DiPietro Janet A, Costigan Kathleen A, Voegtline Kristin M
Monogr Soc Res Child Dev. 2015 Sep;80(3):vii;1-94. doi: 10.1111/mono.v80.3.
Among the earliest volumes of this monograph series was a report by Lester Sontag and colleagues, of the esteemed Fels Institute, on the heart rate of the human fetus as an expression of the developing nervous system. Here, some 75 years later, we commemorate this work and provide historical and contemporary context on knowledge regarding fetal development, as well as results from our own research. These are based on synchronized monitoring of maternal and fetal parameters assessed between 24 and 36 weeks gestation on 740 maternal-fetal pairs compiled from eight separate longitudinal studies, which commenced in the early 1990s. Data include maternal heart rate, respiratory sinus arrhythmia, and electrodrmal activity and fetal heartrate, motor activity, and their integration. Hierarchical linear modeling of developmental trajectories reveals that the fetus develops in predictable ways consistent with advancing parasympathetic regulation. Findings also include:within-fetus stability (i.e., preservation of rank ordering over time) for heart rate, motor, and coupling measures; a transitional period of decelerating development near 30 weeks gestation; sex differences in fetal heart rate measures but not in most fetal motor activity measures; modest correspondence in fetal neurodevelopment among siblings as compared to unrelated fetuses; and deviations from normative fetal development in fetuses affected by intrauterine growth restriction and other conditions. Maternal parameters also change during this period of gestation and there is evidence that fetal sex and individual variation in fetal neurobehavior influence maternal physio-logical processes and the local intrauterine context. Results are discussed within the framework of neuromaturation, the emergence of individual differences, and the bidirectional nature of the maternal-fetal relationship.We pose a number of open questions for future research. Although the human fetus remains just out of reach, new technologies portend an era of accelerated discovery of the earliest period of development
本专著系列最早的几卷中,有一篇由备受尊敬的费尔斯研究所的莱斯特·桑塔格及其同事撰写的关于人类胎儿心率作为发育中神经系统表现的报告。大约75年后的今天,我们纪念这项工作,并提供有关胎儿发育知识的历史和当代背景,以及我们自己研究的结果。这些结果基于对740对母婴在妊娠24至36周期间进行的同步监测,这些母婴数据来自八项独立的纵向研究,这些研究始于20世纪90年代初。数据包括母亲心率、呼吸性窦性心律不齐、皮肤电活动以及胎儿心率、运动活动及其整合情况。发育轨迹的分层线性模型显示,胎儿以与副交感神经调节进展一致的可预测方式发育。研究结果还包括:胎儿心率、运动和耦合测量值在胎儿体内的稳定性(即随时间保持等级顺序);妊娠30周左右发育减速的过渡期;胎儿心率测量存在性别差异,但大多数胎儿运动活动测量不存在性别差异;与无亲属关系的胎儿相比,兄弟姐妹之间胎儿神经发育存在适度的相关性;以及受宫内生长受限和其他情况影响的胎儿与正常胎儿发育的偏差。在此妊娠期间,母亲的参数也会发生变化,并且有证据表明胎儿性别和胎儿神经行为的个体差异会影响母亲的生理过程和局部宫内环境。我们在神经成熟、个体差异的出现以及母婴关系的双向性质的框架内讨论了这些结果。我们提出了一些有待未来研究的开放性问题。尽管人类胎儿仍然难以触及,但新技术预示着一个加速发现发育最早阶段的时代的到来。