It is a happy and blessed thing to be parents. As parents, we hope to see our children live healthily and enjoy happiness when born into this world. Therefore, it is very common for parents to worry about maternal health and fetal health during pregnancy. Some of the common worries include the baby’s health and the ability to be a good parent and complications during childbirth. It would be heartbreaking news if our children happened to have some disorder. However, due to the advancement of medicine and science, there are some known risk factors and screening tests to help parents detect the disorders as early as possible. Other than that, parents should also be aware if they have a high risk of giving birth to a child with special needs disorders so that they can try to minimise their risk through lifestyle modification and regular check-ups.
Today we will introduce you to scientifically proven risk factors and ways to reduce the risk.
Possible Prenatal Factors Related To Special Needs Children
These are the common developmental disorders and some of their prenatal risk factors. The details of these risk factors will be discussed in the future article.
| Autism Spectrum Disorder (ASD) | Attention Deficit Hyperactivity Disorder (ADHD) | Down Syndrome | Cerebral Palsy |
|---|---|---|---|
| Advanced Maternal And Paternal Age≥35 Years. | In-utero Exposure To Maternal Stress | Advanced Maternal Age | Infections |
| Gestational Hypertension | Alcohol Drinking | Western Dietary Patterns (processed foods, red meat, sugar). | Mother‘s Systemic Diseases. |
| Gestational Diabetes | Cigarette Smoking | Cigarette Smoking | Mother Has Immune. Disorder |
| Threatened Abortion | Prescribed Drugs (e.g., paracetamol), AndIllicit Substances | Abnormal Folate Metabolism In Mother; Lower take Of Folate In Father | Multiple Pregnancy |
| Antepartum Haemorrhage | Environmental Toxins | Environmental Exposure To Pyrethroid Insecticides | Drugs And Stimulants Used |
Ways Might Reduce The Possibility Of Giving Birth To A Special Needs Child
1. Eat healthy
Mothers’ excessive weight gain or nutritional deficiency will directly affect their children’s growth and health. Women’s weight gain recommendations should be individualized to reduce the risk of obesity and chronic diseases for the child and mother.
- The Institute of Medicine has developed guidelines for optimal weight gain during pregnancy.
| BMI | Optimal weight gain (kg) |
|---|---|
| <19 | Slightly more than 11.5-16 |
| 19.8-26 | 11.5-16 |
| >26 | 5.9–11.5 |
- Here are listed nutrients’ references to intake for pregnant women aged 19–30 years.
| Nutrient | Amount |
|---|---|
| Energy(kcal/day) | 2855 |
| Carbohydrate(g/day) | 175 |
| Total fiber(g/day) | 28 |
| Protein (g/day) | 71 |
| N-6 PUFA (g/day) | 13 |
| N-3 PUFA (g/day) | 1.4 |
| Calcium(mg/day) | 1100 |
| Fluoride(mg/day) | 3 |
| Phosphorus (mg/day) | 700 |
| Chromium (mcg/day) | 30 |
| Cooper(mcg/day) | 1000 |
| Iodine(mcg/day) | 220 |
| Iron (mg/day) | 27 |
| Magnesium (mg/day) | 350 |
| Manganese (mg/day) | 2 |
| Molybdenum (mcg/day) | 50 |
| Selenium(mcg/day) | 60 |
| Zinc (mg/day) | 11 |
| Choline (mg/day) | 450 |
| Folate(mcg/day) | 600 |
| Niacin (mg/day) | 18 |
| Pantothenic acid(mg/day) | 6 |
| Riboflavin (mg/day) | 1.4 |
| Thiamin(mg/day) | 1.4 |
| Vitamin A (mcg/day) | 770 |
| Vitamin B12(mcg/day) | 2.6 |
| Vitamin B6(mg/day) | 1.9 |
| Vitamin C(mg/day) | 85 |
| Biotin (mcg/day) | 30 |
| Vitamin D (mcg/day) | 5 |
| VItamin E(mg/day) | 15 |
| Vitamin K (mcg/day) | 90 |
| Water (l/day) | 3 |
| Chloride (g/day) | 2.3 |
| Potassium(g/day) | 4.7 |
| Sodium(g/day) | 1.5 |
- An example of a diet for a pregnant woman eating 2800kCal/day
| Food group | 2800kCal/day |
| Fruits | 2.5 cups |
| Vegetables | 3.5 cups |
| Dark green | 3 cups/week |
| Orange | 2.5 cups/week |
| Legumes | 3.5 cups/week |
| Starchy | 7 cups/week |
| Other | 8.5 cups/week |
| Grains | 10-oz |
| Whole | 5 |
| Enriched | 5 |
| Meat and Beans | 7-oz |
| Milk | 3 cups |
| Oils | 36g |
| Discretionary calorie allowance: Excessive calories to enjoy after meeting the above nutrient requirements | 462kCal/day |
2. Exercise Regularly
Pregnant women who do physical exercise regularly can significantly reduce their risk of obesity and comorbidities such as gestational diabetes, gestational hypertension, and other prenatal complications.
