Relationship of fetal breathing movement pattern to surfactant phospholipid levels in amniotic fluid and postnatal respiratory complications.

Fetal breathing patterns in 102 patients delivering before 37 weeks of gestation were divided into three types by the duration of successive respiratory activity using an ultrasonic scanner. Approximately 80% of the fetuses with fetal breathing absent or less than 9 s developed neonatal respiratory complications, including 11 cases of severe RDS and 8 cases of apnea of prematurity. However, no infant showing breathing activity of 30 s or more in utero experienced severe respiratory complications after birth. Furthermore, the surfactant phospholipid concentration in amniotic fluid was significantly increased with prolongation of successive fetal breathing activity. These results suggest that the duration of successive fetal breathing movements closely relates with fetal lung development including biochemical and neuromuscular systems in the humans, i.e. functional maturation of the fetal respiratory system, and also that prenatal analysis of breathing patterns may permit evaluation of pulmonary functional capacity after birth.