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Any further reproduction of copyrighted materials made from this computer system may be in violation of copyright laws and is prohibited. Chapter Three 3 P RO LO G U E: The Start of Life: G e netics and Prenatal Deve lo p me nt TH E F UTU R E I S N O W It came out of the blue: Jana and To m Mon aco's seem i ngl y healthy 3-year-old son Steph n developed a l i fe-threaten i n g stomach virus that led to severe brain damage . His d i agnosis: a ra re b u t t reatable di ease called isovaleric acidemia ( I VA ) , marked by the body' inabili ty to metabolize an am ino acid fo u n d i n dietary protein. Jana and Tom were unkn owing ca rrier of the d i sease . . . . The Monacos had no warn i n g whatsoever. N ot so when Jana got p regnant again. Her da ughter, Caro l i ne, was tested by amnjocen tesis while still in the womb. Knowing ar­ oline had the mutation, doctors were able to ad m i n i ter med ica­ tion the day he was born-and the Monacos were prepared to monitor her diet i mmediately to keep her healthy. Today tephen, 9, is unable to walk, talk or feed him elf. Caro l i ne, meanwh i le, i s an active, heal thy 4-year-old. Genetic te ting, say Jana, "gives Caro­ line the future that Stephen didn't gel to have." ( Kalb, 2006, p. 52) A h i d d e n ge n et i c d i s o rder robbed Jana a n d Tom M o n a o' fi rst ch i l d o t a n o r m a l , healthy l i fe. Their e cond c h i l d w a s pared Lhe a m e fate b y advances i n ge n et i c test i n g, w h i c h gave the M o n acos a c h a n ce l o i n lerve n e before t h e ...--d a m a ge v. a s d o n e. T h e y were a b l t: to \ !O p Caro l i n e' i n h er i t ed d i -,o rd e r fro m d o i n g 1 h e sa m e d a m age b , co n t ro l l i n g aspec t s o f h e r e n , i rn n m en t . • \,\f1iat is o u r basic ge11et ic e11do w111e11t, a ml h o w rt1 11 lz 11mrrn de 1 1elopme111 go ojf t rack? • How clo t/1e C!lll·iro11 111cnl mid ge11et ics work /o�t•lhcr to del er111 i rie h u m a n cl1t1 rnctl!rist ics? CHAP�E R OUTLI N E Multiple Births: Two-or More-For the Genelic Pnce of One Inherited and Genetic Disorders: When Development Goes Awry Prologue: Th e F11 1 11 re Is No w The Basics of Genetics. The M1x1ng and Matching of Traits Genetic Counseling: Predicting the Future From t1,e Genes of the Present L o o k i ng A h ea d Etuliest Develop ment Genes and Chromosomes· n,e: Gode o Lil& 44 I n t h i s ch,, p l cr, wt· ' I I t·xa m i n t• 1\' 1 1 ,1 1 d t• ,·d o p m c n l a l resea rc h e r '> a n d o t h c r ,t·i e n l i !-> h h a vc k.1 r 1 1 nl a hu u t 1,·.1 �· , 1 h a t h e red i t y a n d t h e t· 1w i ro n m e 1 1 1 w o r k i n 1 ,1 1 1 <l c 1 1 1 t o c r ...·,1 1 1.: .1 1 1 d � h a pc h u m a n b e i n g, . \\'c beg i n \\' i t h l h c ba !, i c ., o f' h e rcd i t ) , t h e gcn c t ic t r a n ., m i !, '> i o n o f ch a rac t c r i ... 1 i c ., fro m h i o l o g i t a l p a rc n h I < > t h e i r ch i l d re n , by ex a m i n i n g h o \\' w c rccc i \ c o u r !..:''- J l l' l it e n d o w m e n t . We co n , i d c r beh a v i o ra l gcnt·t i ·,, an a rl',1 of '>t u J �· t h a t ,pcci a l i7cs i n t h e co n ,cq u e n ccs o f h l' rcd i t y 0 11 lwh ,I \ i o r. \\'c a l so d i'>C LI � , w h a t h a p pc n !, w h e n gcn c t i c fa t.:1 o r-, ca u ., ,._. d c \·d o p ­ m e n t t o go ,n,· r�·, a n d h o w '>llch p ro b l c m '> a rc d ca l 1 1, i t h t h n , u g h ge n e t i c coL1 11 ,c: l i 11 g .i n d gt· n c t h era p y. B u t gc n c '> a rc o n l y 0 1 1 c pa rt o f t h e , t o r y o f p re 1 1 a l ,1 I ti c , d n p ­ m c n t . We a l ,o c o n s i d e r t h e wa y:- i n w h i d 1 a c h i l d \ gc n c l i l' h e r­ i t a ge i 11 1 crac 1 w i t h h e r e n v i ro n m e n t : I n o t h e r wo rd , , h o " o n c\ fo m i l y, '>oc i occo n o m ic � l n l u �, a n d J i fl' t' \'Cl l h ca n a ffec1 .1 ,·a r i l' l y o f c h a ra c t e r i s t i c!,, i n c l u d i n g p hy -. i c a l t ra i h, i 11 1 c l l i gt· tKt' , ,1 11 d even pcr!,ona I i t y. h n a l l y, we foc.:t1 , o n t h e ver y fi rq , t age o f d • n· l o p 111 c n l , t rac i n g p rc n a l a l g ro \\• t h a n d drn n gc. \Ve n· , i c \\· <,lJflll' o f t h e a l t e rn a t i ve:,, ava i l a b l e l o o u p l e:-, w h 1 1 fi n d i t d i ffi c u l 1 t o co 1 1 1: ...· i v c . \\I� a l �o t a l k ,1 b o u 1 t h e � t a �c� o r 1 h c p n• m1 1 a l p e r i o d ,1 11d l w w t h e p ren a t a l env i ro n m e n t ffl'r<, bot h 1 h r ·a l '> t o-a n d t h e p ro m i se of-fu t u re g ro w 1 h . A ft e r read i n g t h i � c h a p t e r, ycrn w i l l b c a h l c t o a 1 h \1·c r t l H::-.c q uc:.t i o n s: Transmission of Genetic Information The Human Genome and Behavioral Geneltcs· Cracking the Genetic Code Review The I n te rc;tctio n of H erec;(. i t� ctnd E nvironmeVL t FROM R E SE A R C H T O PRACTICE: Are "Designer Babies" in O u r Future? The Role of the Env1ronm nt 1n Deter1111111ng the Expression of Genes. From Genotypes lo Phenotypes Studying Development: How Mucl1 Is Nature? How Much Is Nurture? Pl,ysical Trails: Family Resemblances Intelligence: More Research. More Controversy Genetic and Environmental Influences on Personality· Born to B Outgoing? DEVELOPMENTAL D IVERSITY: Cultural Differences in Physical Arousal: Might a Cullure's Philosophical Outlook Be Determined by Genet ics? Psychological Disorders: The Role of Genetics and Environment Can Genes Influence ll1e Environment? Review Pre vtettet l G row th etncl C h et n !!.J e Fertilization: The Moment of Conception The Stages of the Prenatal Penod: Tlie Onset of Development Pregnancy Problems Tl1e Prenatal Environmem. Threats to Development B E CO M I N G AN I N FO R M ED CONSU M E R OF D EVELOPM ENT: Optimizing the Prenatal Environment Review T H E CASE OF. . . The Genetic Finger of Fate L o o k i 11g BMk Ep ilog ut! Key Tc: r111 s n 1 1rl 0 1 1 n• p ts 45 Gametes The sex cells from the mother and father that form a new cell at conception Zygote The new cell formed by the process of ferti lization Genes The basic u n it of genetic information DNA (deoxyribonucleic acid} molecules The substance that genes are composed of that determines the nature of every cell in the body and how it will function C h ro m o s o m e s Rod-shaped portions of ONA that are organ ized in 23 pairs M o n ozygoti c tw i ns Twins who a re genetically identical We humans be gin the course of our lives simply. Like individuals from tens of thousands of other species, we start as a single cell, a tiny speck probably weigh i n g no more than 1 /2 0 -milJionth of an ounce. But from this h u m ble beginning, in relatively few months, a l iving, bre ath i ng, un ique infant is born. This fi rst cell is created when a mal e reproductive cell , a sperm, pushes thro u gh the membrane of the ovum, the female reproductive cell. .T hese g� as the male and fem le._rep.w ductiv-e c:ells are als ,vn each con ­ tain huge amounts o enetic i n form ation . About an �r o r s o aft e r the sperm enters the ov um, the two gametes suddenly fuse becomi g_one-Gellra-zr.gore: The resulti ng combinat io n of their genetic instructions-ove r 2 billi o n chemical ly coded messages-is sufficient to begin crea ti n g a whole person . pcc i fic ge nes in p rec ise l oca t i o n s o n the ·h a i n o f chro­ mo o m es determ i n e the n a t u re and fu n c t i o n 1 f c,·cr r el l in the body. Fo r in l a n ce, ge nes detcrm i n l' w h i c h ·l'I I \\· i l l u l t i ­ m a t e l } b c me pa r t o f t h e h ea r t a n d wh ich \\" i l l become part of t h e mu cles of th leg. G e n es a lso l':-t a b l i :, h how d i fferent pa r t of t h e body w i l l fu n c t i o n : h m ra i I I }' t h l' heart ,, ill beat, o r how m uch s t rength a m u ·ell' , i l l h a ve. If each pare n t prov ides j ust 23 c h rn rn o ·n m cs, ,, here doe t h e poten t i a l for t h e vast d i ve rs i t y or h u ma n being come fro m ? The a n swer resi des p r i m a r i l y i n t h e n a t u re of the p rocesses t h a t u n derl ie t h e ce l l d i v i s i o n or t h e gametes. v\fhen t h e sperm a n d ova a re formed in t h e ad u l t h u man body in a pro cess ca l l ed meiosis, each ga m e t e rece ives one of the two chromoso mes that m a ke u 1 each o r t l1l· 23 pa irs. Beca u e for each o f t h e 23 pa i rs i t i s la rge!} a m a t ter of cha nce which m e m ber o f the pa i r is co n t r i h u t l·d, t he re are 2- 3 , or about 8 m i l l ion com b i na t ions poss i ble. Fu r t h ermore, other p roccsse , such as random t ra n s fo r m a t i o ns or pa r t icu­ lar genes, acid to the va r i abi l i t y o f the gen e t i c brew. The u l t i ­ m a t e ou tcome: tens o f t rillio11s of poss i b l e genetic com b i nations. With so many poss i b l e ge n e t i c m i x t u res p rovi ded by hered i t y, there is no l i kel i h ood t h a t someday yo u' l l b u m p i n t o a ge n e t i c d u p l i ca te of you rse l f-w i t h o n e excep t io n : an identical t w i n . Genes and Chromoso m es: The Code of Life M u lt i p l e Bi rths: Two-o r M o re­ Fo r the Genetic Price of O n e • Wh ich human cha racterist ics are sig11 ificr111 t ly influenced by heredity? • What happens during the prenatal stages of development? • What are the th reats to the fetal e11 viro n 111e11l, and what can be done about them? Earliest Develop ment Th e blueprin ts for creating a perso n are stored and com m u ­ n i c ated in o u r genes, the basic un i ts of genetic i n formati on. T he rough ly 25, 000 h uma n genes are the b io­ logical equiva l ent of "softw are" that program s 70,000-1 00, 000 Genes c. e d eve I opmen t of all parts of t h e -- t h e 1utur body's "hardwa re." Al l genes are com posed of speci fi c nces of DNA ( deoxyr ibonuc leic acid) seque = 4 6 Chrom osomes molecules. The genes a re arranged i n specific locatio ns and in a spec ific o rder along 46 ch romo somes, rod-sh aped portions of DNA = 23 Chromos ome Pairs t hat are organized in 23 pairs. O nly sex cel ls­ the ova and the sperm-con tain half this n u m ber, so that a child's mother and father each provide one of the two ch rom osomes i n One Hum an Cell each o f t h e 2 3 pai rs. T h 4 6 c h romosomes ( i n 23 p a i rs ) i n the new zygote co n tain the FIGURE 3- 1 gen e tic bl uep r i n t that wi l l guide cel l activity for t he rest of t h e i n divid u a l 's l i fe ( Pe n n isi, The Content s of a I n ternational S i n g l e Huma n C e l l Human 2000; Genome uencing Consort i u m , 200 1 ; see Seq Figu re 3- 1 ). At the momen t of a process ca l Thro l ed ugh m itosis, which conception, hu mans receive for the repl ica t acco i o n of unts of most types 70,000 to 1 00, 000 genes, cel l s, nea rly a l l the cel l s of the body will con ­ contained on 4 6 chromosomes in 23 pairs. tai n the same 4 6 ch romosom es a s t h e zygote. 46 D i zyg ot i c twi n s Twins who are produced when two separate ova are fert i l i zed by two separate s perm at roughly the same time PA RT O N E Beg i n n i n g s A l tho ugh it doesn't seem surpri i n g when d o g s a n d cat s g ive birth to severa l offspring at one t i m e, i n h u ma ns, m ul t i p l e b i rths a re cause fo r co m m en t . And t hey s h o u l d be: Less t h an 3% of a l l pregnancies p ro d u ce twi ns, a n d the o I ds a re eve n sl i m mer for t h ree or more c h i l d re n . Why do m u ltip le b i rths occ ur? S o m e occu r w h e n a c l us­ ter of cel ls i n th e ov u m spl i ts off with i n t h e fi rs t 2 weeks a fte r fertilization. The res u l t i s two gen et i cal l y i d en t i cal zyg otes, which a re called 111onozygotic beca use they co m e fro m th e same original zygot e. Monozygotic t w i n a re tw i n s wh o are genet ica l l y identica l . Any d i fferences 10 thei r fu t u re deve l op­ ment ca n be attributed o n l y to env i ro n me n t a l facto rs, because genetically they a re exactly t h e sa me. There is a secon d , a n d act ual l y m o re co m mo n , mec ha­ n ism that p rod uces m u l t i ple b i rths. In t hese case , t wo se p a­ rate ova are fert i l ized by two separate sperm a t ro u g h l y t he same t i me. Tw i n s prod uced in t h i s fash i o n a rc k n ow n as d i zygot i c t w i ns. Beca use they a re t h e res u l t of t wo separ a te ovu m-sperm com b i nations, the y a re no more g e n et ical ly s i m i l a r than t wo s i b l i n gs born a t d i ffere n t t i mes. Of co u rse, n o t all m u l t i ple bi r t h s prod u ce o n l y t wo babie . Tr i plets, q uadru plets, and even m o re b i r t h s a re pro ­ d uced by e i t h e r ( o r bo t h ) o f the m echa n i s m s t h at yield twi ns. Thus, t r i plets may be some co m b i n at i o n of rn o n oz)1 got i , d i zygotic, o r t r izygo t i c . A l t hough the chances of hav i ng a m u l t i p l e birth are typ­ ically sl i m , the odd rise con iderably when couples use fer­ t i l i t y d rugs lo i m p rove the probability of conceiving a child. For exam ple, I in IO couple u ing fer t i l ity d ru gs have d i zygotic twi ns, compared to an overal l figure of I in 86 for a ucasian co u ples in the U n i ted tates. Older \\ Omen, too, a rc more l ikely to have multiple birt hs, and multiple bi rths arc also more co mmon in s me familie than they are in oth­ ers. The i ncreased use o f fe r t i l i t y d ru gs and rising average age of m o t h ers g i v i n g b i rt h has mea n t that m u l t i p l e births h ave i n c reased i n t h e last 25 yea rs ( see Figure 3 - 2 ; M a rt i n c t a l . , 2005 ) . There a rc also racial, ethn ic, a n d nat ional differences in the ra te of m u l t i ple bi rths; this is probably due to inher ited d i fferences in the l ikel i hood that more than one o, um will be released at a time. One out of 70 frica n American cou­ ples have di zygotic birth , compared with the I out of 86 fig­ ure fo r \ 'h i te American couples ( Va ughan , McKay, & Beh rman, I 979 ; \1\lood, 1 997 ) . Mot hc.:rs carr y i n g mult iple children run a hi g her than average risk of prem a t u re delivery and birth co mplications. onsc q u e n t ly, these mothers must be particul a rl y concerned abo u t t hei r p renatnl ca re. "' t'. iii 40 30 . . . . . . . . . . . . . . . . . . . . . . .................... . . . . . . . . . . . . . . . . . . . . . . . . . . ..... . 0 0 0 aia. "'C: J 1 98 0 1 985 1 990 1 995 2000 2001 2002 2003 2001 2002 2003 Yea r ... QJ a. V, QJ .c. ... ·t'. - 200 1 50 . . ...... . . . ............. . . . . . . . . . . . . . . . . . . . . . 0 :? � ... 0 0 0 QJ 0 QJ 0 ..c � 1 9 80 1 98 5 1 99 0 1 995 2000 Year F I G U R E 3 - 2 R i s i n g M u ltiples Multiple births have increased significantly over the last 25 years. What are some of the reasons for this phenomenon? (Source: Martin et al. . 2005) Monozyg otic and dizygotic twins present opportu nities to learn about the relative contributions of hered ity and situational factors. What kinds of things can psychologists learn from studyi ng tw ins? Bo y or Girl? Establishin g the Sex of the Child Recall that there are 23 matched pairs of chromo ome . In 22 of these pairs, each chromosome is imi. l ar to the other member of its pair. The one exception is the 23rd pair, which is the one that determine the sex of the child . ln females, the 23rd pair consi ts of two match i ng, relatively large X-shaped chromosomes. appropriately identified as XX. ln males, on the other hand, the members of the p air are dissimilar. One consists of an X-shaped chromosome , but the other is a shorter, smaller Y-shaped chr m s me. This pair is identified as }..'Y. A we discussed earlier, each g amete carrie one chromosome fro m each� of the parent's 23 pairs of chromosome . Be au a female's 23rd pair of chromosomes are both Xs, an ovu m will always carry an X chromo­ some, no matter 1,-v hich chroma ·ome of the 23rd pair it get . A male' 23rd p air is , Y, -o each sperm could carry eith r ·rn X o r a Y c h romosome I f the sperm con t ributes a n X ch ro m o­ some when it meets an o u m ( which, re member, will always co n t r i b u te a n X ., c h romosom e ) , the child w i l l have a n X "'\: Not only is the X chromosome pa i r i n g on the 23rd chro mosoml:' and w i l l important in determining b e a female. l f t h e sp erm o n t ribute a Y gender. but it is also the site of ch ro mosome. the res ult will b an XY pai r ­ genes controlling other ing a n d will be a male ( see Fi gure 3 - 3 ) . aspects of development. C vt. CI Jt) ter 3 The Start of Life: Genetics and Prenatal Development 47 Dominant trait The one trait that i s expressed when two compet i n g traits are present Recessive tra it A trait within an organism that is present, but is not expressed G e n oty p e The u n d e rlyi n g c o m b in a t i o n of g e n e t ic materi a l present (but n o t outward l y v i s i b l e) i n an o rg anism It is clear from this process that the father's sperm determi11es the gender of the child. This fact is leading to the development of techniques that will allow parents to increase the chances of specifying the gen ­ der of their child. In one new tecl1 11 ique, lasers measure the DNA in sperm. By dis­ carding sp e rm that harbor the w1wanted sex chromosome, the chances of having a child of the desired sex increase dramatically (Belkin, 1 999; Van Balen, 2005 ) . O f course, procedures fo r choosing a child's sex raise ethical and practical issues. For example, in cultures that value one gender over the other, might there be a kind of gender discrim ination prior to birth? Furthermore, a shortage of children of the less preferred sex might ultimately emerge. Many questions remain, then, before sex selection becomes routine ( Sharma, 2008) . The Basics of Genetics: The M ixing and Matc h i n g of Traits What determined the color of your hair? Why are you tall or short? What made you susceptible to hay fever? And why do you have so many freckles? To answer these When an ovum and sperm meet at the moment of fertilizati o n , the questions, we need to consider the basic ovum is certa in to provid e an X mechan i sms involved in the way that the chromosome, wh ereas the sperm genes we i nherit from our parents trans­ will provide either an X or a Y mit information. chromoso me. Jf the sperm Vie can start by examining the discov­ contributes its X chromosom e , the eries of an Austrian monk, Gregor Mendel, child will have an XX pairi ng on the in the mid- l 800s. In a series of simple yet 23rd c h ro mosome and will be a girl . convincing experiments, Mendel cross­ If the sperm contributes a Y pollinated pea plants that always produced chromosome, the resu lt will be an yellow seeds with pea plants that always XY pairing a n d will be a boy. Does produced green seeds. The result was not, this mean that g i rls a re more l i kely as one might guess, a