: late in Week 6 up to Week 9

Upper and lower limbs: around Week 5 up to Week 9

Upper lip: around Week 7 up to Week 9

Ears: middle ofWeek 9 through approximately Week 33

Eyes: late Week 8 through Week 38

Teeth: Week 9 through Week 38

Palate: early Week 9 up to Week 16

External genitalia: late Week 9 through Week 38

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Data for each age group are listed here. All values are approximations.

Women ages 15 to 19:

1990: 65

1995: 64

2000: 50

2005: 45

2010: 40

2015: 30

2016: 20

Women ages 20 to 24:

1990: 120

1995: 110

2000: 110

2005: 100

2010: 80

2015: 70

2016: 74

Women ages 25 to 29:

1990: 119

1995: 109

2000: 109

2005: 110

2010: 105

2015: 100

2016: 102

Women ages 30 to 34:

1990: 75

1995: 85

2000: 95.

2005: 98

2010: 100

2015: 100

2016: 103

Women ages 35 to 39:

1990: 40

1995: 42

2000: 45

2005: 48

2010: 48

2015: 50

2016: 53

Women ages 40 to 44:

1990: 5.5

1995: 6.5

2000: 8

2005: 9

2010: 10

2015: 10

2016: 11

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The risk of Down syndrome in live births is listed for ages 20 to 45. The age is listed first, followed by the corresponding risk, given as a percentage. Data values are approximations.

20: 0.1

21:0.1

22:0.1

23:0.1

24:0.1

25:0.1

26:0.1

27:0.15

28:0.15

29:0.15

30: 0.2

31:0.2

32:0.25

33:0.25

34:0.28

35: 0.3

36: 0.4

37: 0.45

38: 0.5

39: 0.6

40: 0.9

41: 1.2

42: 1.5

43: 2.0

44: 2.6

45: 3.5

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Stage 1: Dilation. The amniotic sac has ruptured, and the fetus’s head is positioned close to the urinary bladder.

Stage 2: Delivery. The baby’s head is crowning.

Stage 3: Expulsion of placenta. The baby has completely emerged from the mother’s body. The umbilical cord remains attached to the placenta. The placenta has separated from the uterine wall and is ready to be expelled.

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For each racial/ethnic group, two numbers are listed, in this order: (1) percentage of newborns who were very low birthweight and (2) percentage who were low birthweight.

Non-Hispanic White: 1.13, 6.97

Non-Hispanic Black: 2.94, 13.18

American Indian/Alaska Native: 1.33, 7.61

Asian/Pacific Islander: 1.13, 8.21

Hispanic (total): 1.22, 6.97

Mexican: 1.13, 6.48

Puerto Rican: 1.77, 9.40

Cuban: 1.55, 7.43

Central and South American: 1.13, 6.67

Total: 1.42, 7.99