Spontaneous motor activity in normal fetuses
Introduction
The spontaneous motor activity of fetuses reflects the activity of the central nervous system (CNS) and is, therefore, the focus of much attention because it represents an important means to understand the mechanisms underlying CNS development [1].
The most important data in this field have been reported by Nijhuis et al. [2] and Prechtl [3] and are based on a series of detailed studies on the sequences of the motor activity of normal fetuses, as well as on their experience in the field of evolutionary neurology. They found that the body and eye movements of a fetus are characterised by a series of stable and recurrent sequences that become more distinct as gestation progresses, to make up—along with cardiac activity—a set of true behavioural states [2], [4].
Other authors have focused their analyses on the evolution of the single fetal activities during gestation. Their studies were able to underline a decrease in the incidence of body movements [5] as pregnancy progresses and to detect other fetal activities, such as mouth movements. This activity has aroused great interest especially since the discovery of two different types of movements: pure mouth movements (opening and closing, swallowing, protruding the tongue, etc.) and the so called ‘mouthing’ movements, which are mouth movements characterized by specific rhythm and frequency [6]. In particular, research studies by Pillai and James [6] and Horimoto et al. [7] have shown that mouthing movements are associated with better neurological outcome in the newborn. This activity seems to play an important role also in premature newborns. As a matter of fact, Casaer et al. [8] showed that among preterm babies with a good coordination between suction and breathing, only 12% had poor cardiorespiratory control, whereas this figure was as high as 79% among those who were unable to coordinate these two activities. He, thus, concluded that the observation of coordination between sucking and breathing could be a suitable screening method to evaluate the neurological activity in preterm babies.
Therefore, we have studied these activities (eye, body and mouth movements) and analyzed them in relation to three different gestation periods (28, 34 and 38 weeks) already shown to reflect crucial stages of fetal development [2], [3], [4], [5], [6], [7].
The aim of this study was to perform a quantitative analysis of different fetal activities (eye, body and mouth movements) and to evaluate whether they present trend in normal pregnancies.
Section snippets
Subjects
The fetuses of 15 women with normally evolving pregnancies were evaluated by echography at 28, 34 and 38 weeks of gestation.
All women gave their informed consent. The study was approved by the Ethics Committee of the Federico II University.
Exclusion criteria were congenital malformations, chromosomal defects or intrauterine infections in the fetus, and Type 1 diabetes and use of alcohol or drugs in the mother.
The selection criteria for the newborns were:
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apgar score at birth (≥7 at 5 min of age)
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Methods
Each fetus underwent three 60-min echographic recordings at 28, 34 and 38 weeks of gestation. All tape recordings were performed between 1:00 p.m. and 3:00 p.m., with the mother in a semisupine position. A parasagittal scan of the fetus was made that visualised the upper segment of the thorax, the mouth and at least one eye. The limbs were visualised only when there were movements that involved the whole body of the fetus (i.e. gross body movements).
The fetal activities observed were as follows.
Results
The statistical analysis of the trend of the incidence of the four activities studied in three different gestational periods revealed statistically significant changes only in BM and MM. In particular, a gradual decrease was recorded for BM at the same time as mouthing movements increased (Table 1, 28 vs. 38, P<0.05). Once again, the changes concerning the intervals of the different activities were statistically significant only for BM and MM (28 vs. 38, P<0.05). BM showed a trend towards
Discussion
The results of this study confirm and expand other reports in the literature [5], [9], [10]. Our analysis of fetal movements allowed us to identify how a coordinated motor activity gradually develops,eventually leading to the behavioral states described by Nijhuis et al. [2] and Roodenberg et al. [4].This study is in agreement with those of other authors [2], [7] in showing a trend during pregrancy expressed by the changes in the various activities studied and their capacity to synchronise.
The
Acknowledgements
We are most grateful to Miss Rosanna Scala and Mr. Ken Tobyn for editing the manuscript.
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