plant with a combi ­ to be conceived than are boys? nation of yellow a n d green seeds. Instead, all of the resulting plants had yellow seeds. At first it appeared that the green-seeded plants had had no influence. However, addi tional research on Mendel 's part proved th is was n ot t r u e . He b red toge t h e r p la n t s fro m t h e n ew, ye l l ow- seeded gen e r a t i o n that had res u l ted from h i s o r i g i n a l cross - b reed i n g of the gre e n - seeded and ye llow­ seeded plants. The consistent result was a ratio of th ree­ fourths yel l ow seeds to one- fo u rth green seeds. Why did th is 3-to-l ratio of yel low to green seeds appear so consi stently? ft was Mendel's gen i us to provide an a nswer. Based on h i s experiments w i th pea plan ts, he argued that 48 PA RT O N E B eg i n n i ngs P h e n otyp e An observable t rai t : the trait that actually is seen H o m ozyg ous I n heri t i n g fro m parents s i m ilar genes for a given trait H eterozygous Inheriting from parents d ifferent forms of a gene for a given trait genes fro m each p a re n t . I f the child receives similar genes, he is said to be h o m ozygous for the trait. On the other h a n d , i f t h e ch i l d receives d i ffere n t forms of t h e gene from h i s par­ ents, he is sa i d to be heterozygous. I n the case of heterozy­ gous alleles ( 13b ) , the d o m i n a n t characteristic, b rown eyes, is exp ressed . However, if the child happens to receive a reces­ sive allele from each o f his paren ts, and therefore lacks a dom i n a n t cha racteristic ( bb ) , he ,, ill display the recessive characterist ic, such as blue eyes. Trans m i s s i o n of G e n eti c I nfo rmation Gregor Mendel's pio neeri ng experiments o n pea p l a n t s provided t h e fou n d ation for the study of genetics. wh en two com pet ing t ra i ts, such as a g reen or yel lo w c olor ­ ing o f se eds, were both p rese n t , o n l y o n e co u ld b e e x pre ssed ( di splayed) . The one that was exp ressed was ca l l ed a dom i n a n t tr a i t . Meanwh ile, t h e o t h e r t ra i t rem a i n e d p res ­ e n t i n the orga n i s m , a l though n o t exp ressed . Th i s was called a rec essiv e t ra i t . In the case of M e n d e l ' s o rig i n a l pea pla nts, t he offsprin g p l a n ts received gen etic i n form ation fro m bot h the gree n - seed ed a n d t h e yel l ow-seede d pa re n ts. However, th e yellow trait was d o m i n a n t , a n d conseq ue n tly the recessive green t ra i t d i d not asse r t itself. Ke e p i n mi nd, ho we v er, that genet ic material rela t i ng t ? bot h pare nt plants is present i n the o ffs p r i n g, even th o ugh it cannot be seen . The genetic i n formatio n is kno w n as the � rga n i s m's genotype . A genotype is the underlying comb i n a­ tion of genet ic material p resent ( but outwardl y i n visib le) in a n or� ani sm. I n contrast, a phenotype is t h e o bservable tra i t , the tr ait that actu ally is seen. Al though th e offspri n g of the yel low­ seede d an d green-seeded pea plants all h ave yel l o w see ds ( i.e . , th ey h ave a yell ow-seeded phenotype ) , the ge notyp e consis ts of ge netic i n formation relating to both paren ts. And wha t is the nature of the i n fo rmat i o n in t he geno ­ ty pe? To answer that question, let's turn fro m peas to people . I n fact, the princi ples are the sa me not only fo r pla nts and human s but also for the majorit y of spec i es. Recall that parents transmit genetic i n formatio n to thei r offspring v i a t h e chromosomes they co n t r i b u te t h ro ugh the gam ete they provide d u ring fer t i l i za t i o n . Some o f t h e genes form pai rs called alleles, ge nes govern i ng traits t h a t may take alternate forms, such as h a i r or eye color. Fo r exa m ple, b rown eye color is a dom inan t t ra i t ( R ) ; b l u e eyes a re reces­ sive ( b ) . A ch i ld 's a l l e l e may conta i n s i m i l a r o r d i ss i m i l ar We c a n see t h i s p rocess at work in h u m ans by considering the t ransmission of pl1c11ylketo 1 1 1 1 ria (PKU) , an inherited dis­ order in which a child is unable to make use o f phenylala­ n i ne, an esse n t i a l a m i n o acid p resent in proteins found in m i l k and other foods. If left untreated, PKU allows phe­ nylal a n i n e to build up to toxic levels, causing brain damage and mental retardat i o n . PKU is p rod uced b y a si ngle allele, or p a i r of genes. As show n in Figure 3-4, we can label each gene of the pair with a P if it carries a d o m i n a n t gene, which causes the normal production of phenylala n i ne, or a p if it carries the recessive gene that p ro d u ces PKU. In cases in which neither parent is a P K U ca rrier, both the mother's and the father's pairs of genes are the domi nant form, symbolized as PP. Conse­ quently, no matter wh ich member of the pa i r is cont ributed by the mother and father, the resulting pair of genes in the child will be PP, a n d the child will not have PKU. However, consider what happens if one of the parents has a recessive p gene. In this case , whi ch we can we symbol­ i ze as Pp, the parent will not have PKU, because the normal P ge ne is dominant. But the recessive gene can be passed down to the child. This is not so bad : If the child has only one reces­ sive gene, it will not suffer from PKU. But what if both par­ en ts carry a recessive p gene? In this case, although neither parent has the disorder, it is po ssible for the child to receive a recessive gene from both parents. The child's geno type for PK U then will be pp, and he or she will have the disorder. Rem ember, though, that even children whose parents both have the recess ive gene for PKU have only a 25% chance of inheriting the disorder. Due to the laws of proba­ bility, 25% of ch ildren with Pp parents will receive the dom­ i n ant gene from each parent (these children's genotype would be PP) , and 50% will receive the dominant gene fro m one parent and the recessive gene from the other ( their geno types wo uld be e ither Pp or pP) . Only the unlucky 25% wh o receive the recessive gene from each parent and have the genotype pp will suffer fr o m PKU. Polyg enic Traits The transmission of PKU is a good way to ill ust ra te the basic princi p les of how genetic i nformation passes from parent to child, altho ugh the case o f PKU is sim­ pler than most cases of ge netic transm ission. Relativel y few traits are governed by a si ngle p air of genes. I nstead, most Normal Carries recessive Ca rries recess ive PKU gene PKU gene Ca rrier C a r r i e r Affl i cted with P K U R e s u l t : One in f o u r ch i l d ren w i l l i n herit two d o m i na nt genes a n d w i l l not have P K U ; two in fou r w i l l i n h e rit one recessive gene and not be affl icted with P K U but w i l l carry the recessive gene: a n d o n e i n four will have P K U F I G U R E 3-4 PKU Probabi l ities PKU, a d isease that causes brai n damage and mental retardation, is pro d u ced by a single pair of genes inherited from o ne's mother and father. If neither parent carries a gene for the disease (a), a child can not develop PKU . Even if o n e parent carries the recessive gene, but the other doesn 't (b), the c h i ld cannot i nherit the disease. However, if both parents carry the recessive gene (c), there is a one i n fou r c h ance that the child will have P K U . Ch/;l,l'.)ter 3 The Start of Life : Genetics and P renatal Development 49 Polygenic inheritan ce Inheritance in whi ch a combi nation of multiple gene pairs is respo nsible for the production of a particular trait X- lin ked genes Genes that are considered recessive and l ocated only on the X chromosome B e ha v i o ra l g e n et i c s T h e study of t h e effec ts of heredity on b ehavior FIGURE 3-5 I n h erit i n g H e m o p h i l i a Hemoph i l i a , a blood - c lotting disorder. has been an inherited problem t h ro u g h o u t the royal families of Europe, as i l l ustrated by the descendants of Queen Victoria of Britain . (Source: Adapted from Kimbal l , 1 983) traits are the result of polygenic inheritance. In pol yge n ic i n ­ heritance, a combi nation o f multiple ge n e pa i rs is res p o n s i ­ ble for the production o f a particular trait. Furth erm ore, s o m e genes come in several alternate forms, a n d still o thers act to modify t h e way that p a r t i c u l a r genetic traits ( p roduced by other a l l e l e s ) a re disp layed . Genes also vary i n terms o f t h e i r reaction ra nge, the pote n ­ t i a l degree o f variab i l i t y i n the actual express i o n o f a t r a i t due to environ m e n t a l c o n d i t i o n s . A n d some traits, such as blood typ e , a re p ro ­ du ced by genes i n wh ich nei ther member o f a pair o f genes c a n b e class i fi e d as p u rely d o m i n a n t or recessive . I nstead , the t rait i s exp ressed i n ter ms of a c o m b i ­ nation of t h e two genes-s uch a s t y p e A B blood. A number o f recessive genes, called X­ linked genes, are located only on the X ch romosome. Recall that i n females, the 23rd pair of chromosom es is an XX pai r, whereas in males it is an XY pair. One result is that m ales have a higher risk for a variety of X-linked disorders, because males lack a seco nd X chromosome that can co unteract the genetic information that prod uces the Esti mated percentage o f each disorder. For example, ma les are sign i fi ­ crea ture' s tota l genes fou n d i n cantly more apt to have red-green color hum ans are ind icate d by th e blind ness, a disorder produced by a set of dotted l i ne . genes on the X chromosome . FIGURE 3-6 S i m i l arly, the blood d i s o rd e r U n i q uel y H u m a n ? hemoph ilia i s p ro d u ced by X - l i n ked H umans h ave about 2 5 , 000 ge n e s . H e m o p h i l i a h a s been a rec u r re n t gene s, m aking them n ot muc h p ro b l em i n t h e roy a l fa m i l i es o f E u ro p e , more genetic ally complex than a s i l l u s t r a t e d i n F i g u re 3 - 5 , w h i ch s h ows some prim itive specie s. t h e i n h e r i ta n ce o f h e m o p h i l i a in the (Source: Cetera Genomics : desc e n d a n t s o f Q u ee n V i c t o r i a of G r e a t International Human Genome Sequencing Consorti u m . 2001 ) B r i ta i n . 50 PART O N E Beg i n n i n gs The H u m an G e n o m e and B e h avi oral Gen etics : C rac k i n g the Gene t i c Cod e Men d e l 's a c h i eve m e n t s i n recog n i z i n g t h e ba s i c s o f g e n et i c t r a n s m i ssio n o f t ra i t s were t ra i l b l a z i n g . H owe v e r, t h ey m a r k o n l y th e begi n n i n g o f o u r u n d e r s t a n d i n g o f t h e w a y s t h ose pa rt i c u l a r s o rt s of c h a r a c t e r i s t i c s a rc passed on fro m o n e gen era t i o n to th e next. Th e most recen t m i l e st o n e i n u n d er­ sta nd i ng ge n et i c s was re a c h e d i n ea r l y 200 I , w h e n m o l ec u la r_ ge n e t i cists s u cc eede d i n m a p p i n g t h e s p ec i fi c seq u e n ce o t ge nes o n eac h c h ro mosome. Th i s acco m p l i s h m e n t sta n ds as ? n e of t h e mo st i m po r ta n t m o m e n t s i n t h e h i s t o r y of genet­ JCS, a n d , fo r t h a t m a t t e r, all o f b i o l ogy ( I n t e rn a t i o n a l H u m an Geno m e Seq u e n c i n g Co n so rt i u m , 200 1 ) . Al rea dy, t he mappi ng o f the gene seq uence has pro vid ed impo rtant a dvan ces in o u r u n derstand i ng of genet ics. Fo r i n s tan c e, the n u mber of h u m a n ge n es, long though t to be 1 00, 00 0, has be en revi sed downwa rd to 2 5 ,000- not m any � ore than is found i n organisms that a re fa r l ess co m p l ex ( s ee Fi gu re 3 - 6 ) . Fur the rmore, scientists h ave d iscovered t ha t 99 . 9% of the gene s equ ence is shared by a l l h u m ans. I n sho rt, t his means that we humans a re far m o re s i m i l ar to o ne a not her th a n we are d i fferen t . It also indicates that m a ny of the d i ffe ren ces that see m i ngly separate peopl e-such as race-a re , l iter a lly, o nl y. ski n d e ep . Human genome m a p p i n g w i l l al so help iden t i fy particula r d iso rders to wh ich a give n i n d i v i d ual is s u scep ti ble ( Gee, 2004; Delisi & Fleisch haker, 2007; Gupta & State, 2 007) . The m a p p i n g of t h e h u m a n gen e s e q u ence i s s u p p o r t i n g the fi e l d of behavio ral gen e t i cs. A s t h e n a m e i m p l i es , behavi oral genetic s stud ies the effects o f h e red i t y o n psy­ chologica l c h a racteristic s. R a t h e r t h a n s i m p l y exa m i n e sta ­ b l e , u n c h a n g i n g characte ristics su c h as h a i r o r e ye col o r, behav i o r a l ge net icists take a b ro ader a p proach a n d con s i d e r h o w o u r pers o n a l i t y a n d behav i o r a l h a b i t s a re a ffect ed b y ge netic factors. Perso nal ity tra i ts s uch as s h yness o r sociabi l i t y, mood i n ss a n d assertiveness a re a m o n g t h e a reas b e i n g s t u d i e d . O t h e r b e h a v i o r a l ge n e t i c i s t s s t u d y p s yc h o l o g i c a l The Genetic Basis of Sel ected Behavi oral Disorders and Traits Behavio ral Trait Current Ideas o f Genetic Basis H u ntington's disease Huntington gene has been identified. Early-onset (fa m i l ial) Alzhei mer's d i sease Three distinct genes have been id entified . Frag i l e X mental ret ard ation Two genes have been identified. Late-on set Alzheimer's di sease One set of genes has been associated with increased risk. Atte nti on -deficit/hyperact ivity d i sorder Three locations related to the genetics invo lved with the neurotransmitter dopamine may contribute. -------- Dyslexia Relationships to two locations, on chromosomes 6 and 1 5 , have been suggested. Schizophrenia There is no consensus, but l inks to nume rous chromosomes, including 1 , 5 , 6 , 1 0 , 1 3 , 1 5 , and 22 have been reported . (Source: Adapted from McGullin, Riley, & Plomin, 200 1 ) d i s o rders such a s d e p ressi o n , attention- deficit/hyperac t i vity d i so rder, a n d sch izoph ren i a , looking fo r poss ibl ge netic l i n ks ( Baker, Mazzeo, & Kendler, 2007; DeYo u ng, Quilty, & Pe t e r s o n , 2007; Haeffel et al., 2008; see Ta ble 3 - 1 ) . The p rom ise o f behavioral ge netics i s substa ntial. For one t h i ng, resea rchers worki ng within the field are gai n i n g a better understa n d i n g o f the specifics of the ge netic code t h at u nder­ lie h u m a n behavior and development. Eve n more important, researchers are seeki ng to i dent i fy how genetic defects may be remed ied ( P l o m i n & Rutte r, 1 998; Peltonen & McKusick, 200 1 ) . To u n d e rstand how that goal might be reached, we need to co nsider the ways in which genetic facto rs, which nor­ mally cause develop m ent to p roceed so smoothly, may falter. Alternat ive ly, certain environmental facto rs, such as exposure to X- rays o r even to h ighly polluted air, may uce a malformation of g e netic mater ial ( see Figure 3 - 7 ) . prod V \,hen such dama g ed g enes are p assed o n to a child, the I n herited and Genetic Disorders: When Deve l o p ment Goes Awry P K U is j u st one of several disorders that may be i n herited. Like a b o m b t h a t i s harm l ess u n t i l its fuse is lit, a recessive gene res p on s ible for a d iso rder may be passed on unknow­ i n gly f r o m o n e generation to the next, revealing i tself only when, by cha nce, i t is p a i red with another recessive gene . I t is only when two recessive genes come toget her l i ke a match a n d a fuse that the gene w i l l exp ress itself and a child w i l l i n h e r i t the ge n e t i c disorder. But t h e re is another reason that genes can be a source of conce rn : I n so m e cases, genes beco me physically d a m a g ed. For i n s tance, genes may b reak dow n due to wea r-an d - tea r or to cha nce eve n ts o c cu r r i ng d ur i n g the cell-division p ro cesses of meiosis a n d m i tosis. And someti mes, for no known rea­ so n , genes s p o n t a n eously cha nge t h e i r for m , a p rocess called spontn neous m 1 1 t11tion . F I G U R E 3- 7 I nhaled Ai r and Genetic M utations Inhalation of unhealthy, polluted air may lead to mutations in genetic material in sperm . These mutations may be passed on, damaging the fetus and affecting future generations. (Source: Based on Samet. DeMarini. & Malling. 