DiPietro Janet A
Department of Population and Family Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
Ment Retard Dev Disabil Res Rev. 2005;11(1):4-13. doi: 10.1002/mrdd.20047.
The complexities of neurobehavioral assessment of the fetus, which can be neither directly viewed nor manipulated, cannot be understated. Impetus to develop methods for measuring fetal neurobehavioral development has been provided by the recognition that individual differences in neurobehavioral functioning do not originate with birth and acceptance of the key contribution of the antenatal period to postnatal life. Research has centered around four aspects of fetal functioning: heart rate, motor activity, behavioral state, and responsivity to stimulation. Longitudinal studies have revealed that the developmental trajectories of these characteristics parallel the developing nervous system, detected a transitional period between 28 and 32 weeks gestation, and established within-fetal stability during the second half of gestation. Despite the promise of fetal stimulation and habituation paradigms as measures of neural functioning, significant safety and ethical concerns exist. Construction of a unified fetal neurobehavioral scale is premature until a sufficient degree of normative data is available and the predictive validity of specific aspects of fetal neurobehavior to child developmental outcomes is better established.
胎儿神经行为评估的复杂性不可小觑，因为胎儿既无法直接观察，也不能进行操控。认识到神经行为功能的个体差异并非始于出生，以及产前阶段对产后生活的关键作用，这为开发测量胎儿神经行为发育的方法提供了动力。研究主要围绕胎儿功能的四个方面展开：心率、运动活动、行为状态以及对刺激的反应性。纵向研究表明，这些特征的发育轨迹与发育中的神经系统平行，在妊娠28至32周之间检测到一个过渡期，并在妊娠后半期确定了胎儿内部的稳定性。尽管胎儿刺激和习惯化范式有望作为神经功能的测量方法，但仍存在重大的安全和伦理问题。在获得足够程度的规范数据并更好地确定胎儿神经行为的特定方面对儿童发育结果的预测效度之前，构建统一的胎儿神经行为量表还为时过早。