- Here are the physical activity guidelines for pregnant women from the American College of Obstetricians and Gynecologists, 2020.
| Safe physical activities during pregnancy | Unsafe physical activities during pregnancy |
|---|---|
| Walking | contact activities with a high risk of abdominal trauma or imbalance. |
| Stationary cycling | Scuba diving |
| Aerobic exercise | |
| Dancing | |
| Resistance exercises using weights or elastic bands | |
| Stretching exercises | |
| Hydrotherapy or water aerobics |
3. Maintain good sleep quality
A good sleep quality can help a pregnant woman achieve better physical and psychological health. However, studies show that there is an association between pregnancy and sleeping problems; for example, one cannot fall asleep or cannot maintain sleep. The medical associations have not developed guidelines for sleep in pregnant women. Here we are going to share some medical experts’ opinions on sleep.
- Sleeping position: Medical experts recommend pregnant women lie on their left side while sleeping to prevent the body from pushing too hard on their liver.
- Sleeping duration: Between 7-9 hours
- Sleeping timing: no consensus
Look for counseling and psychological professionals if mothers are feeling stressed.
- Follow up in the Obstetrics and Gynaecology Clinic Checkup on time, and here are listed some prenatal screening and assessments for pregnant mothers.
| Disorders | Timing | Prenatal tests for special-needs disorders |
|---|---|---|
| Autism Spectrum Disorder (ASD) | As early as week 9 | Prenatal genetic testing (PGT) |
| Week 14 to week 27 | Prenatal ultrasound | |
| Attention deficit hyperactivity disorder (ADHD) | nil | Currently, we do not have any prenatal tests for detecting ADHD in infants. |
| Down syndrome | As early as week 10 | Cell-free fetal DNA testing |
| PAPP+ beta-hCG:Week 11 to week 13 NT: Week 10 to Week 13 | First trimester combined test(including nuchal translucency(NT), pregnancy-associated plasma protein(PAPP) and free/intact/total human chorionic gonadotropin (beta-hCG)) | |
| Week 15 to week 18 | Quadruple test | |
| Draw blood two times. First time at week 11 to 13NT: Week 11 to 13Second time at week 15 to week 18 | Integrated or Sequential test (it is a combination of the first trimester combined test and the quadruple test). | |
| Draw blood two times. First time at week 11 to 13Second time at week 15 to week 18 | Serum integrated test(it is an integrated or sequential test without NT) | |
| Week 10 to week 12 | Chorionic villus sampling | |
| Week 15 to week 20 | Amniocentesis | |
| Absent nasal bone and an abnormally huge bladder can be detected from week 10 to week 14. | Ultrasound | |
| Cerebal palsy | Only if the fetus is in a high-risk group for developing cerebral palsy can be detected. | Ultrasound |
Reminder To Parents
It is still unclear whether these factors are causal or play a secondary role in the development of special-needs disorders. Furthermore, no matter the accuracy and the accessibility of the medical tests and imaging studies, medicine still has numerous inevitable limitations in detecting special-needs disorders. Medical professionals and parents with multiple risk factors should closely monitor the development of their offspring, and a comprehensive assessment should be conducted when the fetus is highly suspicious of special-needs disorders. Every life born into this world is equal, no matter if they have special-needs disorders or not. They should enjoy the right to be loved and cherished by humanity.
References:
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