2004 . p. 97 1 ) C hlil.11 te r 3 The Start of Life: Genetics and Prenatal Development Sl Down syndrome A disorder produced by the presence of an extra c h romosome on the 2 1 st pair; once referred to as mongolism Fra g i l e X syndrome A disorder prod uced by injury to a gene on the X chromosome, producing mild to moderate mental retardation Sickle- c e l l a ne m i a A blood d isorder that g ets its name from the shape of the red blood cells in those who have it Tay-Sa chs disease A d i s ord e r t h a t produces b l i n d ness a n d m u scle degen eration p r i o r t o death; there is no treatment results can be disastrous m terms o f fu t u re p hysical a n d cogn itive development (Samet, DeMari n i , & M a l l i ng, 2004 ) . In addition t o P KU, which occurs once i n 1 0 ,000 to 20,000 births, other inheri ted a n d gen etic d isorders i n c l u d e : • Down syndrome. As w e noted earlier, m o s t people have 4 6 chromosomes, arranged in 23 pairs. O n e exception is i n d i ­ viduals with Down syndrome, a disorqer e.!:od uced b y t h e presence o f an extra chromosome on t h e 2 1 st a i r. Once re­ ferred to as mongolism';- Down syn rome is the ;;;��re­ quen t cause of mental retardation. It occurs in abo u t 1 o u t of 5 0 0 births, although the risk i s m uch grea ter i n mothers who a re unusually yo ung or old ( Crane & Morris, 2006 ) . • Fragile X syndrome. Fra gile X syndrome occu rs when a p articular gene is injured o n the X chromosome. The re­ sult is mild to moderate mental retard a t i o n . • Sickle-cell anemia. Around one-tenth o f t h e African Ameri­ can population carries genes that produce sickle-cell anemia, and 1 African American i n 400 actually has the djsease. SickJe­ cell anemia is a blood rusorder that gets its name from the shape of the red blood cells in those who have it. Symptoms include poor appetite, stunted growth , swollen stomach, and yellowish eyes. People afflicted with the most severe form of the disease rarely live beyond childhood. However, for those �th l � ss severe cases, medical advances have produced signif­ tcant mcreases in life expectancy. • Tay-Sachs disease. Occurring mainly in Jews of eastern E � ropean ancestry and in French Canadians, Tay-Sachs disease usually causes death before its victims reach school a g_e. There is n o treatment fo r the disorder, which produces blmdness and muscle degeneration prior to death . • Klinefelter's syndrome. One male out of every 400 is born with Klinefelter's syndrome, an abnormality resulting from the presence of an extra X chromosome. The resulting XXY complement p roduces underdeveloped genitals, extreme heigh t, and enlarged breasts. Klinefelter's syndrome is one of a number of gen eti c abnormalities that result from receiving the improper number of sex chromosomes. For instance, K l i nefe lte r's syn d ro m e A di sorder res u l t i n g from t11e presence of an extra X chromosome that produces underdeveloped genitals, extreme height, a n d enlarged breasts there a re disorders p rod uced b y a n ext ra Y c h ro m osome ( XYY ) , a m issi n g second c h romosome ( ca l l ed Tu rner syn­ drome; XO), and th ree X c h ro m osomes ( X X X ) . Su c h d isor­ ders are typically c h a racterized by p robl e m s rel a 1 i ng to sexual characterist ics and by i n tellec t u a l defi c i t s ( Ke. ler, 2007; J. Ross, Stefanatos, & Roel tge n , 2007 ) . J t i s i m porta n t t o keep i n m i n d t h a t t h e m re fa c t a d i s ­ o rd e r has ge n e t i c ro ots d oes n o t m e a n t h a t e nv i ro n m e n t a l factors do not also play a role ( Mo l d i n & Go t t es m a n , I 997) . Co nsider, fo r i ns t a n ce, sickl e-cel l a n e m i a , wh ich p r i m a r i l y a ffl icts people of A fr i c a n desce n t . Because t h e d i se.ise ca n b e fatal i n ch i l d h ood , we'd ex pect t h a t t h ose w h o s u ffc..: r fro m i t wo uld be u n l ikely to l i ve long e n o u g h t o p a s s i t o n . A n d t h i s does seem to be t ru e , a t l east i n t h e U n i ted S t a tes: C o m p a re d w i t h pa rts of West A fr i c a , the i n c i dence i n t h e U n i t ed S t a t es i s much l owe r. B u t why s h o u l d n ' t t h e i n c i d e n c e o f s i c k l e - c e l l a n e m i a a l s o be grad u a l l y red u ced fo r peo p l e i n We s t A fr i ca ? T h is q u e s t i o n p roved p u zzl i n g fo r m a ny yea r s , u n t i l s c i e n t i s t s d e t e r m i n ed t h a t c a r r y i n g t h e s i c k l e - c e l l ge n e ra i ses i m m u ­ n i t y t o m a l a r i a , wh i c h i s a c o m m o n d i sease i n Wes t A fr ica ( A l l i s o n , 1 9 54 ) . T h i s h e i g h te n e d i m m u n i t y m e a n s t h a t p e o p l e w i t h th e s i c k l e - c e l l gene h a ve a gen e t i c a d va n t a ge ( i n terms o f res i s t a n ce to m a l a r i a ) t h a t o ffs e t s , to s o m e d eg ree, t h e d i sadva n t age o f b e i n g a c a r r i e r o f t h e s i ck l e ­ c e l l gene. The lesson o f s i c k l e - c e l l anem i a is t h a t ge n e t i c fa c to rs are i n te r t w i n ed w i t h e n v i ro n m e n t a l co n s i d e ra t i o n s a n d c a n ' t be l o oked at i n i so l a t i o n . F u r t h e r m o re , we n eed t o r e m e m b e r that a l t h o ugh we've been fo c u s i n g o n i n h e r i ted fac tors t h a t can go aw r y, i n the vast m aj o r i t y o f c a s es t h e genetic mech a n i s m s w i t h w h i c h we a re endowed wo rk q u i te wel l . Overall , 95% o f ch i l d re n born in the U n i ted S t a te s are healthy a n d n o r m a l . For t h e s o m e 2 5 0 ,00 0 wh o a re bo rn w i th some s o r t o f physical o r m e n t a l d i so rd e r, a p p ro p r i a t e i n terve n t i o n o ften c a n h e l p t reat a n d , i n so m e cases, c u re t h e p ro b l em . Moreover, due to advances i n beh avioral gene t i cs, gen et ic . diffic ulties increasingly can be fo recast, anticipated , a nd plan ned for before a chi l d 's birth, enabling parents to t ake steps before the child is b orn to red uce the severity of ce r ta i n geneti c conditions. I n fact, as scientists' kn owledge rega rd i ng the specifi c locatio n of partic u l a r genes expa nds, p red i c t i on s of what the genetic fu ture may hold a re beco m i ng i n c reasi n gly exact, as we d iscuss n ext ( Pl o m i n & Rutter, 1 99 8 ) . Genetic Cou nsel i n g : P red i cti ng the Futu re From the Genes of the Present Sickle-cell anemia, named for t h e presence of m isshapen red blood cells, is carried in the genes of 1 in 1 0 African Americans. 52 PA RT O N E Beg i n n i ngs If you knew that yo ur mother a nd grand mother h a d d ied of Hunti ngton's disease-a devastat i n g, a lways fatal i n h erited d is­ order marked by t remors a n d i n tellect ual deterioratio n-to Genetic c o u n se l i n g The discipline that focuses on helpin g peo ple deal with i ssues relating to inherited d isorders U ltra s o u n d sonography A process i n which high­ freq uency sound waves scan the mother's womb to prod uce an image of the un born baby, whose size and shape can then be assessed whom could you t u rn t o lea rn your own cha nces of comin g down w i t h t h e d isease? The best person to seek wo uld be a genet ic co u nselor, a mt:mber of a fiel d t h at, u n t i l a few dec ad es ago, was nonexis � cn 1 ., Ge n e � ic co u ns e l in g focuse on hel p i ng _ people deal w i t h issues rela t 1 ng to i n h eri ted disor er . Gep e t i c co u n selo rs use a variety of d a ta-i n t h �vo rk. �or i nst,mce, co u p l es co n te m p l at i ng hav i ng a c h i ld may see ' to dete r m i n e t h e r i sks i nvol ved i n a fu t u re p regriancy. n such a case, a cou nselor w i l l t a ke a t h o ro ugh fa m i l y h i sto ry, seek i n g a ny fa m i l i a l i n cide nce of b i rth defects t h a t m i g h t i n d i c a t e a p a t t e rn o f recess ive o r X - l i n ked ge nes. I n addition , th e counsel o r w i l l assess fac t o rs such as the age of the m o ther a n d fa t h e r and a ny prev io us a b n o r m a l i t i es i n o t h er c h i l d ren t h ey m a y have a l ready had ( Resta et a l . , 2006 ) . Ty p i c a l l y, ge n e t i c counselors sugges t a t h o rough physi­ cal exa m i n a t i o n . Such a n exam may i den t i fy physical abnor­ m a l i ties that p o t e n t i a l parents may h ave and n o t be aware of. I n add i t i o n , s a m ples o f b l o o d , ski n , a n d u r i n e m ay be used to iso l a te a n d ex a m i n e spec i fic c h ro m oso mes. Possible ge netic defects, such as t h e p rese nce o f an extra sex c h ro m osome, Chorionic v i l l u s sampl i n g (CVS) A test u s e d t o find genetic defects that involves taking samples of hairlike material that su rrou n d s the embryo can be identi fied by assem b l i n g a ka ryotype, a chart con­ t a i n i ng e n l a rged photos of each of t h e c h romosomes. A va r i ety of tech niques can be used to assess the health o f an unborn child if a woman is al­ ready pregna n t ( see Tab l e 3 - 2 fo r a list of currently avail­ able tests ) . The earliest test is a fi rst- t,·irnester screen , ,,v hich comb i n es a blood test and u l t rasound sonography in the I I th to 1 3 th week of pregnancy. In ultrasourul.s_o.n_Qgia­ phy, high-frequency sound waves oo mbard the mother's womb. These waves p roduce a rather i ndistinct, but use­ ful , image of the u nborn baby, whose size and shape can then be assessed. Re peated use o f ultraso u n d sonography can reveal devel opmental patterns. Altho ugh the accura cy of blood tests and ultraso u n d in iden t ifying abnormal ities i s not high early in p regnan cy, it becomes m o re accurate later o n . A more invasive tes t, chorionic villus sampling (CVS) , c a n be employed in the 1 1 t h to 13th week if blood tests and ultrasound have identi fied a potential p roblem . Prenatal Testi ng Fetal Development M o n itori ng Tech n i q u es Technique Description A m n iocentesis Done between the 1 5th and 20th week of pregnan cy, this proced u re examines a sample of the amniotic fl u i d , which contains fetal cel ls. Recommended if either parent carries Tay- Sach s , s p i n a bifida, sickle-cell , Down syndrome, muscu l ar dystrophy, or Rh d i sease . Chorionic villus sam p l i n g (CVS) Done at 8 to 1 1 weeks, either transabdominally or transcervical ly, depen d i n g on where the placenta is located . Involves inserting a need le (abdominally) o r a catheter (cervically) i nto the su bstance of the placenta but staying outside the amniotic sac and removing 1 O to 1 5 m i l l igrams of tissue. This tissue is manually cleaned of maternal uteri ne tissue and then grown i n culture, and a karyotype is made, as with amniocentes i s . Em bryoscopy Exami nes the embryo or fetus during the fi rst 1 2 weeks of preg nancy by means of a fiber-optic endoscope inserted through the cervix. Can be performed as early as week 5 . Access t o the fetal circu lation may be obtai ned through t h e i n strument , a n d d i rect visualization of the embryo permits the diagnosis of malformations. Fetal blood sampling (FBS) Performed after 1 8 weeks of preg nancy by collecting a small amount of blood from the umbi lical cord for test i n g . Used to detect Down syn d rome and most other c h romosome abnormalities in the fetuses of coup les who are at increased ris k of having an affected c h i l d . Many other d iseases c a n be di agnosed using t h i s technique. Sonoem bryology Used to detect abnormal ities i n the fi rst trimester of pregnancy. I nvolves h i g h-frequency transvag i nal probes and dig ital image processing. I n combination with u ltrasound , can detect more than 80% of all malformations during the second trimester. Sonogram Uses ultrasound to produce a visual image of the uterus, fetus, and placenta. U ltrasound sonography Uses very h igh-frequency sound waves to detect structural abnormal ities or m u ltiple preg nancies, measure fetal growth, judge gestational age, and eval u ate uteri n e abnorm alities. Also used as an adjunct to other proced ures such as amniocentesi s . The Start of Life: Genet ics and Prenatal Developm ent 53 Amn iocentesis The process of identifying genetic defects by exam i n i n g a small samp l e of fetal cells drawn by a needle inserted i nto the amniotic fl u i d surrounding t h e un born fetus In amn iocentesis, a sample of fetal cells is withdrawn from the amn iotic sac and used to identify a number of ge netic defects. Th is proced u re i nvolves inserting a thin needle i n to the fetus a n d extracting s m a l l samples of hairl i ke the material that surro u n ds em bryo. The test can be done between the 8th and 1 1 th week o f preg nancy. However, it produces a risk of m isca rriage of I i n I 00 to l in 200; because of the r i sk, its use is relatively i n frequent. In amniocentesis, a small sample of fetal cells is drawn by a tiny needle i nserted into the amn iotic fluid surro u n d i n g the unborn fetus. Carried out 15 to 20 weeks into the pregnancy, amniocentesis allows the a nalysis of the fetal cell s that can identify a variety of genetic defects with nearly 1 0 0% accuracy. In addition, this test can determine the sex of the ch i l d . Although there is always a da nger t o t h e fetus in an invasive pro cedure such as amniocentesis, it is generally safe. After the various tests are complete and all possible i n for­ mation is available, the couple will meet with the genetic counselor again. Typically, counsel ors avo id giving specific recommendations. I nstead, they lay out th e facts and present various options, ranging from doing nothing to taki ng m ore drastic steps, such as terminating the pregnancy th rough abortion. Ultimately, it is th e parents who m ust dec ide what course of acti on to follow. S c reen i n g fo r Future Prob l e m s The newest role fo r ge­ n e t i c co u n sel ors i n vo lves testing people to i d e n t i fy whether they th emselves, rath e r t h a n th eir ch i l d re n , are susceptible to fu t u re d i s o rders because of gen etic a b n o r m ali ties. For i n stance, H u n t ington's d i sease typ i cally does not appear until peop le reach t h ei r 40s. However, g e n et i c testing can i d e n t i fy m uch e a rlier whether a p e rson car ries the fl awed ge n e t h a t produces H u n t i n gton's d isease. Pres u m a b l y, peo­ p l e's know l e d ge t h a t t h ey ca rry t h e ge ne can help them p re­ p a re t h e m selves fo r t h e fu t u re ( E n s e n a uer, M i chels, & Re i n ke, 2 0 0 5 ; C i n a & Fell m a n n , 2006 ) . I n a d d i t i o n t o H u n tingto n's d isease, m o re t h a n 1 , 000 d i sorders can be pred icted o n the basis of ge n e t i c test i n g ( see Ta b l e 3 - 3 ) . A l t h o ugh s u c h test i n g m a y b r i n g wel co m e re l i ef fr o m fut u re worr i es-i f t h e resu l ts a re n egative­ p o s i t i ve res u l t s may p ro d uce j u s t t h e o p p o s i te effec t . I n fa c t , ge n e t i c test i n g rai ses d i ffi c u l t p ract i c a l a n d e t h i c a l q uesti o n s ( Jo h a n n e s, 2 00 3 ; Two m ey, 2006 ) . 54 PA RT O N E B eg i n n i n g s Suppose, fo r i n s t a nce, From wo m a n who t h o u gh t she w a s a h e a l t h - c a re s u s ce p t i b l e to H u n t i n g t o n 's p ro v i d e r's d i sease was t e s t e d i n h e r perspective: 2 0 s a n d fo u n d t h a t s h e 1/1/ ·11 ;1r0 ·I·r · ,, , - ,. , , ' · 11 d i d n o t ca r r y t h e d e fe c ­ [H1(1 pi 11l(J<, 'I I r ii 1j I• •Si l 11 lS t i ve gene. Obviously, s h e il lrit SI r w1 1111 f t • ,; SSL(; Oi wo u l d experience t remen­ \:J r ,lir. C°l llT lc-• · IIT U ' I , 1qi1t II d o u s rel i e f. But s u p pose ·01 1 101 11 ne� I )( , t,r 11.·1Is , , · o kl l(l'II , 11 l( ',1( I ,· .i ilf r " ' , ll Od she fo u n d t h a t she d i d po. ,•,,t)lr ur;r 1t · i 1 [ 11 1 111ked carry t h e flawed ge ne a n d rl1sorclc � 11 1,li · 1 H<Jl1 w a s t h ere fo re go i n g to gel i l lir y, Jt r r I 11k f ,r the d i sease. In t h i s case, she yo, 11 s , ,li? m ight wel l expe r i e n ce depres­ sion a n d remorse. I n fa c t , some studies show that I 0% o f people who find they h ave the fl awed gene that leads to H u n t i ngto n's dis­ ease never recove r fu l ly o n an e m o t i o n a l level ( G roo p m a n , 1 9 9 8 ; Wa h l i n , 2007 ) . Clearly, ge n e t i c test i n g i s a co m p l ica ted i ssu e . I t rarely provides a s i m p l e yes or no a nswer as to w h e t h e r a n i n d i v i d ­ u a l w i l l be s usceptible to a d iso rder. I n stead , t y p i c a l l y i t p res­ ents a ra nge of p robab i l i t i es. I n s o m e cases, the l i kel i h ood of actually beco m i n g i l l depe n d s o n the type o f e nv i ro n m e n tal st ressors to which a pers o n i s exposed . Perso n a l d i ffe rences also affect a given pe rso n's suscep t i b i l i t y to a d i so rd e r ( Pate­ naude, Guttmach er, & Col l i n s, 200 2 ; B o n ke et a l . , 200 5 ) . A s o u r u n d e rs t a n d i n g o f gen et ics co n t i n ues t o grow, resea rchers a n d m e d i c a l p ra c t i t i o n e rs h a ve m oved beyo n d te s t i n g a n d counsel i n g to ac tively wo r k i n g t o c h a n ge flawed genes. The possi b i l i t ies for ge n e t i c i n terven t i o n a n d m a n i p u ­ l a t i o n increas i ngl y b o rder o n wh a t o n ce w a s sc i e n ce fi c­ t i o n-as we consider in the Fro m Resea rch t o Prnct ice box on page 5 6 about p re i rn p l a n ta t i o n gen e t i c d i a g n o s i s . J . R E V I E W ..J : Some Cu rrently Available DNA-Based Genetic Tests Disease Description Ad u l t pol ycystic kid ney disease Kidney failure and l iver d isease Alpha- 1 -antitrypsin deficiency Em physema and liver disease Alzheimer's d i sease Late-on set variety of senile dementia Amyotrophic lateral scl erosis (Lou Gehrig's disease) Progressive motor function loss leading to paralysis and death Ataxia tel angiectasia Breast and ovarian cancer (inhe rited) Progressive brain disorder resulting in loss of m uscle contro l and cancers Charcot-M arie-Tooth Congenital adrenal hyperplasia Cystic fibrosis Early-onset tumors of breasts and ovaries Loss of feeling in ends of limbs Hormone deficiency; ambig uous genitalia and male pseudohermaphrodrtism Thick mucus acc u m u l ations in lu ngs and chro n i c infections in lungs and pancreas Duchenne muscular dystrophy (Becker muscular dystrophy) Severe to m i ld muscle wast i ng , deterioratio n , weakness Dystonia Factor V-Le iden M u scle rigidity, repet itive twisting movem ents Fanconi anemia, gro u p Fragile X synd rom e Gaucher d isease Hemophilia A and B Hered itary non polyposis colon cancer a Huntingto n 's disease Myotonic dystro phy B lood-clotting disorder Anemia, leukemia, skeletal deformities Mental retardation Enlarged liver and spleen, bone degenerat ion Bleeding d isorders Early-onset tumors of colon and someti mes other organs Prog ressive neurological degeneration, usually beg inning i n m idl ife Progressive muscle weakness N e urofi bromatosis, ty pe 1 Multiple benign nervous system tumors that can be disfig u ring: cancers Phenylkelo n uria Progressive mental retardation due to missing enzyme; correctable by diet Prader Wi l l i/An gelman syndromes Sickle-cell disease Spinal m uscular atrophy Blood cel l disorder; chronic pain and infections Severe, usually lethal p rogressive m u scle-wasting di sorder in children Spinocerebel lar ataxia, type 1 Tay-Sachs disease Seizures, paralysis; fatal neurological disease of early child hood Thalassemias Anemias Decreased motor skills, cogn itive impairment, early death I nvolu ntary muscle movements, reflex disorders, explosive speech These are susceptibility tests that provide only an estimated risk for developing the disorder. (Source: Human Genome Project, 2006, http ://www.oml.gov/scl/techresources/H uman_Genome/medicine/genetest.shtml.) 0 1 . The h u m a n gen e t i c cod e , t ra n s m i t ted a t t h e m o m e n t of conce p t i o n , i s stored 1 11 o u r genes and i s co m posed of specific seq u e n ces o f ____ V N C l :.l clA\SllV 2. ____ t w i n s a re ge netica l l y i d e n t i c a l a n d c o m e from the same zygote. :i 1 1 o � k1. u u o i,\1 :.1 at.