Fetal behavior in diabetic and nondiabetic pregnant women: An exploratory study

Allen, C. L.; Kisilevsky, Barbara S.

doi:10.1002/(sici)1098-2302(199907)35:1<69::aid-dev9>3.0.co;2-w

Cited by 35 publications

(4 citation statements)

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“…Abnormalities in behavioural state cycling precede abnormalities in general movement quality in IUGR fetuses [59], whilst fetuses of diabetic women exhibit delayed behavioural state organisation [60] and changes in fetal behaviour are seen on ultrasound prior to evidence of ‘brain-sparing’ [61]. It has been hypothesised that these changes are indicative of neurodevelopmental delay in these fetuses, however they might just as likely be indicative of altered metabolic environment [62]. …”

Section: Discussionmentioning

confidence: 99%

“…The possibility of actual reduction in fetal movements in obese women during pregnancy, as opposed to reduced perception has not been ruled out. Studies have shown fetal activity is reduced in pregnancies complicated by diabetes [62, 65]. In diabetic pregnancies, resulting in fetal hyperglycaemia and hyperinsulinaemia, the risk of fetal hypoxemia and acidaemia are increased due to competing oxygen requirements [33].…”

Section: Discussionmentioning

confidence: 99%

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Fetal response to maternal hunger and satiation – novel finding from a qualitative descriptive study of maternal perception of fetal movements

Bradford

Maude

2014

BMC Pregnancy Childbirth

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BackgroundMaternal perception of decreased fetal movements is a specific indicator of fetal compromise, notably in the context of poor fetal growth. There is currently no agreed numerical definition of decreased fetal movements, with the subjective perception of a decrease on the part of the mother being the most significant definition clinically. Both qualitative and quantitative aspects of fetal activity may be important in identifying the compromised fetus. Yet, how pregnant women perceive and describe fetal activity is under-investigated by qualitative means. The aim of this study was to explore normal fetal activity, through first-hand descriptive accounts by pregnant women.MethodsUsing qualitative descriptive methodology, interviews were conducted with 19 low-risk women experiencing their first pregnancy, at two timepoints in their third trimester. Interview transcripts were later analysed using qualitative content analysis and patterns of fetal activity identified were then considered along-side the characteristics of the women and their birth outcomes.ResultsThis paper focuses on a novel finding; the description by pregnant women of fetal behaviour indicative of hunger and satiation. Full findings will be presented in later papers. Most participants (74% 14 of 19) indicated mealtimes were a time of increased fetal activity. Eight participants provided detailed descriptions of increased activity around meals, with seven (37% 7 of 19) of these specifying increased fetal activity prior to meals or in the context of their own hunger. These movements were interpreted as a fetal demand for food often prompting the mother to eat. Interestingly, the women who described increased fetal activity in the context of hunger subsequently gave birth to smaller infants (mean difference 364 gm) than those who did not describe a fetal response to hunger.ConclusionsFood seeking behaviour may have a pre-birth origin. Maternal-fetal interaction around mealtimes could constitute an endocrine mediated communication, in the interests of maintaining optimal intrauterine conditions. Further research is warranted to explore this phenomenon and the potential influence of feeding on the temporal organisation of fetal activity in relation to growth.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Fetal response to maternal hunger and satiation – novel finding from a qualitative descriptive study of maternal perception of fetal movements

Bradford

Maude

2014

BMC Pregnancy Childbirth

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“…Fetal response to the mother's or a female stranger's voice was examined. Differential fetal responding to sensory stimuli has been reported in previous studies of low risk, uneventful pregnancies compared to pregnancies complicated by conditions associated with nutritional/oxygen deprivation-for example, studies investigating mother's voice and preeclampsia , mother's voice and hypertension (Lee et al, 2007), vibroacoustic stimulus and hypertension (Warner et al, 2002), vibroacoustic stimulus and diabetes (Allen & Kisilevsky, 1999), mother's voice and diabetes (Kisilevsky et al, 2012), and mother's voice and smoking (Cowperthwaite et al, 2007)-which is the most common cause of growth restriction (Giles et al, 1985;Resnik, 2002;Trudinger et al, 1987).…”

