Pregnancy is a time in a woman's life where her actions not only affect her own health but the health of her unborn child as well. Intellectual Disability (I.D) is what will be explored in the following text and specifically I.D that occurs during prenatal stages of development. Prevention methods will also be discussed.

I.D is not a specific medical disorder nor is it a mental health disorder. It's a condition were intelligence is lower than average which in turn impacts on the effected persons adaptive skills, (i.e. self care and social activities etc.). I.D. affects different people to different degrees. There is 3-5% chance with any foetus developing birth defects. Some causes are genetic, some causes occur prior to or at conception, others occur during the pre-natal stages or during birth and possibly even after birth. The common characteristics of I.D are basically the interference in the growth and development of the brain. However not all causes of I.D are established, Symptoms of I.D can either be physical such as abnormalities in limbs or facial features or they can be neurological were the child's appearance is normal but maybe are suffering from seizures or failure to feed etc. Those who have hereditary disorders within the family can do little in the prevention of I.D. the only available intervention is genetic testing which would help parents evaluate the risk of the foetus having the genetic condition, which may include: Down syndrome, Fragile x syndrome, Prader-willi syndrome and Williams's syndrome etc.

Non genetic forms can usually be prevented through avoidance of certain items, correct nutrition, adherence with the medical profession and most importantly knowledge. Knowledge plays a key contributing factor, the less the woman knows the more at risk her and her baby are of certain defects. An example of non genetic forms of I.D. includes children suffering from F.A.S. which will be explored further. These factors are unfortunately made apparent due to the transfer of substances taking place through the placenta; teratogens are defined as harmful substances that play a major role in the deformities of the foetus they include drugs, viruses and infections etc.

Various supportive interventions are available throughout pregnancy to monitor the health of both the mother and the child, such as ultrasounds, amniocentesis, blood tests and maternal serum alpha-fetoprotein etc. They allow for detection of any abnormalities which help prepare the parents and give them the option of abortion or in some cases allow the health care professionals to treat an abnormality e.g. RH Incompatibility

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Foetal Alcohol Syndrome (F.A.S) is the leading preventable cause of I.D. The foetus's brain can be affected by even a small amount of alcohol. Foetal Alcohol Syndrome (F.A.S) is a side effect of heavy drinking during pregnancy. It will affect 4 out of 10 babies whose mothers are alcoholics. He states that it can be physical and non physical. The physical effects are seen in 1 in 750 infants. The non physical are characterised by brain abnormalities. Midwives are made available to help woman during pregnancy make an informed choice about alcohol consumption. This is important and needs to be continuously implemented.

In a recent study in Australia one-third of woman viewed alcohol as being safe to drink during pregnancy and only 22% knew about F.A.S. The RCOG, The Royal College of Obstetricians and Gynaecologists, provide support and guidance to midwives who counsel pregnant woman about alcohol use during their pregnancy. Evidence has shown that 14 units per week which would be classed as social drinking has opposing effects on foetal growth, it may also be at an increased risk of preterm labour. This in itself brings about problems. Even a single binge drink can destroy millions of cells in the foetus.
The RCOG have recommended a measure of no more than one alcoholic unit per day. They also recommend not saving the drink allowance to one sitting as it could potentially harm the foetus.

What determines the effects on the foetus is the amount of alcohol taken and the foetus's gestational age when exposure occurred.
The mother's age has an effect (i.e. the older the mother when participating in moderate to heavy drinking the greater the risk to the child in developing F.A.S when compared to younger mothers.
What happens is that alcohol causes amino acid transport interference across the placenta resulting in the embryonic organisation being disrupted. Its result is thought to include chronic uterine hypoxia and contributes to foetal growth retardation.
F.A.S. is the most serious consequence usually to infants of mother who are alcohol dependent throughout the pregnancy.
The characteristics of F.A.S. are:

1. Neurological dysfunction
2. Mental retardation
3. Behavioural disorders
4. Facial abnormalities
5. And an increased risk of infant mortality

Physical facial abnormalities include short upturned nose, elongated mid-face and thin upper lip etc. Physical features will lessen with age. However neurological disorders persist throughout life.
Milder forms exist also were maybe only one abnormality is present or there is a mild developmental delay or occasionally hyperactivity etc.
Effective screening programmes which identify light, moderate and heavy drinkers would enable the appropriate counselling strategies to be used for each identified group.

"Prenatal intervention programmes, including education and counselling and group therapy, have indicated that 67-76% of participants including high risk drinkers reduce or abstain from alcohol consumption". (Smith and Cole, 1991, cited by Dunkley, 2000, p.137)

Abuser of alcohol are more likely to abuse other substances such as drugs. Illicit drugs should be avoided throughout the pregnancy; they increase the child's risk of developing problems. Cocaine, Amphetamines and cannabis all have negative effects on the child which range from behavioural problems to growth retardation. It is however Cocaine and Amphetamines that mainly causes I.D. The extent of these effects is mainly factors which include:

1. Dose taken
2. In what stage of pregnancy
3. How often
4. And the type of drug taken.

There is an increase of up to 5 times the rate of I.D. when the foetus is exposed to cocaine compared to those who aren't