\S U V 3 . A ____ i s t h e u n derl y i n g com b i n a t i o n o f ge netic mate r i a l p rese n t ( b ut o u t wa r d l y i n v i s i b l e ) i n a n o rga n ­ ism, w h i l e a p h e n o t y p e i s the obse r v a b l e t r a i t . •· To see 1 1 1 0 re re view ,1 1 1 cs t i o 1 1 s, log 0 1 1 t o lvly l >c , ,cfop 1 1 1 c 1 1 1 /_, , /1. The l nteructio n of H ereditM und Enviro nme nt Like many other paren ts, Jared's mother, Leesha, and h is father, J a m a l , t r ied to figure out which o n e of them their new baby resembled the most. He seemed to h ave Lee­ sh a's big, wide eyes, and Jamal's genero us smile. As he grew, Jared grew to resemb l e h i s mother and father eve n more. H is hai r grew i n with a h a i rl i n e just like Leesh a's, a n d h i s teet h, when they came, made his s m i le resemble J amal 's even more. He also seemed to act l ike his par­ ents. For exa mple, he was a charming little baby, always ready to s m i l e at people who visited the house-i ust l ike h is fr iendly, jovial dad. He seemed to sleep like his mom which was lucky because Jamal was an extremely l ight sleeper who could do with as l i ttle as 4 hours a night, ,vhereas Leesha l i ked a regu l a r 7 or 8 hours. Were Jared's ready s m ile and regular slee p i ng habits some­ thing he j u s t l uckily i n h erited fro m h is parents? Or did Tamai and Leesha provide a happy and stable home that encouraged Chctp te r 3 The Start of Life: Genetics and Prenatal Development 55 M u ltifa c tori a l tra n s m is s i o n The determ i n a t i o n of traits by a combinat i o n of genetic and environ mental factors in which a genotype provides a ra nge within which a phenotype may be expressed Tempera ment Patterns of arousal and emotionality that represent consistent and enduring c haracteri stics i n an i n dividual From Research to Practice Are " Designer Babies" i n Our Future? Adam Nash was born to save h i s older sister Mol ly's l ife-lit­ eral ly. Molly was suffering from a rare d i sorder called Fanconi ane m ia, w h i c h meant that her bone ma rrow was fai l i n g to p roduce blood cel l s . This d isease can have devastat ing effects o n young c h i l d re n , i n c l u d i n g birth defects and certa i n c ancers. M a n y don't survive to a d u lth ood . M o l ly's best hope for overcoming this di sease was to grow healthy bone mar­ row by rece i v i n g a transplant of i mmature blood cells from the p l acenta of a n ewborn s i b l i n g . But not j u st any s i b l i n g wou ld do-it had to be one with com pati ble cells that wou ld not be rej ected by Molly 's i m m u n e system. So M olly's parents turned to a n ew and risky tec h n i q ue that had the potential to save M o l l y by using cel ls from her u n born broth er. M o l ly's parents were t h e fi rst to use a genetic scree n i n g tech n i q u e cal led preimplan ta tion genetic diagnosis (PG D) t o ensure that their next c h i l d wou l d be free of Fancon i anemia. With PGD, a newly fer­ til ized embryo can be screened for a variety of genetic d iseases before it is im pl anted in the mother's uterus to d evelop. Doctors fer­ tilized several of M o l l y 's m oth er's eggs with her hu sband's sperm i n a test tube. They then examined t h e e m b ryos to ensure that they would only i m p l ant the embryo that PG D revealed to be both genet­ ically healthy a n d a match for M o l ly. When Adam was born 9 months l ater, M o l ly got a new lease on life, too: The trans plant was a success, and M o l l y was c u red of her d i sease . Molly's parents were understandably focused on saving their seriously ill daughter's l ife , but they and their doctors also opened a controvers ial new ch apter in genetic engi neering involving t h e use of advan ces i n reproductive medicine t h at give parents a degree of prenatal control over the traits of their c h i l d re n . Another procedu re that makes t h i s level of genetic control poss i b l e is germ line therapy, i n which cells are taken from an embryo and then replaced after t h e defective genes they contain have b e e n re paire d . W h i l e P G D and g e r m l i n e therapy h a v e important u s e s i n t h e pre­ vention and treatment of seri ous genetic d i so rders , concerns have been raised over whether such scientific advances can lead to the development of "desig ner babies"-infants t h at have been genet i ­ cally man ipu lated to h ave traits t h e i r parents wish for. The q u estion is whether these procedures can a n d s h o u l d be used not only to correct u n d es i rable genetic d efects, but also to breed i nfants for specific pu rposes or to " i m prove" future generat i o n s on a genetic leve l . T h e et hical concerns are numero u s : I s i t ri g h t to tailor babies t o serve a specific p u rpose, however noble? Does t h i s k i n d o f genetic control pose any dangers to the h u man gene pool? Wou ld unfair advantages be conferred on the offspring of t h ose who are wealthy or privileged enough to have access to these p roced ures? (Sheldon & Wilkinson, 2004). Designer babies are n ' t with us yet; c u rrently, scientists d o not u n d erstand enough about the h u man genome to i d e n t i fy the genes that control most traits, nor are they able to make g e n e t i c mod ifi ca­ tions to control how those traits w i l l be e x p ressed . Moreov er, the term itself is a bit m i sl ead i n g . For one t h i n g , babies a re n ' t being genetically engi neered ; PGD merely entails selec t i n g a n e m b ryo that already has the d esired genetic makeu p . Fo r another t h i n g , i t 's a d if­ fic u l t and expensive proced u re that does not l e n d itself to casual use. Sti l l , as Adam Nash 's case reve a l s , we are i n c h i n g c l oser to a day when it is possible for parents to decide what gen es their c h i l ­ d ren w i l l and wi l l not have . • How m i g h t Adam feel w h e n h e l earn s t h a t h e was sel e c t e d to be born i n o rder to s ave h i s si ster? o these welco me traits? \,Vh at causes our behavior? Nature o r nurture? I s behavior produced b y i n h erited, genetic i n fl u ­ ences, or is it triggered by factors in the environment? The simple answer is: Th ere is n o s i m ple a n swe r. The Role of the Envi ronment i n Determ i n i ng the Expression of Genes: From Genotypes to Phenotypes As devel opmental research accu m ulates, it i s beco m i n g increasi ngly clear that t o view b e h av i o r a s due t o either ge n e t i c or env i r o n m ental factors is i n ap p ro p r i ate. A given behavi or is not ca used j ust by genetic fa c tors; n o r i s it ca used sol ely by envi ron m e n tal forces. I n stead , as we fi rs t d i scussed 56 PART O N E B eg i n n i n g s How m i g h t the c i rc u m stances of Adam 's b i rt h affect t h e rela­ t i o n s h i p between h i m and M o l l y as t h ey g row u p ? What if o u r u n derstan d i n g of t h e h u m an g e n o m e develops to the point t h at it becomes p o s s i b l e to use P G D to control the fut u re i n t e l l i g e n c e , attracti ve n e s s , or sexual i ty of one's c h i l ­ d ren? Where should we d raw t h e l i ne o n parents' a b i l ity t o d i c ­ t ate what traits t h e i r c h i l d re n w i l l have? i n Chapter I , the behav i o r is t h e pro d uct o f s o m e co m b i n a ­ t i o n o f the two. For i n stan ce, c o n s i d e r tempe ra m e n t , p a t t e r n s of a rousal a nd emo t i o n a l i t y t h a t rep rese n t consi s te n t and e n d u ri n g cha racte ristics i n a n i n d i v i d u a l . S u p pose w e fo u n d-as i n c reas i n g evidence sugges t s is t h e c ase-t h a t a s m a l l per ­ centage of ch i l d re n are b o rn w i t h te m pe ra m e n ts t h a t p ro d uce a n u n u sual degree of p hys i o l o g i c a l rea c t i v i t y. H a v i n g a ten­ dency to s h r i n k fro m a n yth i n g u n u s u a l , s u c h i n fa n t s r eact to n ovel sti m u l i w i t h a rapid i n crease i n h e a r tbea t and u n usual e x c i t a b i l i ty o f t h e l i m b i c s y s t e m o f the b ra i n . Such h e i g h t ­ e n ed reac t i v i t y to s t i m u l i a t t h e s t a r t o f l i fe, w h i c h see m s to be l i n ked to i n h e r i ted facto rs , i s a l so l i ke l y to c a u se c h i l d re n , by t h e t i me t h e y a re 4 o r 5 y e a r s o l d , tu be co n s i d e rt?d shy by t h e i r pa rents a n d tea c h e r s . B u t n o t a l w a y s : S o m e o f t h em beh ave i nd i s t i n g u i s h a b l y fr o m t h e i r peers a t t h e same age ( Kaga n & S n i d m a n , 1 99 l ; McCrae et al., 2000 ) . Wh a l m a kes t h e d i fferen c ? T h e an s wer seems t o b e t he en v i ron m e n t in which the ch il dren a re raised. Children, whose p a ren ts encourage them to be ou tgo i ng by arran gi n g new o p p o rt u n i t ies for them, may ove rcom e thei r s hyness . I n co n ­ t rast , ch i l d ren rai sed i n a st ressful env i ro n m ent m arked by m a r i tal d i sco rd or a prolonged i l l ness may be more l i kely t o ret a i n the i r shynes later in l i fe ( Ka ga n, A rcus, & S n idman, 1 993; R. Joseph, 1 999; Propper & M oo re, 2006 ) . Jared, des c r i b ed e·irlier, may have been b o rn with a n easy temperame n t, w h i c h was rea d i l y rei n forced by his cari n g p arents. I nte raction of Factors Such fi n d i n gs i llustrate th a t many t ra i t s refl ect rn u l t i fa ctoriaJ t ra n s , · ion, mea n i n g that they are determ i 1iecl by .�inat i o n o f b o t h oenetic a n d e nv 1 ro n ­ rfl e rit,il facto rs:- m mu lf i fact orial t ra n sm issi o n , a genotype pro ­ v ides a part icu ,11.--r,1 11ge within \v h ich a p h enot ype ma)' a ch ie ve exp ressio n . Fo r instance, peopl e wi t h a genotype t h at p e r m i t s t h e m to ga i n weigh t eas i l y may n eve r be sli m , no mat ter h ow much t hey diet. They m ay be relatively s l i m , given t h eir ge n et i c heri tage, b u t they may never be ab l e to get beyo nd a certai n d e ­ gree o f t h i n ness ( Fa i t h , J o h nson , & Allison, 1 997 ) . In many cases, t h e n , it is the environment that determ i nes the way i n which a particular ge n o t ype will be expressed as a p he notyp e ( Wachs, 1 99 2 , 1 993, 1 9 96; P l o m i n , 1 9946 ) . On t h e o t h e r hand, certain genotypes a re relatively unaf­ fected by environmental factors. In such cases, development fo l l ows a preorda i n ed pattern, relat ively i n depend e n t o f the spec i fi c env i ro n m en t i n which a perso n is raised. For instan ce, resea rch on preg n a n t wome n who were severely malnour­ ished d u r i n g fa m i n es caused by World War I I found that the ir N a t u re chil d ren were, o n average, unaffected physically or intellectu­ ally as adults (Z. Stei.n et al., 1 975 ). Similarly, no matter h ow m u ch health food people eat, they are not going to grow b eyond certain genetically in1posed limitations in height. Lit­ tle Jared's hairline will p robably be affected very little by any ac t ions on the part of his parents. Ultimately, of course, it is the u n ique i nteraction of inherited and environ mental factors that determ ines people's pa tterns of development. The more a p p ro p r i a te question, then, is how m uch of the behavior is caused by genetic factors, and how much by env i ro n m ental factors? ( S ee, fo r exa mple the range of possi­ b i l it ies fo r the determi n a n ts o f in telligence, illust rated i n Figure 3 - 8 . ) A t one extreme is t h e idea t h a t oppo rtun ities i n the e nv i ro n me n t are solely responsible fo r intel ligence; o n the other, that i n telligence is p u r e l y genetic-you either have it or you don't. The usefulness of such extremes seems to p o i n t us toward the middle gro u nd-that i ntelligence is the r e sult o f s o m e comb i n ation of natural mental ability a n d environmental opportunity. Studyi ng Development: How M uch Is Nature? How M uch Is Nurtu re? Developmental researchers use several st rategies to try to resolve the question of the degree to which traits, character istics, and behavior are produced by genetic or environmental factors. Their studies i nvolve both nonhuman species and humans. N o n h u m an An i mal Studies: Contro l l ing Both G eneti cs and Enviro n m ent It is relatively simple to deve lop breeds of animals that are genetically sim ilar to one another in terms of spec i fi c traits. The people who raise B utterball turkeys for ---- I n t e l l i g e nce i s prov ided entirely by genetic fac­ tors; environment pl ays no ro le. Even a h i ghly enriched environment � a n d exce l l ent e d u cation :fl m a ke no d i fference. N u rt u re Although larg e l y i n h e rited, i ntelligence is affected by an extremely en riched or depr ived enviro n m ent. .!!:! .c 'iii V, 0 CL I ntel l i gence is affected both by a person's genetic e n d owment a n d envi ronment. A person geneti cally predisposed to low intelligence may perform better if raised in an enriched e n v i ro n ­ ment o r w o r s e i n a dep rived environm ent . S i m i l arly, a person genetica ll y p red is posed to h i g her intellig ence may perform worse i n a deprived e n v i r o n m e nt or better i n a n en riched enviro n m ent. Altho u g h inte l l igence is l a rg e l y a result of enviro n m e nt, g e n etic a b normalities may prod uce menta l retardati o n . Inte llig ence depends entirely o n the environ­ m e nt. G e n etics p l ays no role in d eterm i n i n g i ntel l ectual success. F I G U R E 3 · 8 Poss i b l e Causes of I nte l l igence Intelligence may be explai ned by a range of differing poss ible sources, spanning the nature-nurture con t i n u u m . Which of tl1ese explanations do you find most convi ncing, g i ven the evidence discussed i n the chapter? Ch CI.p te r 3 The Start of Life: Genetics and Prenatal Deve l o pment 57 Thanksgiving do it all the time, producing turkeys that grow especially rapidly so that they can be b rought to market inex­ pensively. Simil arly, strains of laboratory animals can be bred to share similar genetic backgrounds. By observing animals with similar genetic backg rounds in different environmen ts, scientists can determin e, with reaso nable precision, the effects of specific kinds of environ­ mental stim ulation. For example, animals can be raised in unusually stimulating environmen ts, with lots of items to climb over or th rough , o r they can be raised in relatively bar­ ren envi ronments, to determ ine the results of living i n such different settings. Co nversely, researchers can exam i ne groups of animals that have been bred t o h ave significan tly different gen etic backgro unds on particular traits. Then, by exposing such animals to identical environments, they can determin e the role that genetic backgro u n d plays. Of co urse, the drawback to using n o n humans as research subjects is th at we can't be su re how well the find­ ings we obtain can be generalized to people. Still, the oppo r­ tunities that an imal research offers are substantial. Contrasting Related ness and Behavior: Ado ption, Twi n , and Fam i ly Stu dies Obviously, researchers can't control either the genetic b ackgro unds or the envi ronments of humans in the way they can with nonhumans. However, na­ ture conveniently has provided the potential to carry o u t vari­ ous kinds of "natural experi ments"-i n the form of twins. RecaU that identical , monozygotic twins are also identical genetically. Beca use their i nherited backgro u nds a re precisely the same, any vari ations in their behavior m ust be due entirely to envi ron mental facto r 58 PA RT O N E Beg i n n i n gs It would be rat her s i m p l e for resea rc h e rs lo mnke u ·e of identical twin to d raw u neq u ivocal co n c l u s i o n s about the roles of nature and n u r t u re. Fo r i n sta nce, by scp:1ra t i ng iden­ tical twins at b i r t h and placing 1 h c m in t o l a l l y d i ffcrc n l envi­ ron ments, researchers could assess t h e i m pact of enviro n ment u n a m biguously. Of cou rse. e t h ical considera­ tions make t h i s i m possible. I- 1 0\-v cvcr, w h a t rL'searcher can-and do-st udy, are cases in wh ich idL'n l i cal ! \\'i n s have been put up for ado ption ·1 1 b i r t h a n d a rc rai. eel i n substan­ tiall y different env i ronmen ts. Such i nsta nces a l l ow us to draw fairly confident concl usions abo u t t hL' rela t ive contri­ butions of genet ics and env i ron men t ( Ba i l ey ct al., 2000; Richardson & Norgate, 2007 ) . The data from such stud ies of ident ical twins raise d in d i fferent environments are not always w i t hout bias. Adopt ion agencies typically take the characteris t i cs ( a n d wishes ) of birth mothers i n to acco u n t when they place bab i es in ado ptive hom es. For instance, children tend to be placed w i t h fa milies of the sam e race and rel igion. Conseq uent ly, even when mon ozygotic tw i n s are placed i n d i ffe re n t ado ptive homes, there are often s i m i l arities between the two home env iron­ men ts. As a resul t, resea rchers ca n't always be cen ai n t hat dif­ ferences in behavior a re due to d i ffe rences i n t he env i ro n m ent. St udies of nonidentical, d i zygotic tw i ns a l s o presen t op portu nities to learn about the rela t i ve co n t rib ut i on s of natur e and n u r ture. Recall that d i zygotic twi ns a re gene t ical ly no more sim ilar t han sibl i ngs in a fa m i l y born a t diffe rent tn:n es . By co mpa ring behavior w i t h i n pai rs of d i zygot ic tw i ns �vith � hat of pa irs of mono zygotic twins ( who a re gene tic al � y ident ICal ) rese archer s can determ i n e whether mo no zygo tJC twins are more si m i l ar on a particu lar trait, on average, th a n ?i zygot i c twins. If so, t hey can as s ume tha t genetics p l a ys a n imp ortant role in determining the exp ression o f t hat t rait. Still a nother approach is to stud y people who a re tota lly unrel ated to one another and who therefo re have dissi mi lar geneti c backg ro unds, but who s h a re an enviro n me ntal back­ ground. For instan ce, a family that adopts, a t the same _ time � two very young unrelated ch ildren p ro babl y will prov ide them with quite similar env i ron ments throu gho ut their childho od. In this case, similari ties in t h e ch ildren's cha r­ acteristi cs and behavi or can be attributed with some confi ­ dence to env ironm ental influen ces ( N . L. Segal , 1 993 , 2000) . _ Fmally, develo pmental researcher s have exa m ined groups ? f people _ i n light of their d e g ree o f ge netic simila r i ty. Fo r mstance, if we fi n d a h igh association on a pa rticu lar trait betw een biological parents and thei r children , but a weake r associatio n between adoptive pare nts and their chi ldren , we have evide � ce for the impo rtance o f genetics i n determ i n i ng the express10n of that trait. On the other hand, i f there is a stronge r association on a trait betwee n adoptive parents and their ch i l d ren than between biological parents a n d thei r ch i l ­ dren, we have evidence for t h e importance o f the enviro n ment i n determ i n i ng that trait. I f a particular t rait tends to occur at similar levels amon g genetical l y similar individua ls, b ut occurs at d i fferent levels among ge net ically more d i stant i ndivid uals, signs poi n t to the fac t that genetics plays an important role in the development o f that I ra it ( Rowe, l 994 ) . Developmental resea rchers have used these approaches and others 10 st udy the relat ive i m pact of genetic and envi ron­ mental factors. \Vhat have they found? Before t u rn ing to speci fic fi n d i ngs, here's the general con­ clusion resu l t i ng from decades o f research: Virtually all tra its, characterist ics, and