Section: Study 1: Auditory-information Processing In Sga Fetusesmentioning

confidence: 92%

“…Researchers investigating animal models of placental insufficiency have demonstrated subtle deficits in neural conduction, which may have implications for auditory perception (Rees, Proske, & Harding, 1989;Rehn et al, 2002). In addition, differential fetal cardiac responses to auditory probes have been reported in comparisons of low-risk, uneventful, and high-risk pregnancies complicated by conditions associated with nutritional/oxygen deprivation, such as preeclampsia , hypertension (Lee, Brown, Hains, & Kisilevsky, 2007;Warner, Hains, & Kisilevsky, 2002), diabetes (Allen & Kisilevsky, 1999;Kisilevsky, Gilmour, Stutzman, Hains, & Brown, 2012), and smoking (Cowperthwaite, Hains, & Kisilevsky, 2007). Taken together, these findings indicate that fetal auditory-system development may influence subsequent language abilities.…”

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confidence: 99%

Auditory Processing in Growth-Restricted Fetuses and Newborns and Later Language Development

Kisilevsky

Chambers

Parker

et al. 2013

Clinical Psychological Science

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Growth-restricted fetuses and newborns are at increased risk for language deficits, and language impairments have been associated with increased risk for cognitive, social, emotional, and behavioral clinical disorders. Auditory-information processing was examined longitudinally in 167 fetuses in Study 1, 96 of whom were reexamined as newborns in Study 2. In Study 3, language was assessed at 15 months of age for 75 infants from Study 1. Compared with participants who were appropriately grown for gestational age, growth-restricted fetuses showed less sustained response to their mother's voice; growth-restricted newborns showed less recovery to a novel word after habituation and no preference for their mother's voice. At 15 months of age, those infants who had been born growth restricted showed expressivelanguage deficits on Mullen Scales of Early Learning and MacArthur-Bates Communicative Development Inventory subscales. Our results support the hypothesis that fetal growth restriction affects the development of auditory-system functioning and indicate that it may be possible to identify individual fetuses and newborns at risk for language deficits and to intervene early, when the foundation for language is being laid.

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Fetal cyclic motor activity in diabetic pregnancies: Sensitivity to maternal blood glucose

Robertson

Dierker

2002

Developmental Psychobiology

266

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Spontaneous fetal movement in the last third of human gestation is dominated by irregular oscillations on a scale of minutes (cyclic motility, CM). The core properties of these oscillations are stable during the third trimester of gestation in normal fetuses, but disrupted by poorly controlled maternal diabetes. Here we investigated whether fetal CM is linked to short-term instabilities in maternal glucose metabolism. The fetuses of 40 mothers with type I (n = 28) or gestational (n = 12) diabetes were studied one to six times between 27 and 40 postmenstrual weeks of gestation. Fetal movement and maternal blood glucose concentration were measured during two separate periods of fetal activity in each session. Fetal CM was quantified with spectral analysis. Early in the third trimester, changes in the rate of oscillation in fetal CM between the two periods of activity were inversely related to changes in maternal blood glucose levels. Fetal CM was unrelated to concurrent maternal blood glucose levels at any point in the third trimester. The pattern of results suggests that disruption of the temporal organization of spontaneous fetal motor activity in pregnancies complicated by maternal diabetes represents an acute response to fluctuations in the metabolic environment rather than an alteration of CM development.

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Fetal behavior in diabetic and nondiabetic pregnant women: An exploratory study

Cited by 35 publications

References 50 publications

Fetal response to maternal hunger and satiation – novel finding from a qualitative descriptive study of maternal perception of fetal movements

Fetal response to maternal hunger and satiation – novel finding from a qualitative descriptive study of maternal perception of fetal movements

Auditory Processing in Growth-Restricted Fetuses and Newborns and Later Language Development

Fetal cyclic motor activity in diabetic pregnancies: Sensitivity to maternal blood glucose

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