Patterns of gross fetal body movements over 24-hour observation intervals during the last 10weeks of pregnancy

Patrick, John; Campbell, Karen; Carmichael, Lesley; Natale, Renato; Richardson, Bryan

doi:10.1016/s0002-9378(16)32375-4

Cited by 433 publications

(125 citation statements)

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“…[18][19][20][21] Progressive differentiation of the central nervous system correlates with the development of general movements in the early fetal period, whereas transient organization and further maturation of central nervous system is expressed as a behavioral pattern resembling goal-directed behavior in the late fetal period and transient behavioral pattern in the early neonatal period. 22 The results of our study suggest a need for further investigation of prenatal twins' activity in a larger sample.…”

Section: Discussionmentioning

confidence: 68%

Twins’ temperament: early prenatal sonographic assessment and postnatal correlation

et al. 2009

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Objective: To study inter-twin differences in activity during early pregnancy and to examine their relationship to subsequent infant twins' temperament.Study Design: Measures of fetal motor activity (frequency, duration and number of movements) were collected from 26 twin pairs during ultrasound nuchal translucency scan at late first trimester and early second trimester (11 to 14 weeks gestation). In twenty-two patients, the twins were dizygotic (dichorionic); of them, 13 twin pairs were of different sexes, five were both females and four were both males. Of the four monozygotic twin pregnancies, two were dichorionic and two were monochorionic, three were both females.The more active fetus in each pair was noted according to the position and/or sex without reporting to parents. Reported maternal perception of the more active twin was documented at the mid-trimester anatomical scan.Maternally reported postnatal temperament data of the infants were collected at 3 and 6 months, using Rothbarts' Infant Behavior Questionnaire (IBQ).Results: After birth, maternal reports on infants' temperament and the more active twin in each pair were in good correlation with prenatal inter-twin differences in activity. The receiver operating characteristic (ROC) curves shows a better performance of ultrasound compared with maternal perception in prediction of the more active twin. Conclusions:The features of fetal neurobehavioral activity provide the basis for individual differences in twins' activity in infancy. Differences in activity in early pregnancy even before the emergence of fetal behavioral patterns were followed by temperamental differences postnatally. Keywords: twins; temperament; ultrasound; fetal movements; activity Introduction Fetal motor activity seems to predict temperament attributes related to regulatory behaviors in early childhood. 1 Using fourdimensional (4D) ultrasonography for the assessment of fetal behavior, a continuity from fetal to neonatal behavior was shown, 2 especially in terms of isolated eye blinking movements, mouth and eyelid opening, yawning, tongue expulsion, smiling, scowling and hand movements directed to other parts of the face.Physiological markers of individual differences in infant temperament are identifiable in the fetal period, and are possibly shaped by the prenatal environment. 3 Twins' gestations provide an opportunity to study the behavioral differences between pairs. Temperament variations were studied from the neonatal period to childhood. [4][5][6][7] Twin and adoption studies suggest that individual differences in infant and child temperament are genetically influenced. 8 Developmental aspects of behavioral organization were investigated in fetuses during the second and third trimester. Fetal behavioral states were defined according to the pattern and sequence of fetal motor activities throughout this period. [9][10][11] However, behavioral state variables before 36 weeks of gestation are not synchronized.Our objective was to study inter-twin differences in activity during e...

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Section: Discussionmentioning

confidence: 68%

Twins’ temperament: early prenatal sonographic assessment and postnatal correlation

et al. 2009

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“…Diurnal rhythms of FHR and its variation, body and breathing movements exist in the second half of pregnancy (5)(6)(7)(8). FHR peaks during the day and minimum values are reached between 0200 and 0600 h, whereas FHR variation reaches lowest values between 0600 and 1200 h and peaks around 2400 h (6).…”