behav iors a re the joint res u l t of the com­ b i nation and i n teract ion of natur e and nurt ure. Genetic and environ m e n t a l factors wo rk in tandem, each affect ing and being a ffected b y the oth er, c reating the u n ique individual that each of us i s and will become (G. E. Robi nson, 2004; Waterl and & J i rtle, 2004 ) . Over a 3-month period, t h e twins gained almost identical amounts of weight. Moreover, different pairs of twins varied substantially i n h o w much weight they gained, with some pairs ga ining almost three ti mes as much weight as other pairs ( Bouchard et al., 1 990 ) . Other, less obvious physi cal characteristics also show strong genetic i nfluences. For instance, blood p ressure, resp iration rates, and eve n the age at which l i fe ends a re m o re similar in closely related i n d ividuals than in those wh o are less genetically alike ( Sorensen et a l . , 1 988; Price & Gottesman, 1 99 1 ) . Phys ical Traits: Fam i ly Resemb lances I nte l l i gence: M o re Research , M o re Controversy 'vV h e n pa t i e n t s e n tered the examining ro o m of Dr. Cyril Ma rc us, t hey didn't rea l i ze t h a t sometimes t h ey were actually being t reated by h i s ident ical tw i n b rother, D r. Stewa rt Mar­ cus. So si m i l a r i n a ppea rance and manner were the twins that even l o n g - t i me patients were fooled by this admittedly u nethical behavior, wh ich occurred in a b izarre case made famous in the fi l m Dead Ri1 1gers. Monozygo t i c twins a re merely the most ext reme exam ple of the fact that the more geneticall y similar two peo­ ple are, the more l i kely they are to share physical character is­ tics. Tal l parents tend to h ave tall children, and short ones tend to have short c h i ldren. O6es1ty, which is defined as·oemg mo re t h a n 20% above the average weight for a given height, also has a st ro n oo ooenetic compo nent. For example, in one . t h at c onta1ne . d study, p a i rs of identical twins were put on d 1ets to not exercise. ordered day-and an ex tra l ,000 calories a No other issue i nvolving the relative influence o f h eredity and environment has generated more research than the topic of intelligence. Some traits-like curly hair­ Why? The m a i n reason is that intelligence, gen- have a clear genetic erally measured in terms of an IQ score, is a component. central h u man characteristic that differentiates h u m ans from other species. I n addition, intelligence is strongly related to success in scholastic endeavo rs and, so mewhat less strongly, to other types of achievement. Genetics plays a ign i fi c a n t role in intelligence. In studies o f both general intelligence and of specific sub­ componen ts of i n telligence ( such a s spatial skills, verbal skills, and memory ) , t h e closer the genetic link between two individu als, the greate r the correspo ndence of their overa l l IQ scores. ( See Figure 3 - 9 ) F I G U R E 3 - 9 Genetics and I Q The closer the genetic link between two individuals, the greater the correspondence between their IQ scores. Why do you think there is a sex d ifference in the fraternal twins' figures? M ight there be other sex differences in other sets of twi ns or siblings, not shown on this chart? (Source: Bouchard & McGue. 1 98 1 ) C h ct p te r 3 The Start of Life: Genetics and Prenatal Development 59 Not only is genetics an impo rtant i nfluence o n i ntelligence but also the impact increases with age. For instance, as fraternal ( i .e., d izygotic) twins move from i n c1 ancy to adolesSome people have used cence, their I Q scores become less simila r. I n the proven genetic basis contrast, the IQ scores of iden tical of intelligence to argue ( monozygotic) tv1ins become increasi ngly against strenuous educational similar over the cou rse of time. These efforts on behalf of ind ividuals opposite patterns sugges t the i:itensifying with below-average IQs . Does _ _ . ' h1s v1ewpo1nt make sense / mfluence of mhented factors with mcreasbased on what you have ing age ( Brody, 1 993; McGue et a l . , 1 9 93 ) . learned about heredity Al though it is clear that h e redity p lays and environment? an important role in inte 11 igence, i nvestiga­ Why or why tors are much more divided on t h e question o f not? the degree t o which i t i s i n h erited. Perhaps the most extreme view is held by psychologist Arthur Jensen ( 2003 ) , who argued that a s m uch as 80% o f i n tel l i ­ gence i s a result of heredity. Others have suggested more modest figures, ranging from 50% to 70%. I t is critical to keep in mind that such figures a re averages across large gro ups of people, and any particular i n dividual's degree of inheritance cannot be predicted from these averages ( e.g., Herrnstein & Murray, 1 994; Devl i n , Dan iels, & Roeder, 1 99 7 ) . From an educator's perspective: I Social potency 61 % 1 A person h ig h in this trait is masterful, a forceful leader who li kes to be the center of attenti o n . I Traditionalism 60% 1 Foll ows rules and authority, endorses high moral standards and strict disci p l i n e . I I I I I s s o/o 1 Stress react.ion 55% Feels vul nerable and sensitive and is g iven to worries a n d is easily u pset. It is important t o keep i n m i n d that a l t hough hered ity clearly plays an i mportant role i n i n tell igence, envi ro n men tal factors such as exposure to books, good educa t i onal experi­ ences, and intel l i ge n t peers a re p ro fo u n d l y i n fl u e n t i a l . Even t hose like Jensen who make the m ost ex t reme est i m a tes of the role of ge netics sti l l al low for enviro n m e n ta l factors to play a sig­ nificant role. In fact, in terms of public p o l i cy, env i ro n m ental i n fl uences are the focus of efforts geared towa rd maxi m i zing people's intellect ual su ccess. As developmental psychologist Sandra Sca rr suggests, we should be asking what can be clone to maxim ize the i n tellectual devel opment of each i nd ividual ( Scarr & Carter-Sal tzman, 1 98 2 ; Sto rfer, 1 9 90; Bouchard , 1 9 97 ) . Genetic and Environm ental I nfl uences on Personal ity: Born to Be Outgoing? D o w e i n herit o u r personal i ty? At least in part. There's i n c reasing resea rch evidence sug­ gesti ng that some of our most basic perso n a l ity traits have ge netic roots. For example, two of the key " B ig Five" persona li ty traits, neuroticism and extroversion, have been l i n ked to genetic factors. Neurot icism, as used by personality researchers, is the degree of emotional stabil ity an i n d ividual cha racterist ically displays. Extroversion is the degree to which a person seeks to be with oth ers, to behave i n an outgoing manner, and gen erally to be sociable. For instance, Jared, the baby described ea rl ier i n this chapter, may have i n h erited a tendency to be o u t go i n g from his Absorption 55% Has a vivid imagination read i l y captured by rich experience; re linqu ishes sense of real ity. Alienation Feels mi streated and used, that "the world is out to get m e . " I Well-being Has a cheerful disposition, feels confident and opti m i stic. s4% 1 I ext roverted fa t her, J a m al ( Plomin & Caspi, 1 998; Benja min, Ebstei n, & Bel m a kc r, 2002 ; Zuckerman, 2003 ) . How do w e know w h i c h personality traits reflect genetics? Some evidence comes from d i rect exam i n at ion of genes them­ selves. For i n sta nce, it appea r · t h at a spec i fic gene is very influ­ ential in determ i n ing risk-taking behavior. T h i s novelty- seeking gene a ffects the production of the b ra i n chemical dopamine, making some people m o re prone than others to seek out novel situations a n d to take risks ( Ebstein et a l . , I 996; Gi llespie et al, 2003; Serre t t i ct a l . , 2007 ) . Other evidence for t h e ro le o f ge netics i n t h e determina­ tion of personality t ra its comes from studies of twins. For instance, in one major · tud y, researchers looked at the personal­ i ty tra i ts of h u nd reds of pairs of twi ns. Because a good number of the twi n s were ge net ically identical but had been raised apart, it wa possible to d etermine with some confidence t he influence of genet ic factors ( Tellcgen ct al., 1 9 8 8 ) . The researchers found that certa i n t ra i ts reflected the contribution of genetics consid­ erably more than other . As you can see i n Figure 3- 1 0, social potency ( the tendency to be a masterful, forceful leader who enjoys being the ce nter of atte n t i o n ) and tradit ionalism (strict endorsement of ru les and authority) are strongly associated with ge netic factors ( H arris, Vernon, & Ja ng, 2007 ) . Even less b a s i c perso nality tra i ts are linked t o genetics. For exa m p le, p o l i t ical a t t itudes, rel igious in terests and values, and eve n a t t i t udes towa rd human sexuality have ge netic com­ ponents ( Eley, 2003; Bouchard, 2004; Koenig et al., 2005 ) . Clearl y, genetic factors play a role i n determ i n i ng per­ sonal i t y. At t h e same ti me, the env i ro n m ent i n wh ich a ch ild is raised also a ffects persona l ity development. For example, some pare n t s e n c o u rage high activity levels, seeing activity as a m a n i festation of i n dependence and intel l igence. Ot h er par­ ents m ay encourage lower levels of activity on the part o f t h e i r ch i l d ren, feel i n g t h a t more passive chil d ren will get along better in soci ety. Pa rt of these paren tal attit udes are cul­ turally determ i ned ; p a rents i n the United S t ates may encour­ age h i gher activity levels, whereas parents i n Asian cult ures may enco urage grea ter passivi ty. In both cases, children's per­ sonalities will be sh aped in part by their p arents' attitudes. Because both genetic and environmental factors have con­ sequences for a ch ild's personality, personality development is a perfect example of a central fact of child development: the interplay bet:\veen nature and nurture. Fu rthermore, the way in which nature and nurture interact can be reflected not only in the behavior of individuals, but also in the very foundations of a culture, as we see next. D I V E R S I TY Cultural Differences i n P hysical Aro usal : M i ght a C u ltu re 's P h i l osophical Outlook Be Determ i ned by Genetics? The Buddhist philosophy, an inherent part of many As ian cul­ tures, em phasizes harmony and peacefu lness. I n contrast, some traditional Western philosophies, such as those of Martin Luther and John Calvi n , accent uate the i m portance of control­ ling the anxiety, fear, and g u i lt that they assume to be basic parts of the human conditi on. Could such philosophical approaches reflect, in part, genetic factors? That is the controversial suggestion made by devel opmen­ tal psycholog ist Jerome Kagan and his colleagues. They speculate that the underlying tem perament of a given society, determined geneti cally, may predispose people in that society toward a particu­ lar philosophy (Kagan , Arcus, & Snidman, 1 993; Kagan, 2003). Kagan bases h is adm ittedly speculative suggestion on well­ confirmed findings that show clear differences i n tem perament between Caucasian and Asian c h i l d ren. For i n stance, one st udy that com pared 4-month-old i nfants i n China, Irel and , and the United States found several relevant d ifferences. I n comparison to the Caucasian American babies and the I rish babies , the Chi­ nese babies had sign ificantly lower motor activity, irritability, and vocalization (see Table 3-4) . Kag an suggests that the Ch i nese, who enter the world tem­ peramentally calmer, may find Buddhist philosoph ical notions of Harm avoidance so% 1 Shuns the excitement of risk a n d danger. prefers the safe route even if it is ted ious . I Agg ression Is physically agg ressive- and vind ictive, has ta ste for violence and is '"out to get the world . " M ean Behavioral Scores for Caucasian Am erican , I ri s h , a n d C h i nese 4-M onth-Old I nfants I Ach ievement 46 % \ Wo rks hard, strives for m astery, and puts work and accomplishment ahead of other things. I Control Be havior I 43 % Is ca utious and plodding, rational and sensible, l i kes carefu l ly planned events . I Social closeness 33% 1 P refe rs emoti o n a l intim acy and close ties, turns to oth ers for comfort and help. F I G U R E 3 - 1 0 I n herit i n g Traits These traits are among the perso nal ity factors that are related most closely to genetic factors . The higher the percentage, the greater the degree to which the trait reflects the influence of hered ity. Do these figures mean that "leaders are bor n . not made"? Why or why not? (Source: Adapted from Tellegen et al. . 1 988) 60 PA RT O N E Beg i n n i n g s American Irish M otor activity score 48.6 36.7 1 1 .2 Crying (in seconds) 7.0 2.9 1 .1 Fretting (% trials) 100 6.0 1 .9 Vocal izing (% trials) 31 .4 31 . 1 8.1 4.1 2.6 3.6 S m i l i ng {% trials) "The good news is that you will have a healthy baby girl. The bad news is that she is a congenital liar. " Chinese (Source: Kagan , Arcus. & Snid ma11 , 1 993) Cl1.C?i.µ te r 3 The Start of Life: Genetics and Prenatal Development 61 serenity more in tune with their natural inclinations. In contrast , Westerners, who are emotionally more volatile and tense, and who report higher levels of guilt, are more likely to be attracted to philosophies that articulate the necessity of controlling the unpleasant feelings that they are more apt to encou nter in their everyday experience (Kagan et al., 1 994; Kagan , 2003) . It is important to note that this does not mean that one philo­ sophical approach is necessarily better or worse than the other. Nor does it mean that either of the temperaments from which the philosophies are thought to spring is superior or inferior to the other. Similarly, we must keep in mind that any single ind ivid ual within a culture can be more or less tem peramentally volatile and that the range of tem peraments found even with in a particular culture is vast. Final ly, as we noted in our initial discussion of tem­ perament, environmental conditions can have a sign ificant effect on the portion of a person 's temperament that is not genetical ly determi ned. But what Kagan and his colleag ues' speculation does attempt to address is the back and forth between culture and temperament. As religion may help mold tem perament, so may temperament make certain religious ideals more attractive. The notion that the very basis of culture-its philosophical tra­ ditions-may be affected by genetic factors is intriguing. More research is necessary to determine just how the unique interaction of heredity and environment within a given culture may produce a framework for viewing and understanding the world. 62 Lifetime R i s k of Developing Schizophrenia (percent) General population Spouses of patients Fi rst cousins Uncles/au nts 1% 2% 2% 2% Nephews/nieces 4% Grandchildren Half-siblings Children Sibli ngs Siblings with 1 parent with schizophrenia Dizygotic twins S% 13% 9% Parents 6% Monozygotic twi ns 48% 6% 17% 17% 0 10 20 30 Degree of Risk 40 so F I G U R E 3 - 1 1 The Genetics of Schizophre n i a Psychologi cal D i so rders: The Role of Genetics and Enviro n ment The psychological disorder of schizophrenia has clear genetic components. The closer the genetic links between someone with schizophrenia and another family member, the more likely it is that the other person will also develop sch izophrenia. (So urce: Gottesman. 1 99 1 ) Lori Schiller bega n t o hear voices when s h e was a teenager in summer camp. Without warning, the voices screamed "You m ust d i e ! Di e! Die!" She ran fro m her b unk i n to the da rkness, where she thought she could get away. Camp counselors found her screaming as she j u mped wildly on a trampoline, "I thought I was possessed ," she s a i d l ater. ( Bennett, 1 992 ) I n a sen se, she was possessed: possessed with schizophren ia, one of the severest types of psych ological disorder. Normal and happy through ch ildhood, Sch i l l er's wo rld took a tumble d uring adolescence as she increasingly lost her hold on real ­ i ty. F o r the next 2 decades, s h e wo uld b e i n and o u t of i nsti t u ­ tions, struggl i n g t o ward o ff the ravages of t h e diso rder. What was the cause of Sch iller's mental disorder? Increas­ ing evidence suggests that schizophrenia is b ro ught about by genetic factors. The disorder runs in families, with some fami­ lies showing an u nusually h igh incidence. Moreover, the closer the genetic links between someo ne with sch izoph ren ia a n d another fa m i ly member, t h e more l ikely i t is that t h e other per­ son will also develop schizophrenia. For i nstance, a monozy­ gotic twi n has close to a 50% risk of developing sch izo p h renia when the oth er twin develops the disorder ( see Fi gure 3 - J l ) . O n the other hand, a n iece o r nephew o f a person w i th schizo ­ ph ren ia has less than a 5 % chance o f develo ping the disorder ( Prescott & Gottesman, l 993; Han son & Gottesman, 2005 ) . However, the e d a t a a l so i l l ust rate t h a t ge n e t i cs a l o n e doe n o t i n fl uence t h e develo pment o f t h e d i so rd e r. I f gen et­ ics were the sol e c a u se, the risk for a n i d e n t ical twi n wo u l d b e 1 00%. Consequent ly, other factors a c co u n t fo r t h e d i so r­ der, ra n g i n g from struc t u ral abnorma l i t i es i n t h e b ra i n to a b i ochemical i mbalance ( e.g., Lyo ns, 13a r, & Kremen , 2002; H i etala, Can n o n , & va n Erp, 2003 ) . I t also seems that even i f i ndivid uals h a rbor a genetic pre­ disposition towa rd schizophren ia, they are not desti ned to develop the disorder. Instead , they may i n herit an u n usual sen ­ sit ivity t o stress in t h e envi ronment. I f stress i s low, schizophre­ nia will not occur. But if stress is sufficiently strong, it w i l l lead to schizoph renia. On the other hand, for someone with a s t rong genetic predisposi tion toward the diso rder, even relatively weak environ mental stressors may lead to sch izophren ia ( Paris, 1 999; Norman & Malla, 200 l ). Several other psychological disorders have been show n to be related, at least in part, to genetic factors. For i nsta nce, major depression, alcoholism, autism, and attention -defici t/hyperac­ tivity disorder have significa n t i n h erited components ( Prescott et al., 2005; Dick, Rose, & Kaprio, 2006; Monastra, 2008 ) . The example o f sch izophrenia and other genetically related p ychological disorders also illustrates a fu ndamental princi ple regarding the relationship between heredity and environm ent, one that underl ies much of our previous discussion . Spec i fi ­ call y, t h e role of genetics i s often t o prod uce tendency towa rd a fu ture co u rse of develo pmen