Supplements taken before and during pregnancy may prevent brain abnormalities although be sure not to take more than the RDA as it may also cause birth defects.
The variety of foods and nutrients that are beneficial, which woman during pregnancy should be encouraged to eat are, plenty of fruit and vegetables, protein, fibre and diary foods.
However some foods do put the expecting mother at risk. These foods include liver, liver products, soft mould ripened cheese, uncooked meat and raw shellfish etc. which may cause food poisoning like salmonella etc. or may provide too much of a certain nutrient as in the case of liver that is high in vitamin A which is identified to cause abnormalities in a foetus.
A lack of folic acid before conception and during 6-12 weeks of gestation can pose potentially drastic implications for the unborn child as it could result in the child being born with neural tube defects such as spina bifida (recommended amount is 400 microgram's/day),

High levels of mercury can damage the foetus's brain development. That is why certain fish should be limited in pregnancy. In certain regions mercury levels within the fish differs. Perhaps opt for canned tuna as it has lower levels of mercury due to smaller fish being used.

Around 8% of pregnant woman need to continue taking medication during pregnancy for health problems they have e.g. medication for diabetes and high blood pressure etc.
Few medications have been identified as safe however there is still a lot to be deemed as safe. Medication taken prior to pregnancy may need to be stopped when the pregnancy is discovered or preferably well before conception or if essential to the mother's health, other safer alternatives for this medication can be taken. For over the counter medications you purchase consult your doctor or midwife etc to ensure there safety. Painkillers like aspirin and ibuprofen need to be avoided instead resort to paracetamol as it is safe.
Pregnant woman use alternatives to drugs, e.g. in treating constipation, increase dietary fibre in the diet. Avoid smells etc that trigger nausea and in avoiding heartburn try eating small frequent snacks instead of 3 large meals.
You should also ensure your doctor is aware you are pregnant if he is prescribing you medication.

Viruses are another culprit in causing impairments in the foetal brain development if contracted in mid-pregnancy. Influenza contracted in mid-pregnancy increased the foetus's chance of suffering from schizophrenia later in life. If a pregnant women suffered from influenza during the second trimester the risk of the foetus developing schizophrenia in later years increases from 1-2%. To prevent the risk of contracting the flu while pregnant the flu vaccine should be got, it is regarded as safe during pregnancy by both CDC and ACOG

Infections in pregnancy pose hazards as well. One in particular known as cytomegalovirus is an infection which may cause brain and liver damage. Treatment of this infection can be tackled with antibodies which in turn will decrease the risk to the foetus. It is contracted through bodily fluids and is really only a hazard to the foetus if contracted during pregnancy

In the first three months of pregnancy a temperature which rises above 103 degrees F increases the risk of child developing brain defects and spinal cord defects. So if suffering from any illness, severe or not, contact your doctor immediately

Another risk factor during pregnancy is a medical factor which may occur through no fault of the mother. It involves blood types and is called RH incompatibility. It is when the pregnant woman has RH-negative blood and the foetus has RH-positive. If the RH- positive enters the mother's blood stream from the foetus, the mother's immune system may start building up antibodies to destroy the foetus's red blood cells as they are seen as foreign objects. These antibodies cross the placenta and cause destruction of the foetus's red blood cells usually resulting in anaemia. As the red blood cells are destroyed haemoglobin from them are broken down and converted to yellow pigment called bilirubin. Destruction of this kind is called haemolytic disease of the foetus and one of the results of this is jaundice as well as the possibility of brain damage due to high levels of bilirubin in the child's blood if not treated.
At 28 weeks of pregnancy and immediately after delivery an injection of RHo(D) immune globulin preparation is given. This injection destroys RH-positive blood cells that enters the mothers blood stream from the placenta before it results in the formation of RH antibodies

X-Rays have a negative effect on the unborn child. As x-rays pass through any material it changes it, resulting in a change in terms of damage to the cells or DNA in living matter. The foetus is at great risk due to its cells rapidly dividing and growing. If changes were to occur at this stage it would have major consequences, maybe resulting in birth defects, I.D or even miscarriage. Although this effect would depend on timing and amount of exposure. The first three months are the most delegate stages were these effects would be more serious.
Decreasing your risk would involve telling your doctor your pregnant if an x-ray is needed, then other solutions could be resorted to such as ultra sound etc.
If in doubt of pregnancy have a pregnancy test before having an x-ray and if holding a child for an x-ray while pregnant ask for a lead apron or alternatively a safer solution would be to get someone else to use it.

A broad range of issues were described on this page many of which are preventable through either the mothers action or the intervention of the medical professionals. In short the majority of factors which cause I.D are avoided with maintenance of good health, and avoidance of teratogens such as certain foods and certain drugs. The intake of proper nutrition and regular checkups are all beneficial in securing the health of any unborn child. Prevention is always better than cure.

Has your child developed a disability of some kind? Do you want to know how to create an individual education plan and so much more then

A broad range of issues were described on this page many of which are preventable through either the mothers action or the intervention of the medical professionals. In short the majority of factors which cause I.D are avoided with maintenance of good health, and avoidance of teratogens such as certain foods and certain drugs. The intake of proper nutrition and regular checkups are all beneficial in securing the health of any unborn child. Prevention is always better than cure.