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confidence: 99%

Transient Loss of the Diurnal Rhythms of Fetal Movements, Heart Rate, and Its Variation after Maternal Betamethasone Administration

et al. 2005

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Antenatal betamethasone administration to enhance fetal lung maturation is associated with transient reductions in fetal heart rate (FHR) variation, breathing, and body movements 2 d after the first dose (d 2). This study examines whether steroid administration affects the natural diurnal rhythms of fetal variables. Sixteen women at 27-32 wk of gestation received two doses of betamethasone 24 h apart. One-hour recordings of FHR, breathing, and body movements were made in the morning, afternoon, and evening of d 2, and again in the morning of d 3. Repeat recordings were obtained at 4 -6 d later from 9/16 women. Maternal blood samples were obtained with each recording to determine ACTH and cortisol. No diurnal rhythm was present for FHR, FHR variation, breathing, and body movements on d 2. This resulted from suppression of the expected natural rise in body and breathing movements, and heart rate variation in the course of the day. Suppression of the diurnal rhythm of body movements depended on gestation (R ϭ Ϫ0.89; p Ͻ 0.01). All variables showed diurnal rhythms 4 -6 d later. Maternal ACTH and cortisol diurnal rhythms were completely suppressed on d 2. Four to six days later, the normal diurnal pattern was resumed, although absolute levels of ACTH and cortisol were still suppressed. We conclude that maternal betamethasone administration transiently abolishes the fetal diurnal rhythms of heart rate and its variation, breathing, and body movements. Abbreviations FHR, fetal heart rate GR, glucocorticoid receptor LTV, long-term variation MHR, maternal heart rate SCN, suprachiasmatic nuclei STV, short-term variation In cases of threatened preterm delivery, synthetic glucocorticoids are administered antenatally to enhance fetal lung maturation. A meta-analysis by Crowley (1) showed that antenatal glucocorticoids not only reduced the incidence of respiratory distress syndrome by 50% but also the incidences of neonatal mortality, periventricular hemorrhage, and necrotizing enterocolitis. In 1994, this led to a recommendation by the National Institutes of Health to routinely administer either betamethasone or dexamethasone to all pregnant women at risk of preterm delivery before 34 wk of gestation (2). We have previously shown a transient reduction in fetal heart rate variation, breathing, and body movements 2 d after the first dose of betamethasone was administered (d 2) with a return to normal values 2 d later (3). It is not known what the effects were throughout d 2, i.e. whether diurnal rhythmicity is affected or not. Although our findings could be suggestive of fetal hypoxemia, we did not find any changes in Doppler flow velocity waveforms in the uterine and umbilical arteries after betamethasone administration, nor did we find increased occurrence of fetal heart rate decelerations or a reduction in fetal eye movements (3,4). We concluded that the observed effects were more likely the result of a glucocorticoid receptor mediated process in the fetal brain.Diurnal rhythms of FHR and its variation, body and breathing mo...

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“…In the literature the maternal perception ranges between 37 and 80% [17,19]. Although as stated the number of events recorded by the Actocardiograph is somewhat higher than the number of movements, the results obtained with the Actocardiograph is of the same order of magnitude as the quoted studies [3,4,13]. If only clusters are considered they always represent movements, but then the actual number of movements is underestimated.…”

Section: Discussionmentioning

confidence: 95%

“…If few movements are noted the fetus may be asleep and in order to ensure correct interpretation the recordings must last at least 45 minutes. PATRICK et al [13] using continuous real time observation lasting 24 hours in each of the 31 uncomplicated pregnancies between 30 and 39 weeks of gestation only in 1 % of the total observation noted an absence of movements for more than 45 minutes. None of the fetuses rested longer than 75 minutes.…”

Section: Discussionmentioning

confidence: 99%

Combined electronic fetal heart rate and fetal movement monitor — a preliminary report

Schwöbel

Fallenstein²,

Huch³

et al. 1987

Journal of Perinatal Medicine

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Patterns of gross fetal body movements over 24-hour observation intervals during the last 10weeks of pregnancy

Cited by 433 publications

References 17 publications

Twins’ temperament: early prenatal sonographic assessment and postnatal correlation

Twins’ temperament: early prenatal sonographic assessment and postnatal correlation

Transient Loss of the Diurnal Rhythms of Fetal Movements, Heart Rate, and Its Variation after Maternal Betamethasone Administration

Combined electronic fetal heart rate and fetal movement monitor — a preliminary report

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