t . \,Vh en and whether a certain behavioral characteristic will actually be displ ayed depends on the nature of the enviro n m ent. Th us, although a pred isposit ion PA RT O N E B e g i n n i ng s Developmental psychologist Sandra Scarr arg ues that children's genetic characteristics actively influence and shape their environ ment. for schizophrenia may be present at bi rth, typically people do not show the disorder until adolescence-if at all. S i m i l a rly, certain other kinds o f traits are more likely to be displayed as the i n fl uence o f parents and other socializing fac t o rs decl i n es. For example, ado pted children may, early in their lives, display t r a i ts that are relatively similar to their adopt ive parents' t ra i ts, given the overwh elm ing influence of the envi ro n m e n t o n you ng children. As they get older and their p a ren ts' d ay- to -day i n fl uence declines, ge netically influe nced t r a its m ay begin to manifest themselves as unseen gen etic fac tors begin to play a grea ter role ( Caspi & Moffitt, 1 993; Arsen a u l t et a l . , 2003; Pou lton & Caspi , 2005 ) . Can Genes I nfluen ce the Environment ? Accord ing t o develop m e n tal psycholog is � Sandra _ Scarr ( I 993, 1 998 ) , the genetic endo wment provided to children by their p a rents not o nl y d eterm i n es their genetic character ­ ist ics, but a l so act ively i n fluences their em'. i ro n � en t. S � arr suggests th ree ways a child's genetic prechspo s1t1011 might i n fluence h i s or her env i ronment. Children tend to act ively focus on those aspects of their environment that are most connected with their genetically determined abilities. For example, an active, more aggressive child will grav i tate toward sports, wh ile a m_ore reserve � ch ild _ will be more en gaged by academics or solitary pursuits like _ computer games or drawing. Children also pay less attentw n to those aspects of the environment that are less �ompat1ble with their genetic endowment. For instance, two girls 1:1 ay be reading the same school bulletin board. One may notice the sign advertising tryo uts for Little League baseba � , wher� as her less coordinated but more musically endowed fnend might be more apt to spot the notice recruiting students for an after­ school chorus. In each case, the child is attending to those aspects of the environment in which her genetically determined abilities can flourish. I n some cases, the gene-environment influence is more pas­ sive and less direct. For example, a particularly sports-orit::nted parent, who has genes that promote good physical coordination, may provide many opportunities for a child to play sports. Finally, the genetically driven temperament of a child may evoke certain enviro nmen tal infl uences. For instance, an infant's demanding behavior may cause parents to be more attentive to the in fant's needs than they would be if the in fant were less demanding. Or, for instance, a child who is geneti­ cally inclined to be well co ordinated may play ba!I with any­ thing in the house so often that her parents notice. They may then decide that she should have some sports equipment. ln sum, determining whether behavior is primarily attrib­ utable to nature or nurture is a bit like shooting at a moving tar­ get. Not only are behaviors and traits a joint outcome of genetic and enviromnental factors, but also the relative influence of genes and environment for specific characteristics shifts over the comse of people's lives. Altho ugh the pool of genes we inherit at birtl1 sets the stage for om future development, the constantly shifting scenery and tl1e other characters in our lives determine j ust how our development eventually plays out. The environment both influences our experiences and is molded by the choices we are temperamentally i nclined to make. REVI EW .J 1 . Mapping the gene sequence has provided support for the field of ____ genetics, which studies the effects of heredity on psychological characteristics. j\'..lO!Al'.ljdq :JdMSUV 2. ____ counsel ing focuses on helping people deal with issues related to inherited disorders. syn ­ 3. Examples of i n herited disorders are drome, once referred to as mongolism; fragile X syn drome; sickle-cell anem ia; and Tay-Sachs disease. Ui\"\OQ :Jd,1,\SUV 4. Fo r women wh o are already pregnant, the health of the unborn child can be assessed using ---� chorionic vi!Jus sampli ng, or ultrasound sonography. S!Sd)lld) O) lllll\'. :J;J,1,\SUV * To see 111 o re re view q11esrions, log 0 1 1 to J\llyDe velop111e11tLnb. Prenatal G rowth and Chanf}e Robert accompanied Lisa to her fi rst appointment with the midwife. The midwife checked the results of tests done to confirm the couple's own positive home pregnan­ cy test. "Yep, you're going to have a baby," she confirn1ed, speaking to Lisa. "You'll need to set up mon thly visits fo r the next 6 mon ths, then more frequently as your due date approaches. Yo u can get this prescription ti.w prenatal vi ­ tami ns filled at any pharmaq and here a re some guide­ li nes about diet and exercise. Yo u don't smoke, do vo u 7 1, Ch.apter 3 The Start of Life : Genetics and Prenatal Development 63 Ferti lizati on The process by which a sperm and an ovum­ the male and female gametes, respectively-join to form a single new cell Germ ina l stage The fi rst , and shortest, stage of the prenatal period , which takes place during the first 2 weeks fol lowing conception P l acenta A conduit between the mother and fetus, providing nourishment and oxygen via the umbilical cord That's good." Then she turned to Robert. " How about you? Do yo u smoke?" After giving lots of instructions and advice, she left the couple feeling slightly dazed, but ready to do whatever they could to have a healthy baby. Fro m the moment of conception, d evelopment proceeds relentlessly. As we've seen , many aspects are guided by the complex set of genetic guidel i n es inherited from the parents. Of co urse, prenatal growth, like all development, i s also influenced from the start by environmental facto rs. As we will see later, both parents, like Lisa and Robert, can take part in providing a good prenatal environment. Fert i l ization : Th e Moment of Concepti o n When mos t o f us t hink about the facts of l i fe , we tend to focus on the even ts that cause a male's sperm cells to beg i n their jou rney toward a female's ovu m . Ye t the a c t o f sex t h a t b rin gs about t h e potential fo r conception i s b o t h the co nse­ qu ence and the start of a long string of events that p recede and follow fertilization , or conception: t h e j o i n i n g o f sperm and ovum t o create t h e single-celled zygo te fro m which each of us bega n our l ives. Both the male's sperm and the femal e's ovum co m e w i t h a histo ry of their own. Fem ales are b o r n w i t h aro u n d 400,000 ova located in the two ovaries ( see Figu re 3 - 1 2 fo r the basic anatomy o f the female reproductive o rga n s ) . How­ ever, the ova do not mature until the female reaches puberty. Fro m that point until sh e reaches menopa use, the fe male will ovulate about every 28 days. During ovu l a t i o n , a n egg is released from one of the ovaries and pushed by m i n ute hair cells thro ugh the fallopian tube toward the u teru s. I f the Fal lopian tube Zygote isk Tro p h o b l ast Soft uteri n e lining Uterus Ovary Vag i n a ----- � U R E 'J .t:. Anatomy of the Female Reproductive Organs The basic anatomy of the female reproductive organs is illustrated in this cutaway view. & Persa u d . 2003) {Source: Moore 64 PA R T O N E Beg i n n i n g s E m b ry o n i c sta g e The period from 2 to 8 weeks fol lowing fertil ization during which sig nificant growth occurs in the major organs and body systems ovum meets a sperm in t h e fa l l o p i a n t u be, fe rt i l i za t i o n takes p l ace ( A i tken, 1 995 ) . Sperm , which l ook a l i ttle l i ke m i c rosco p i c tad poles, h ave a shorter l i fe span. They are created by the test i c l e s a t a rapid rate: An a d u l t m a l e typically p rod uces seve ral h u nd red m i l l io n sperm a day. Co nsequent l y, t h e sperm ej a cu lated d u r i ng sexual i n tercou rse a re of co n s i derably more recent origi n t h a n the ovu m to which t hey a re head i n g. When sperm enter the vagi n a , t hey beg i n a w i n d i n g j o u rn ey t h a t takes them t h rough t h e cerv i x , t h e o pe n i n g i n t o t h e u teru s , and i n t o the fa l l o p i a n t ube, where fe r t i l ization may take p l ace. H oweve r, o n l y a t i ny fr act i o n o f t h e 300 m i l ­ l i o n cells t h a t a re typica l l y ej acula ted d ur i n g sex u a l i n ter­ course u l t i mately survive the a rd u o u s j o u rney. Tha t 's usually o kay, though: I t t a kes only one sperm to fe rt i l i ze an ov u m , and each sperm a n d o v u m conta i n s a l l t h e ge net ic d a t a nec­ essary to p roduce a new h u m a n . The Stages of the Prenatal Peri o d : The O n set of Deve l o p ment The prenatal period co nsists of three phases: the ge rm inal, embryonic, and fetal stages. They are s u m m a r i zed i n Table 3 - 5 . The Germ i n al Stage: Fertil ization to 2 Weeks I n t h e germ inal stage, t h e fi rst-a n d sho rtest-stage o f t he p re n a ­ tal period, the zygote begins to d iv i d e a n d grow in co m plex­ ity d u r i n g the fi rst 2 weeks fol l ow i n g conce p t i o n . D u r i n g t h e ge rminal stage, t h e fe r t i l i zed egg ( n ow called a /;/c1:;tocys t ) t ra ve l s towa rd the u terus, wh ere i t becomes i m p l a n ted i n t h e u terus's wa ll, wh ich is r i c h i n n u t rients. The ger m i n a l stage i s characterized b y m e t h o d i c a l c e l l division, w h i ch gets o ff to a q u i c k start: Th ree days a fter fer t i l iza t i o n , the o rgan ism con­ sists o f so m e 3 2 cel ls, a n d by the n e x t day the n u mber d o u ­ b les. Vli t h i n a week, i t i s m a d e u p o f I 00 to 1 50 ce l l s , a n d the n u m ber rises w i t h in creasi n g rapidi ty. In addition to increasing in n u mber, the cells of t h e o rga n ­ i s m become i ncreasingly specialized . F o r i nstance, s o m e cells form a protective layer around the mass of cells, wh ereas others begin to establish the rud i m e n ts of a placenta and umbil ical cord . When fully developed, the placenta serves as a conduit between the mother and fetus, prov iding nou rishment and oxygen via the wnhilical cord. I n addition, waste m aterials from the developing child are removed th ro ugh the u m b i l ical co rd . The Em bryon i c Stag e: 2 Weeks to 8 Weeks By th e e n d of t h e ger m i n a l period, j u s t 2 weeks a fter concep t i o n , t h e organ i s m is fi rm l y sec ured to the wa l l o f t h e mot her's uterus. At this poi n t , t h e c h i l d is c a l led a n e11Jbryo . The embryo n i c stage is the period fro m 2 to 8 weeks fo l l o w i n g fer t i l i za t io n . One of t h e h i g h l i g h t s o f t h i s stage i s t h e devel­ opment of the major o rga n s and basic a n a t o m y. At the begi n n i n g of t h e e m b r yo n ic stage, t h e develo p i n g c h i l d has th ree dist i nc t l ayers, e a c h of w h i c h w i l l u l t i m a t el y fo r m a d i fferen t s e t o f s t r uct u res as deve l o p m e n t p roceeds. Stages of the Prenatal Period Germinal (Fertil ization-2 Weeks) Fetal (8 Weeks-Birth) Embryonic (2 Weeks-8 Weeks) The germinal stage is the first and short­ The zygote is now designated an embryo. The embryo develops th ree lay­ est , characterized by methodical cel l division and the attachment of the organ­ ers , which ultimately form a different set of structures as development proceeds. ism to the wall of the uterus. Three days The layers are as fol lows: Ectoderm : after fertil ization, the zygote consists of Ski n, sense organs, brain, spinal cord; 32 cells, a number that doubles by the next day. Within a week, the zygote mul­ Endoderm: Digestive system, liver, respi­ ratory system; M esoderm : Muscles, tiplies to 1 00 to 1 50 cells. The cells blood , circulatory system. At 8 weeks, become special ized , with some forming the em bryo is 1 inch long. a protective layer around the zygote. The outer layer o f t h e emb ryo, the ectodcn1 1 , w i l l form skin, h a i r, tee t h , sense o rga ns, a nd the brain an d spinal cord . The endoden1 1 , t h e i n ner layer, produces the digest ive system, liver, pancreas, a n d res p i ra tory system. Sandwiched between the ectoderm and cndoderrn i s t he 111esoden11, from which the m uscles, bones, blood and circula tory system are forged. Every part of the body is fo rmed from these three layers. If you were looki ng at an embryo at the end of the embry­ o n i c stage, yo u m ight be hard-pressed to iden tify it as human. Only an inch long, an 8- week-old embryo has what appea r to be gills and a tai l - l ike stru c t ure. On the other hand, a closer look reveals several fa m i l i a r features. Rudimentary eyes, nose, Fetus at 5-6 weeks The fetal stage formally starts when the differentiation of the major organs has occurred. Now called a fetus, the individual g rows rapidly as length increases 20 times. At 4 months, the fetus weig hs an average of 4 ounces; at 7 months, 3 pounds; and at the time of birth, the average child weighs just over 7 pounds. l ips, and even teeth can be recognized, and the embryo has stubby bulges that will form arms and legs. The head and brain undergo rapid growth during the embryo nic period. The head begins to represent a significant proportion of the e mbryo's size, encompassing about 50% of its total length . The grow th of nerve cells, called neurons, is Fetus at 8 weeks Fetus at 1 2 weel�s Chvt. p te r 3 The Start of Life: Genetics and Prenatal Devel opment 65 The stage that begins at about 8 weeks after conception and continues until birth Feta l stage astonishing: As many as 1 00,000 neu­ rons are produced every minute dur­ ing the second month of life! The nervous system begins to function around the 5th week, and weak brain waves begin to be produced as the nervous system starts to fu nction (Lauter, 1 998; Nelso n & Bosquet, 2000 ) . Th e Fetal Stage: 8 Weeks to Birth It is not u n til the final period of prenatal development, the fetal stage, that the devel oping child be­ comes easiJy recogn i zable. The fetal stage starts at about 8 weeks after conception and continues u n t i l bi rth. The fetal stage formally starts when A s with adults, there are broad the d i fferentiation of the major or­ differences in the nature of fetuses. Some are very active while others are ga ns has occurre d . more reserved, and these Now called a fetus, the developing characteristic s can continue after birth. child undergoes astoundingly rapid change. For i nstance, it increases i n length approximately 2 0 times, a n d i t s p roportions change dramatically. At 2 months, ap proxima tely one-half of t h e fetus is what will ultima tely be i t s h e a d ; 5 m o n ths, t h e h ead accou nts for j ust over one- fo urth o f its total s ize ( see Figure 3- 13 ). The fetus also substantially increases in weight. At 4 months, the fetus weighs an average of about 4 ounces; at 7 months, it weighs about 3 pounds; and at the time of bi rth the average child weighs j ust over 7 pounds. 1 /2 2 months after conception 3/8 5 months after conception 1 /4 Newborn F I G U R E 3 - 1 3 Body Proportions During the fetal period, the proportions of the body change dramatically. At 2 months, the head represents approxi mately half the fetus. but by the time of birth, it is one fourth of its total size. 66 PA RT O N E B e g i n n i ngs Infe rti l ity The inabil ity to conceive after 1 2 to 1 8 months of trying to become pregnant A developing child, from weeks after conception unti l birth Fetu s 8 At the same time, the develop i n g child is ra pidly becoming more complex. Orga ns become more d i ffere n t ia ted and tart to work. By 3 months, for exa m ple, t he fet us swallow and uri­ nates. In add ition, the i n terconnections bet ween t he d i fferent parts of the body become m o re com plex and i n tegrat ed. Arn1s develop hands; hands develop fi n gers; fi n gers develo p nails. As this is happen i ng, the fetus makes i tself known to the outside world. In the earliest stages of p regnancy, m o t hers may be unaware t J1at tJ1ey are, in fact, pregn a n t . As t he fetus bec omes increasingly act ive, however, most mothers certa i n ly take notice. By 4 months, a mother can feel the movement of her ch i ld, and several months later, others can feel tJ1e baby's kicks throug h the mother's skin. In addition to the kicks that alert its moth er to its prese nce, the fetus ca n t u rn , do somersa ults, cry, hiccu p, clench its fist, open and close its eyes, and suck its t h u mb. The bra i n beco mes i ncreas i ngly so p h i s t i cated d u ring the fetal stage. The two sym metrical left a n d righ t h a l ves of the bra i n , known as hem ispheres, grow rn p i d l y, and t h e i n te r­ conne ctions between neurons beco m e m o re co m p lex . The neurons become coated w i t h a n i n s u l a t i n g m a te ria l cal led myelin which helps speed the transmissi o n of m essag es from the brain to the rest o f the body. By the en d of the fetal period, bra i n waves arc p rodu ced tha t indicate the fetus passes through d i fterent stages of sleep and wakefulne ss. The fetus is also able to hear ( and feel t h e vibrat ions of) soun ds to which it is exposed. For i nstance, resea rche rs _ Antho ny DeCasper and Melanie Spence ( 1 986 ) aske d a gro up of pregn ant mot hers to read aloud the Dr. Seuss story T'l1e Cnt in the Hat two times a day during the latter months of preg nan cy. T�1ree days after tJ1e babies were born, they appeared to recog­ mze the story they had heard, responding more to it th an to another story that had a different rhythm . In weeks 8 to 24 following conce p t i o n , hormo ne s are released that lead to the increas i n g d i ffe ren tiatio n of m ale and female fet uses. For exa m p le, high levels o f a n d rogen are produc ed in males that a ffect t h e size of b ra i n cel ls a nd t he grow th of neural connections , wh ich, some sci e n t ists spec u ­ late '. ultima tely may lead to differenc es i n male a n d ..