The authors investigated the association between maternal psychological and fetal neurobehavioral functioning. Data were provided by 52 maternal-fetal pairs at 24, 30, and 36 weeks gestation. The relations between maternal measures and fetal heart rate, variability, and motor activity were statistically modeled. Fetuses of women who were more affectively intense, appraised their lives as more stressful, and reported more frequent pregnancy-specific hassles were more active across gestation. Fetuses of women who perceived their pregnancy to be more intensely and frequently uplifting and had positive emotional valence toward pregnancy were less active. Associations with fetal heart-rate measures were detected at 36 weeks gestation. These data provide evidence for proximal effects of maternal psychological functioning on fetal neurobehavior.

Maternal stress and affect influence fetal neurobehavioral development.

The ontogeny of fetal autonomic, motoric, state, and interactive functioning was investigated longitudinally in a sample of 31 healthy fetuses from 20 weeks through term. Fetal heart rate and movement data were collected during 50 min of Doppler-based fetal monitoring at 6 gestational ages. Measures of fetal heart rate and variability, activity level and vigor, behavioral state, and reactivity were derived from these digitized data. Weighted least squares analyses were conducted to model the developmental patterns and to examine the role of maternal and fetal covariates. With advancing gestation, fetuses displayed slower heart rate, increased heart rate variability, reduced but more vigorous motor behavior, coalescence of heart rate and movement patterns into distinct behavioral states, and increasing cardiac responsivity to stimulation. Male fetuses were more active than female fetuses, and greater maternal stress appraisal was associated with reduced fetal heart rate variability. An apparent period of neurobehavioral transition exists between 28 and 32 weeks. Fetal research methods are evaluated.

Fetal Neurobehavioral Development

Development of fetal movement--fetal heart rate coupling from 20 weeks through term.

This study established the emergence of stable individual differences in neurobehavioral functioning prior to birth and examined their relation to subsequent infant temperament. Fetal heart rate and movement were recorded longitudinally for 31 fetuses at 6 gestational ages beginning at 20 weeks' gestation. Maternally reported temperament data were collected at 3 and 6 months. Moderate stability in all measures except reactivity was apparent at some time before birth. By 36 weeks, fetal neurobehavior accounted for between 22% and 60% of the variance in prediction of temperament scores. In general, more active fetuses were more difficult, unpredictable, unadaptable, and active infants. Higher fetal heart rate was associated with lower emotional tone, activity level, and predictability. We conclude that features of fetal neurobehavior provide the basis for individual differences in reactivity and regulation in infancy.

Fetal Antecedents of Infant Temperament

This study evaluated whether motor activity prior to birth is predictive of motor behavior and temperament in neonates, infants, and toddlers. Three measures of fetal motor activity (activity level, amplitude, and number of movements) were collected at 24, 30, and 36 weeks of gestation in 52 healthy fetuses using Doppler-based actography. Postnatal data collection included a neurobehavioral assessment at 2-weeks postpartum (n = 41), and laboratory-based behavioral observations at 1 and 2 years of age (ns = 35). Individual stability in motor activity was present during gestation. Predictive relations between fetal movement and neonatal behavior were inconsistent; significant but small positive associations were detected between motor behavior at 36 weeks and neonatal irritability and motor development. Fetal activity level at 36 weeks was positively associated with observed 1-year activity level for boys (but inversely related for girls) and maternal report of activity level at 2 years. Fetal movement was consistently and negatively predictive of distress to limitations at 1 year and behavioral inhibition at 2 years, accounting for 21 to 43% of the variance in these measures. Intrafetal variability in motor behavior makes this a relatively unstable metric for prediction to neonatal maturational outcomes, which are relatively constrained, but fetal motor activity appears to predict temperament attributes related to regulatory behaviors in early childhood.

What does fetal movement predict about behavior during the first two years of life

Two cases of physiologic sinusoidal FHR pattern and one case of pathologic sinusoidal FHR pattern recorded on fetal actocardiograms are reported. The physiologic sinusoidal FHR patterns were recorded during periodic fetal respiratory movements and sucking movements. The physiologic sinusoidal FHR patterns were accompanied and synchronized with periodic fetal movement bursts. The pathologic sinusoidal FHR pattern observed in a case of severe fetal anemia due to massive fetal-to-maternal hemorrhage was not accompanied by any fetal movement bursts. It is suggested that with the use of fetal actocardiogram physiologic sinusoidal FHR pattern can be distinguished from pathologic sinusoidal FHR pattern.

Differentiation between physiologic and pathologic sinusoidal FHR pattern by fetal actocardiogram.

Actocardiogram is the simultaneous recording of fetal movement (FM) and fetal heart rate (FHR) with the use of a single transducer by weak ultrasound. Fetal behavioral states, fetal hiccups, nonpathologic sinusoidal FHR pattern induced by cyclic FM were reported in the use of this technique. Computer processing of FM signals enabled automatic recognition of fetal behavior. Fetal hypoxic state preceding fetal distress was diagnosed by the actocardiogram. Cross-correlation coefficient of FHR and delayed FM was high, showing a new possibility of detailed grading of mild fetal hypoxia.

Objective and quantitative evaluation of fetal movement with ultrasonic Doppler actocardiogram.

Gross fetal movement was detected using a lower frequency ultrasonic Doppler shift than that used in the study of fetal heart action. The movement signal was changed into deflection which was recorded on CTG chart simultaneously with the fetal heart rate (FHR), and was called the fetal actocardiogram. Visual analysis of the actocardiogram showed bursts of active fetal movements in the active fetal state which were concordant with acceleration of FHR. The analysis was useful in the study of fetal behavioural states. Imminent fetal distress produced a loss of FHR acceleration which was accompanied by a burst of fetal movement, i.e. a true non-reactive state of the FHR. The output of the actocardiograph was analysed using a PC98XA computer with a simple statistics of deflection amplitude and interval, displayed as 3-dimensional histograms of the number and frequency, and the formation of the envelope curve of the deflections. The study demonstrated that it is possible to recognize fetal behavioural states automatically. This includes active and resting fetal states as well as fetal breathing movements.

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Kazuhiko Nakajima

Papers

Differentiation between physiologic and pathologic sinusoidal FHR pattern by fetal actocardiogram.

Objective and quantitative evaluation of fetal movement with ultrasonic Doppler actocardiogram.

The ultrasonic Doppler fetal actocardiogram and its Computer processing