A. Kurjak, M. Stanojevic, W. Andonotopo, A. Salihagic-Kadic, J.M. Carrera, Guillermo Azumendi
Behavioral pattern continuity from prenatal to postnatal life a study by four-dimensional (4D) ultrasonography
Aim: To investigate whether the same behavioral patterns
were present pre- and postnatally, and whether there
were any differences in the frequency of movements
observed in fetal and in early neonatal life.
Subjects and methods: Ten out of 37 pregnant women
in the third trimester of pregnancy (median gestational
age 34 weeks, range 33 to 35 weeks) in the two-month
period (from November 1st to December 31st, 2003) were
enrolled in the investigation. Ten term, appropriate for
gestational age newborns (seven born vaginally, three by
elective SC, six girls, six first-born) and were enrolled in
the study. All 4D examinations were performed on Voluson
730 (Kretztechnik, Zipt, Austria) and Acuvix (Medison,
Korea) with transabdominal 5 MHz transducer. After
standard assessment in 2D B-mode ultrasound, a 4D
mode was switched on and live 3D image was reconstructed
by selecting the ideal representative 2D image
placed in the region of interest (ROI). The recordings of
neonatal behavior were made on the Sony P-612 OHMPL
videotape by video camera (Sony Camcoder CC DTRV
318 Hv8) and reviewed on the videocassette recorder
(Sony VHS SLV-N 900). The median of newborns' age at
the moment of recording was 49 hours (range 4 to 112).
During the examination, newborns were lying in the bed,
separated from other infants in the nursery, dressed, and
lying on their backs in a supine position with unrestrained
hands. The temperature in the room was 22 to 24°C. The
video recording was performed mainly while the children
were actively awake or during alert inactivity.
Results: There were no movements observed in fetal life
that were not present in neonatal life, while the Moro
reflex was present only in neonates. The most frequent
fetal and neonatal movements were scowling, eye and
mouth opening, and hand to face, hand to eye and hand
to head movements. Isolated blinking, mouth to eyelid
movement, yawning, tongue expulsion and scowling
were more frequent in neonates than in fetuses, although
the difference was not statistically significant. Hand to
mouth movements were more frequent in neonatal than
in fetal life while all other hand movements were less frequent
in neonates than in fetuses, although the differences
did not reach statistical significance. Spearman
rank order correlation reached statistical significance in
smiling (R=0.71; t=2.91; P=0.02) and in hand to ear
movement (R=0.80; t=3.86; P=0.005), and was almost
statistically significant in isolated eye blinking (R=0.61;
t=2.17; P=0.06), while the correlations between the rest
of the movements were not statistically significant.
Conclusions: 4D ultrasonography is a powerful tool in
the assessment of fetal behavior, and our study showed
that there is a continuity from fetal to neonatal behavior,
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.
Journal of Perinatal Medicine, Walter de Gruyter
Print ISSN: 1619-3997
Volume: 32, 07/2004
Pages: 346 - 353
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