(e m ale bra111 stru cture and even later va riations in gen d e r- rela ted _ behav ior ( Berenbaum & Bai ley, 2003 ; Reiner & Gea r ha rt, 2004; Knickm eyer & Baron- Cohen, 2006 ) . J ust a s no two adults are al ike, n o two fetuses a re the same. Although develop ment dur i n g the prenatal peri od follows the b ro a d pa ttern s o u tl i ned h ere, t h e re a re sign i fi ­ cant d i fferences i n t h e speci fic nature o f i n d ivid ua l fetuse s' behavio r. Some fetuses are exceed ingly active, wherea oth­ ers are mo re sedentary. ( The more active fetuses will p roba ­ bly be m o re active after b i r th . ) S o m e have rel atively q u ick heart rates, whereas others' heart rates a re slowe r, w i th the typ i cal range varying betwee n 1 20 and 1 60 beats per m i n u te ( D i Pi etro et al., 2002; Niederhofer, 2004; Tongsong et al., 2005 ). Such d i fferences i n fetal behavior are d u e i n part to genetic cha racteri stics inherited at the moment of ferti l i z a ­ t i o n . Other kinds o f d i fferences, though , a re bro u g h t about by t he n a t ur e o f the env i ro n m e n t in wh i c h the ch i l d spends Artificial i nsemi nati on A process of fertilization in which a man's sperm is placed directly into a woman's vagina by a physician I n vitro ferti l izati on (IVF) A proced ure in which a woman's ova are removed from her ovaries, and a man's sperm are used to fertilize the ova in a laboratory its first 9 months of l i fe. As we will see, there are numerous ways in which the prenatal environment of infants affects their devel opment-i n good ways and bad . Pregnancy Pro b lems For s o m e co uples, conception p resents a major challenge. Let's consider some of t h e challenges-both physical and eth ical-t hat relate to pregnancy. I nferti lity Some 1 5% of couples suffer from infertility, the in­ abi lity to conceive after 1 2 to 1 8 months of t rying to become pregnant. I n ferti.l ity is negatively correlated with age. The older the parents, the more likely infertility will occur; see Figure 3- 1 4. In men, i n fertility is typically a result of producing too few sperm. Use of illicit dru gs or cigarettes and previous bouts of sexually t ra nsmit ted diseases also increase infertility. For wo men, the most common cause of infertility is failure to release an egg thro ugh ovulation. This may occur because of a hormone i mbalance, a damaged fallopian tube or uterus, stress, or abuse of alcohol or dru gs ( Pasqualotto et al., 2005; Lewis, Legato, & Fisch, 2006; Kelly-v\leeder & Cox, 2007 ). Several t rea t ments fo r infertility exist. Some difficulties can be co r rected through the use of d ru gs or surgery. Another optio n may be artificial insem ination, a procedure i n which a man's sperm is p laced directly into a wo man's vagi n a by a physi cian. I n some situati ons, the woman's hus­ band p rovides the sperm, whereas in others it is an anonymous donor fr om a sperm bank. . I n othe r cases, fertilizati on takes place outside of the m other's body. In vitro fertilizat ion (IVF) is a procedure in ... ..c: C: 0 C: n:J C: Cl) � � ... .... ..c: u c.. 0, Cl) C � n:J ·UJ V, -0 -0 0 F I G U R E 3- 1 4 Older Women and R i s ks of P reg nancy Not only does the rate of inferti lity increase as women get older, but also the risk of chromosomal abnormality. (Source: Reproductive Medicine Associates of New Jersey, 2002) C: E C. o- - QJ '-' QJ a:i 0 25 20 15 10 5 0 'Tm their real child, and you're just afrozen embryo thingy they boughtfrom some laboratory. " which a woman's ova are removed from her ovaries, and a man's sperm are used to fertilize the ova in a laboratory. The fertilized egg is then implanted in a woman's uterus. Similarly, gamete intrafallopia n trails/er (GIFT) and zygote intrafallopian tra nsfer (ZIFT) are procedures in which an egg and sperm or fertilized egg are implanted in a woman's fallopian tubes. In IVF, GIFT, and ZIFT, implantation is done either in the woman who provided the donor eggs or, in rarer instances, in Preg nancy � \: .& C: (I) 2 QJ 1 -" ,.,.. � o _,___c___--'--------� 1 2-1 9 20-24 2 5-29 30-34 35-39 40-44 45+ Age 1 5 20 25 30 35 40 45 50 Age 60 Misca rriage 5 � OJ 40 \: -"' � QJ C. ...: 20 ii: in V, u.. - C: 0 Ectopic p reg nancy 3 II) ·Ct: .... Cl) __L__:____;___;_____;___;____:__J 20-24 25-29 30-34 35-39 40-44 45-50 Age ChliLpter 3 .... C: Cl) \: Cl) C. Chromosomal abnormality 4 3 , 2 o_ 20 25 30 3 5 40 Age of Mother 45 The Start of Life: Genetics and P renatal Devel opment 67 Teratogen A factor that produces a birth defect a surrogate mo ther, a woman who agrees to carry the child to term. Surrogate mothers may also be used in cases in which the mother is unable to conceive; the surrogate mother is arti­ ficially insemi nated by the biological father, and she agrees to give up rights to the infant ( Frazier et al., 2004; Kolata, 2004 ) . In vitro fertilization is increasingly successful, with suc­ cess rates of as high 33% for younger women (but with lower rates for older women ) . Furtherm ore, reproductive tech­ nologies are becoming increasingly sophisticated , perm itting parents to choose the sex of their baby. One technique is to separate sperm carrying the X and Y chromosome and later implanting the desired type into a woman's u teru s . In another technique, eggs are removed from a wo man and fer­ tilized with sperm using in vit ro fertil iza tion. Three days after fertilization, the emb ryos are tested to determ i n e thei r sex. If they are the desired gender, they are then impla nted into the mother (D uenwald, 2003, 2004; Kalb, 2004 ) . Eth ical I ssues The use o f surrogate mo thers, i n v i t ro fe r­ tilization, and sex selection techniques p resent a web of eth i ­ cal and legal issues, as well as many emotio nal concerns. I n some cases, surrogate mothers have refused t o give u p the child after its birth, whereas in others the surrogate mother has sought to have a role in the child's life. In such cases, the rights of the mother, the father, the surrogate m other, and ultimately the baby are i n conflict. Even more troubling are concerns raised by sex selection techniques. Is it ethical to terminate the life of an embryo based on its sex? Do cultu ral press ures that may favor boys over girls make it permissible to seek medical in tervention to produce male offspri ng? And-even more d isturbing-if it is permissible to intervene in the reprod uctive process to obta i n a favored sex, what abo u t other characteristics determined by genetics that it may be possible to preselect for in the fut u re? for instance, assuming the technology advances, would it be eth ical to select for a favored eye or hair color, a certain level of intelligence, or a particular ki n d of personality? That's not feasible now, but i t is n ot out the realm of possibility in the future ( Bonnicksen, 2007; Mameli, 2007; E. Ro berts, 2007 ) . For the moment, many o f these ethical issues rem ain unresolved. But we can an swer one question: How do ch i l ­ dren conceived using emerging reproductive tech nologies such as in vitro fertil ization fare? Research shows that they do q u i te wel l . In fact, some stu d i es fi nd that the qual ity of fam ily l i fe for those who have used such techn iques may be superi or to that i n fa m i l ies with n aturally conceived ch ildren. Furthermore, the later psych ological adj ustment of children co nce ived usi ng in vitro fert i l ization and artificial i nsem inat i o n is no d i fferent fro m that of c h i l d ren con ceived using natural tech n iques / Hahn & Di P ietro, 200 1 ; Gol umbok et al., 2004; D i P i et ro, Costiga n , & Gurewi tsch , 2005; Hjel msted t, Widstro m , & CoJ l i n s, 2006 ) . O n the other h a n d , th e i n creasing use o f ! V F tech n iq ues by older i n d i v i d u a l s ( who m ig h t be q u i te elderly when t h e i r 68 PA RT O N E Beg i n n i n g s ch i ldren reach adolesce nce ) may cha nge t hcse posi t i vc fi nd­ i ngs. Because widespread u se o f 1 \/F is only recen t , we j ust don't know yet what will happen w i t h agi ng parents ( Col p i n & Soenen, 2002 ) . Miscarriage a n d Abortion A 1 1 1 isrnrringe-known a s a sponta neous abort ion-occu rs when p regn a nq' ends before the developi ng chi l d is able to s u rvive ou tside t h e mot her's womb. The emb ryo det aches fr om t h e wa l l n f t h e u t e r u s and is expelled. Some 1 5% to 20% of all p regna n c ies end in m i scarr i age, usual ly i n the fir st several m o n t h s o f p regnan cy. Many occur so early that the mother is not even aware she was preg n a n t a n d may n o t even know s h e h a s suffe red a m i sca r r iage. Ty p ­ ically, miscarriages are a t t r i b u table t o some sort o f genetic abnormality. I n abortion, a mother vol u n tari l y ch ooses to t e r m i n ate pregnancy. I nvolvi ng a complex set of physical, psychological, legal, and ethical issues, abortion is a d i ffi c u l t choice fo r every woman. A task force of the American Psychologica l Associa­ tio n ( A PA ) , wh ich looked at the aftereffects of abortion, fo u n d that, fol lowi n g a n abort ion, most wo men experienced a combin ation of rel ief over term i nating an u nwa n ted p reg­ nancy, and regret and gu i l t . However, i n most cases, the nega­ tive psychological aftere ffects d i d not las t, except for a small proportion of women who al ready had serious emot ional problems ( A PA Reproductive Choice Worki ng G ro u p, 2000 ) . Other research fi n ds that abortion may b e associa ted with an increased risk of fu t u re psychological p roblems. H owever, the fi nd i ngs a re m i xed, and th ere a re sign i fica n t ind ividual differences i n how wo men respond t o the experi­ en ce of abortion. What is clear is t h a t i n all cases, abort ion is a difficult decision ( Ferguss o n , Horwood, & Ridder, 2006) . environ mental age n t such a s a dru g, chemical, virus, o r other factor that produces a bi rth defect. Although it is the job of the placenta to keep teratogens from reach ing the fetus, the placenta is not en t i rely successfu l at this, and probably every fetus is exposed lo some teratogens. The t i m i n g a n d q u a n t ity of exposure to a teratogen are cru cial. At o m e ph ases of prenatal devel opment, a certain teratogen may have only a m i n i mal impact. At other periods, however, the same tera togen may have profound conse­ quences. Genera lly, teratogens have their largest effects d ur­ i ng periods of especially rapid prenatal development. Sensitivity to specific teratoge ns is also related to racial and cultur a l backgro u nd. For exam ple, Nat ive American fetuses are more susceptible to the effects of al cohol than those of European American descent ( Kinney et al., 2003; \.\l inger & Woods, 2004 ) . Furthermore, d i fferent organ systems are vu lnerable to teratogens at d i fferent t i mes during develo pment. For exam- pie, the brain is most susceptible 1 5 to 25 days after concep­ tion, whereas the heart is most vulnerable 20 to 40 days fol­ lowing conception (see Figure 3- 1 5; Bookstein et al ., 1 996; Pakjrt, 2004) . We will consider t h e findings relating t o specific terato­ gens next. As we do, we keep in mind the broader social and cultural conte;,..i: in which teratogen exposure occurs. For example, living in poverty increases the chances of exposure to teratogens. Mothers who are poor may not be able to afford adequate diets, nor may they be able to afford adequate medical care, making them more susceptible to illness that can damage a developing fetus. They are more likely to be exposed to pollution. Consequently, it is important to con­ sider the social factors that permit exposure to teratogens. Mother's Diet Most of our knowledge of the enviro n ­ mental factors that affect the developing fetus comes from the study of the mother. For instance, as the midwife pointed The Prenatal Envi ron m ent: Threats to Development Acco rd ing t o the Siriono people o f South America, i f a p reg­ nant woman eats the meat of cer tain kinds of a n i m a l s , she runs the risk of having a ch i l d who may act and look l i ke those animals. According to o p i n i o n s offe red o n dayt ime tel ­ evision talk, a pregnant mother should avo id getting a ngry in order to spare her c h i l d fr om entering the world with anger ( Cole, J 992 ) . Such vi ews are l a rgely the stuff o f fo lkl o re, a l t hough there is some evidence that a m o t her's anxiety d u ri n g preg­ nancy may affect the sleep ing patterns of the fetus prior to birth . There are certa i n aspects of a mothers' a n d fa thers' beh avior, both before and after concep t i o n , that can produce l i fel o n g conseq uences for t h e ch i l d . Some conseq uences show up i m mediately, but half the possible p ro b l e m s a ren't appare n t before birth. Other p roblems, more i n sidious, may not appear u n t i l yea rs after b i rt h ( G ro o m e et a l . , 1 995; Couzin, 2002 ) . Some of th e most pro f o u n d co nsequences a re bro u g h t abo u t by tera toge n i c agen ts. A te ratogen is a n Depending on their state of development, some parts of the body vary in their sensitivity to teratogens. (Source: Moore . 1 9 74) Cnctp te r 3 The Start of Life: Genetics an d Prenatal Development 69 Feta l a l c o h o l syndrome (FAS) A disorder caused by the pregnant mother consuming substantial quantities of alcohol during preg nancy, potentially resulting in mental retardation and delayed growth in the child out in our earlier example of Lisa and Robert, a mother's d iet The ri sks i nvolved in pregn ancy arc grea ter not only for clearly plays an important role in bolstering the develop­ older mothers but also for atypically you n g women. Wo men ment of the fetus. A m o ther who eats a varied diet h igh i n who become pregnant during adol esce nce-a n d such preg­ nutrients i s a p t t o have fewer compl ications du ring pregnan­ nancies actually encompass 20% of a l l p regnancies-a r more cy, an easier labor, and a generally healthier baby than a likely to have premature deliveri es. Fu rt hermore, t h e mortality mother whose diet is restricted in nutrients ( Kaiser & A l l e n , rate of i n fa nts born to adolescent m o t hers i · double t ha t for 2002; Guerrini, Thomso n , & Gurling, 2007 ) . mothers i n their 20s ( Ki rchengast & 1-I a rt man n , 2003 ) . The problem of diet i s of i mmense global concern, with ( 800 million h ungry people i n the world. Even worse, the Mother's Prenatal S u p port Keep i n m i n d , t h ough , t h a t number of people vulnerable to h unger is close to 1 billion. t h e h igher mortal i t y r a t e fo r b a b i e s o f adolesce n t mot hers Clearly, restrictions in diet that bring about hunger o n such reflects more than j ust physiol ogical p ro b l e m s rel a t e d t o the a massive scal e affect mill ions of ch ildren born to women mothers' yo u n g age. You ng m o t hers o ften face ad verse social l iving under such conditions ( Un ited Nati ons, 2004) . and economic factors which can a ffect i n fa n t h ea l t h . Many Fortunately, there are ways to counteract the types of teen age m o t hers do n o t have enough money o r soc ial sup­ maternal malnourishment that affect prenatal developm e n t . port, a s i t uation that p revents t h e m from get t i ng goo d pre­ Dietary s upplem ents given t o moth ers can reverse s o m e o f natal ca re and pare n t i ng support a fter t h e baby i s born. the problems produced b y a poor diet. Fur thermore, Pove rty o r social c i rcu msta nces, such as a lack o f pa ren tal in­ research shows that babies who were malnou rished as volveme n t or supervision may eve n have set t h e stage fo r the fetuses, but who are subsequently raised i n enriched envi­ adolescen t to beco me p reg n a n t i n the fi rst p l ace ( D i Piet ro, ronments, can overcome some of the effects of their early 2004; H u i zi n k , Mu lder, & B u i t e l a a r, 2004 ) . malnourish ment. However, the real ity is that few o f the wo rld 's children whose mothers were malno urished befo re M other's H ealth M o t h e rs who eat t h e r i g h t foods, m a i ntheir bi rth are apt to find themselves i n enri ched environ ­ , t a i n an acceptable weight, and who exe rc ise a p p r opriat e! }' ments after birth ( G rantham-McG rego r et al., 1 994; Kramer, maxim ize the chances of having a heal thy baby. Fu r t her­ 2003; Olness, 2003 ) . more, they can red uce t h e l i feti m e risk of obes i t y, h i gh bl ood press u re, and heart d i sease i n t h e i r ch i l d re n by m a i n t a i n i n g a Mother's Age More women are giving birth later i n l i fe healthy l i festyle ( Wa l ker & H u m p h r i es, 2005, 2007 ) . than was true j ust 2 or 3 d ecades ago. The cause for t h i s I n co n t rast, i l l ness i n a p regn a n t wo m a n can have d evas­ change i s l argely due t o transformations in society, as m ore tating conseq uen ces. Fo r i n sta n ce, the o nset of rrrudln ( Ger­ women ch oose to conti nue th eir education with adva nced man measles ) i n the mother prior to the I 1 t h week of degrees and to start careers p rior to givi ng bi rth to their fi rst pregna ncy is likely to cause serious co nsequences i n t h e chi l d (Gibbs, 2002; Wildberger, 2003; Bornstein et al . , 2006 ) . baby, including b l i n d n ess, dea fness, heart defects , o r b ra i n Consequently, the number o f women wh o give birth i n damag e. In later stages o f a pregnancy, howeve r, a dvers e con ­ their 3 0s and 40s has grown considerably si nce the 1 970s. seq uences o f rube l l a beco m e i n c reas i n g l y less l i ke l y. However, this delay in childbirth has potential conseq uences Several other d iseases may a ffec t a devclo p i n g fetus, for both mothers' and children's heal th. Women who give agai n depen d i ng on wh en the i l l n ess i s co n t ra c t e d . Fo r birtI1 when over the age of 30 are at greater risk for a va riety instanc e, chicken pox may produce b i rt h defec ts, whereas of pregnancy and birth complications than are younger m u mps may increase the risk of m i scarr iage. mothers. For i nstance, they are more apt to give bi rth prema­ So me sexu ally t ra n s m i t ted d i s eases such a s syp h ilis ca n turely, and their children are more likely to have low b i rth be passed directly t o t h e fetus, who w i l l be bo r n s u ffer i ng weights. This occurs in part because of a decline i n the cond i ­ fro m the d i sease. In some cases, sex u a l l y t r a n s m i tted d i sease s tion o f a wom an's eggs. For example, b y t h e t i m e they a re 4 2 such as gon o rrhea a re com m u n i cated to t h e c h i ld as i t passes years old, 9 0 % of a woman's eggs are no longer normal t h rough t h e birth canal to be b o rn . A cq u i red i111 1 1 1 1 1 11e de/i­ (Cnatti ngius, Berendes, & Forman, 1 993; Gi bbs, 2002 ) . Older cie11 cy syndrome ( A IDS ) is t h e n ewest of t h e d i seases to a ffect moth ers are also considerably more l i kely to give birth to a newbo rn . Moth ers who h ave the d isease or who m erel y are children with Down syndrome, a form of mental retardat i o n . ca rriers of the v i r u s may pass i t on to t h e i r fet u ses t h ro ugh About 1 o u t o f I 00 babies born t o m others over 4 0 yea rs o f the blood that reaches the p l ace n t a . However, if m others age h a s Down syndro me; for mothers over 5 0 , t h e i n c i dence , with A I D S a re t reated w i t h a n t ivi ral d ru gs such as AZT d u r­ i n c reases to 25%, o r I i n 4 ( Gaulden, I 992 ) . O n the other i n g pregn a n cy, less than 5% o f those i n fa n ts a re b u rn w i t h hand, some re earch shows that older mothers a re not auto­ t h e d i sease. I n fa n ts w h o are bo rn w i t h A I DS m us t rem a i n o n matica l l y at risk for m o re pregnancy p robl ems. For instance, a n t iv i ral d r ugs t he i r e n t i re l i ves ( Nes h e i m et a l . , 2004 ) . one study fou n d that when women i n their 40s who had n o t experien ced health d i ffi c u l t i es were co n s i dered, they were n o Mothers' Drug U se Mothers' use o f many k i n d s o f more l i kely t h a n women i n thei r 2 0 s to have prenatal prob ­ d rugs-both legal and i l l ega l-poses s e r i o u s r i s ks to t h e u n ­ l e m s ( A les, Druzi n , & Sa n t i n i , 1 990; D i l d y et a l . , 1 996 ) . b o r n c h i l d . Eve n ove r - th e - co u n t e r remed i es fo r co m m o n 70 PAR T O N E Beg i n n i ngs Feta l a l c o h o l effects ( FAE) A cond ition in which children display some, although not all, of the problems of fetal alcohol syndrome due to the mother's consumption of alcohol during pregnancy ailment can have su rprisi ngly i njurious conseq uences. For in­ stance, aspi r i n taken fo r a h eadache can lead to fetal bleeding and growth i m pa i rments ( G r i ffith, Azu ma, & Chasnoff, 1 994 ) . Eve n d rugs p resc r i bed by medical pro fessionals have som e t i mes h ad d isast ro u s conseq uen ces. I n the l 950s, m a ny wo men who were told t o t a ke 1!,o/irlo111irle for m o rn i n g sick­ ness d u r i n g t h e i r p reg n a nc ies gave birth to children w i t h s t u m ps i nstead o f a n m and legs. Alt hough the physicians who p resc ribed the drug d i d not know it, thalido m i d e inhib­ ited the grow t h o f l i mbs that normally wou l d have occurred during t h e fi rst 3 m o n t h s of pregnancy. Some d ru gs ta ken by mothers cause d i fficulties in their children l iterally decades after t I1ey were taken. As recently as the 1 970s, rhe art i ficial hormone rliethylstiluestrol ( DES) was fre­ quently prescribed to prevent miscarriage. Only later was it found that the da ughters of mothers who took DES stood a much h igher than n�rmal chance o f developing a rare form of vagi nal or cervical cancer and had more di fficulties during their pregnancies. Sons of the mothers who had taken DES had their own p roblems, includ i ng a h igher rate than average of repro­ ductive difficulties ( Schechter, Finkelstein, & Koren, 2005 ) . B i r t h con t ro l or fert i l i ty p i l l s taken b y pregna nt women before they arc aware o f their p regnancy can also cause fetal da m age. Such medicines contain sex hormones that affect developing bra i n s t ru c t ures in the fetus. The se hormones, wh ich when prod uced naturally a re rela ted to sexual differenti­ ation i n the fetus and gender differences after birth, can cause sign ificant dam age ( M iller, 1 998; Brown, H ines, & Fane, 2002 ) . I l l ic i t d r u gs m ay pose equally great, a n d sometimes even greater, r i sks for the enviro n ments of pre natal childre n . For one t h i ng, the p u r ity of d ru gs purchased il legally varies sig­ n ifi cantly, so drug users can never be qui te s ure what speci f­ ical ly they are i ngest i ng. Furthermo re, the effects of some commonly used i l l ic i t drugs can be particu larly devastatin g ( Mayes et a l . , 2007 ) . Consider, fo r instance, the use o f 111a rij11a11n; i t is cer­ tainly one of the most co m m o n ly used illegal d ru gs-mil­ l ions o f people i n the United States have admi tted trying it. Marij u a na used d ur i ng pregnancy can restrict the o>..-y ge .n that reaches t h e fetus. Its use can lead to i n fants who are nTt ­ table, nervo us, a n d easily disturbed. Children exposed t o marijuana p renatally show learning and memory deficits at the age of 10 ( Huizink & Mulde r, 2006; Sm ith et al., 2006; Wi lliams & Ross, 2007 ) . During the ea rly l 990s, cocni,,e use by pregnant women led to an epidem i c o f thousands of so-called "crack babies." Coca i ne produces an intense restriction o f the arteries leadi ng to the fetus, ca using a significant reduction in the flow of blood and oxygen, i ncreasing the risks of fetal death and a n u mber of birt h defects and disabilities ( Schuetze, Eiden, & Coles, 2007 ) . Children whose mothers were addicted to cocaine may themselves be born addicted to the drug and may have to suffer through the pain of ,vithdrawal. Even if not add icted, they may be born with significant problems. They are often shorter and their weight is less than average, and they may have serious respiratory problems, visible birth defects, or seizures. They behave quite dif­ ferently from other infants: Their reactions to stimulation are muted, but once they start to cry, it may be hard to soothe them (Singer et al., 2000; Eiden, Foote, & Schuetze, 2007) . It is difficult to determine the long-term effects of mater­ nal cocaine use in isolation, because such drug use is often accompanied by poor prenatal care and impaired nurturi ng following birth. In fact, i n many cases it is the poo r caregiving by m others who use cocaine that results in children's prob­ lems, and not exposure to the drug. Treatment of children exposed to cocaine consequently requires not only that the ch ild's mother stop using the dru g but also a positive i m p rovement in the level of infant care that the mother or other caregivers provide. ( Brown et al . , 2004; Schempf, 2007) . M others' Use of Alcohol and Tobacco A pregnant woman who reasons that having a drink every once in a while or smokin g an occasional cigarette has no appreciable effect on her unborn child is, in all l ikelihood, kidding herself: In­ creasing evidence su gg ests that even small amounts of alco­ hol and n icotine can disrupt the development of the fetus. Maternal use of alcohol can have profound conse­ q uences for the unborn child. Alcoho lics who consume sub­ stantial quant ities of alcohol during pregnancy, place their children at the greatest risk. Ap p roximately 1 out of every 750 i n fants in the United States is born with fetal alcohol syndrome ( FAS) , a disorder that may include below- average intell igence and sometimes mental retardation, delayed growth , and facial deformities. FAS is now the primary pre­ ven table cause of mental retardation ( S teinhausen & S p ohr, 1 998; Burd et al., 2003 ; Calhoun & Warren, 200 7 ) . Even mothers who use smaller amounts of alcohol dur­ ing pregna ncy place their ch ild at risk. Fetal alcohol effects ( FAE) is a condition in which children display some, altho ugh not all, of the problems of FAS due to their mothe r's consu mption of alcohol during pregnancy ( Baer et al., 2003 ; Molina et al., 200 7 ) . Children who do n o t have FAE may sti l l b e a ffected by their mothers' use of alco hol. Studies have found that mater­ nal consumption o f an averag e o f just two alcoholic drinks a day durin g p regna ncy is associated with lower intelli gence i n their o ffsp ring at age 7 . Other research concurs, suggesting that relatively small quantities of alco h o l taken d urin g preg­ na ncy can have future adverse effects on children's behavior and psychological fu nctioning. Furthermore, the conse­ quences of alcohol ingestion during p reg na ncy are long last­ ing. For example, one study fo u nd that 1 4-yea r-o lds' success on a test i nvo lving spatial and visual reasonin g ,,v as related to their mothers' a lcohol consum p t i o n d urin g pre g nancy. The more the mothers r ported d r i n ki n g , the less accurately their chi ldren responded ( Johnson et al. , 200 l ; Lynch et a l . , 2003; Mattson, Calarco, & La ng, 2006 ) . Because o f t h e risks asso c i a ted w i t h a l c o h o l , phys i ­ c i a n s today counsel p reg n a n t wo m e n ( a n d even t h o s e w h o a r e t ry i n g to beco m e p regn a n t ) to avo i d d r i n k i ng a n v ChCl.p te r 3 The Start of Life: Genetics and Prenatal Develo pment 71 alcoholic beverages. In additio n , they c a u t i o n aga i nst smoking-an other practice p roven to h ave an adverse effect o n an unborn child. Smoking produces seve r a l c o n ­ sequences, n o n e go od. F o r sta rters, smoking reduces t h e oxygen content a n d increases t h e carbon m o n ox i d e i n t h e mother's b l o o d , which quickly reduces t h e oxyge n a va i l ­ a b l e t o th e fetus. I n additio n , the nicotine a n d o t h e r tox­ ins in cigarettes slow the res p i ration rate of t h e fet u s and speed up i t s heart. The ultim ate res ult is an increased possibility o f m iscar­ riage and a higher likelihood of death d u ring infancy. I n fact, estimates s uggest that smoking by p regnant wo men leads to more than 1 00,000 miscarriages and the deaths of 5,600 babies in the United States alone each year ( Hasl a m & Lawrence, 2004; Triche & Hossain, 2007 ) . Sm okers are two times a s l i kely a s non s m okers t o have babies with an abnormally low bi rthweight, and sm okers' babies are shorter, o n average, than those of n o n smokers. Furth ermore, women who smoke during pregnancy are 50% m o re likely to have m e ntally reta rded c h i l d ren. Finally, m others who s m o ke a re m o re l i kely to h ave c h i l ­ dren who exh i b i t disruptive behav i o r d u r i n g c h i l dhood ( D rews et a l . , 1 99 6 ; D ej i n - Karlsson et al., 1 9 9 8 ; Wa ksc h a l g et a l . , 2006 ) . The consequences of smoking are s o p ro fo u n d that i t may affect n o t o nly a mother's children, b u t h e r grandch i l ­ dren. F o r example, children whose grandmoth ers smoked during pregnancy are m ore than twice as likely to develop childhood asth ma than are children o f grandmothers who d i d not smoke ( L i et al. , 2005 ) . D o Fat h e rs Affect t h e P re n atal E n v i ro n m e nt? It wo u l d b e easy to reason that once the fa t h e r has d o n e h i s p a rt in t h e sequence o f events l ea ding to co n c e p t i o n , h e would h ave n o role in t h e prenata l environment o f the fetus. In the past, develo p m ental res e a rchers h ave general­ ly sh ared th i s vi ew, and there is relatively little research i n ­ vestigatin g it. However, it is becoming increasingly clear that fathers' b ehavi o r m ay in deed i n fluence the prenatal environment. Consequently, health practition ers are utilizing avail­ able research to suggest ways fathers can s u p p o rt healthy prenatal development, as ou r story of Lisa and Robert's visit to the midwife i l l ust rated. Prov i de r's For instance, fathers- to-be should avo id p ers pec tive: smoking. Secondhand smoke fro m a father's cig­ Ir arJ r 1t1o r , t0 avr_,1d1 g arettes may affect the mother's health, which in srrn-_, k1ng !!ha ".Jther turn influences her unborn child. The greater the sr,rts 'J rr,ir-19s might level of a father's smoking, the lower the birth­ rrnr,r:; rs - tr..,- 1:;<:, d':J tr,, nelr-, weight of h is children ( Hyssaelae, Rautava, & 1he1r x1r./::irr Heleni us, 1 995; Tomblin, Hammer, & Zhang, -.r 111r:Jri:;r, ':Je1':Jl1Jµ 1 998 ) . Simila rly, a fath er's u s e of alcohol a n d i l l egal drugs can have significant e ffects o n the fetus. Alco­ h o l a n d drug u se i m p a i r s sperm and may l ead to f 72 PA RT O N E B eg i n n i n g s ch romosomal damage that may affect the fe t u a l conception. ln addition, alcohol and drug use during p regna ncy may also affect the prenatal environ ment by c rea t i n g st ress i n t h e mot her and ge nerally prod ucing an u n healthy env i ro n m e n t . A father's expo­ sure to environmental toxins i n the wo rkp lace, such as lead or mercury, ma}' bind themselves to sperm and cause birth defect ( Wakefield et al ., 1 998; Dare et a l . , 2002; Choy ct a l . , 2002 ) . Finally, fathers w h o are phys ica l l y or e m o t i o n a l l y abusive to their pregnant wives can damage t h e i r u n b o rn c h i l d ren. By increasing the level of maternal st ress, or act u a l l y causi ng physi­ cal da mage, abusive fathers i n c rease the risk o f h a rn1 to their unborn children. In fa c t , 4% t o 8% of wo men face physical abuse during pregnancy ( Gazmarian et a l . , 2000; Bacchus, Mezey, & Bewley, 2006; M a r t i n et -,I . , 2006 ) . B eco ming a.n I nfo rmed Co ns ume r of D eve l o p me nt • Mon itor caffei n e i ntake. Although it is sti ll unclear whether caffe ine produces b i rth defects, it is known that the caffeine found i n coffee , tea, and chocolate can pass to the fetus, acting as a sti m ulant. Because of thi s, you probably should­ n ' t dri nk more than a few cups of coffee a day (Wisborg et al. , 2 003) . R EV I EW l . vVhen sperm enter the vagina, they travel thro ugh the cerv ix. and i n to the fallopian tube where ____ may take place. UO!JEZ!f!l.IJJ :JJ.M.SUV • Whether preg n ant or not, don't smoke. This holds true for mothers , fat hers , and anyone els e in the vicin ity of the preg­ nant mother, because research suggests that smoke i n the fet al environment can affect birthweig ht. • .J 2. A ___ occurs wh en pregnancy ends before the developing child is able to survive outside the mother's wo mb. JEE\.l.lEJS!lU :Jc>.M.SUV environmental age n t such as a drug, 3. An chemical, virus, o r other factor that produces a birth defect is called a Exerc i s e reg u l arly. In most cases, women can continue to exercise, particula rly exercises i nvolving low-impact rou­ tines. On the other h a n d , extreme exercise should be avoid­ ed, especially o n very hot or very cold d ays . "No pai n , no gain" isn 't applicable d u ring pregnancy (Paisley, J oy, & Price, • 2003 ; Schmidt et al . , 2 006) . uc>l3oie1;,J :.1a.M.suy � Ta see more review q 11estio1 1s, log on to /vfyDevelopmen tLa b. Opti m izing the Prenatal Envi ron ment If you are contemp lating ever h aving a chi l d , yo u may be over­ w hel med , at this point in the c h a pter, by t h e n u m ber of things that can go wron g . Don't be. Although both genetics and the environ ment pose their share of risks, in the vast major ity of case s , p reg na ncy and birth proceed without m i s h a p . M o reov er, there a re several t h i n g s that women can do-bo t h be fore and d u ring preg nan cy-to optimize the p robabil ity that pre gn ancy will p rog ress smoothly (Massaro , Rothbau m , & Aly, 20 06) . Amon g the m : • • For women who are p l a n n i n g to become p reg n a n t , s evera l p reca utio n s a re in o rd e r. Fi r st , wome n s h o u l d h ave n o n ­ emerge ncy X- ray s o n l y d u r i n g t h e f i r s t 2 weeks afte r their menstru al p e ri o d s . Seco n d , women s h o u l d b e va cci n ated a g a i n st rubel l a (German measl es) at l east 3 a n d prefe rabl y 6 mo nths b efore gett i n g preg n a n t . F i n a l ly, w o m e n who are p l a n n i n g to b ecome pregn ant s h o u l d avo i d t h e u se of birth co n tro l p i l l s at least 3 m o n t h s before try i n g to c on ceiv e, be cause of disruptions t o h o rmonal p ro d u c t i o n cau se d by th e p i l ls . Eat w el l , both before and d u ring (and after, for that m atter!) pregnancy. Pregnant mothers are , as th e sayi ng goes, eating for two. This means that it i s more essential th a n ever to eat regular, wel l- balanced meals . I n addition , physicians typically recommend taki ng prenatal vitam i n s which include fo lic acids, which can decrease the likelihood of birth defects (Amit ai et al . , 2004 ). • D o n ' t u s e a l c o h o l a n d other d r u g s . T h e e v i d e nc e i s clea r t h at m a n y d ru gs pass d i rectly to t h e fet u s and may cause b i rt h d efects . I t i s also c lear t h at the m o re on e d r i n k s , the g reater the ri s k to t h e fet u s . T h e best a d v i c e , w h et h er y o u are a l ready pre g n a n t or p l a n n i n g to h ave a c h i l d : Do n 't u s e any d r u g u n l e s s d i rected by a p h y s ic i a n . I f you are p l an n i n g t o get p reg n a n t , e n c o u ra g e your p a rt n e r to avo i d using a l c o h o l o r other drugs too ( O ' C o n n o r & Wha­ ley, 2 0 0 6) . CASE STU DY T h e C a s e of . . . T h e G e n et i c F i n g e r of Fat e Melindah and Jermain Tessel were incred i bly happy last week when they learned that M e l i n d ah was pregnant with their first c h i l d , but now they ' re so worri ed they can 't sleep. When they got home from the physican 's visit, they began _ to o i j k n gly consider such characteristics as height (tal l l i ke _ Melm ­ dah or on the short side, l i ke Jermain) , tendency to obesrty (like Jermain) , ath l etic abil ity (like Melindah ), intell igence (h i g h , of cou rse, l i ke both of them), and so o n . But then they turned to other traits. Even as adu lts both Melinda h and J ermai n are overly shy and quiet, and they wish they were more assertive . Neither is a natural leader or confiden t public speaker, but they want their child ren t o be. Both were loners when they were younger, and they agree that their kids wou ld have an easier time if they turn ed out to be more sociab le and outgoing. They worry whether these personal ity traits are prede termined , o r if their kid s' fates can be d i fferent. Later, the conversat ion got even more u nsettling. Melind ah remem bered that there was some mental illness in her family and th ere were even rumors of violent behavior by one of her uncles. This prompted Jermain to recall an alcoholic cousi n and a more d i stant relative who, he thought, had d i ed early from sickle-cell anemia. There seems to be so many th i n g s that cou ld go w rong-al l because of the baggage they carry in their genes! 1 . How would you beg in to reass u re Mel indah and J er­ main about their worries? 2 . Which c haracteristics that they discussed are largely genetic, and which are more e nvi ronmentally influ­ enced? Are the geneti c traits equ ivalent to fate, or can their expression be modified? Why or why not? 3. How much should M e l i ndah worry about the m ental i l l ­ ness a n d violence in h e r fam i ly ? What w ould yo u tell her? 4. H ow much sho uld Jermain worry about his c hildren in­ heriting sickle-cell anemia? 5. Wou ld you advise Meli ndah and Jermain to s eek ge­ netic counseling? Why or why n ot? What factors wou ld you consider i n advisi n g them to visit or not to visit a counselor? C h. titpter 3 The Start of Life : G e n etics and Prenatal Development 73