Effect of (minor or major) maternal trauma on fetal motility: A prospective study

Knoop, Bloeme J van der; Schie, Petra E. M. van; Vermeulen, R. Jeroen; Pistorius, Lourens R.; Weissenbruch, Mirjam M. van; Vries, J.I.P. de

doi:10.1016/j.earlhumdev.2015.06.003

Cited by 9 publications

(3 citation statements)

References 44 publications

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“…42 According to another study, maternal traumas such as traffic accidents or falls had an impact on the quality and quantity of fetal movements, but had no neurological sequelae at 12 months of age. 43 Thus, prenatal GMA has not brought the expected breakthrough, yet. 8,37,38 The value of these spontaneously generated movements for typical development remains undisputed, and we also continue to believe in their potential value for identifying atypical neurological development, but our recording and assessment tools simply lack the refinement (and we lack the knowledge) required to understand the meaning of various motor patterns.…”

Section: The Role Of Fetal General Movement Assessmentmentioning

confidence: 99%

Fetal movements: the origin of human behaviour

Einspieler

Prayer

Marschik

2021

Develop Med Child Neuro

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The study of the onset and ontogeny of human behaviour has made it clear that a multitude of fetal movement patterns are spontaneously generated, and that there is a close association between activity and the development of peripheral and central structures. The embryo starts moving by 7.5 week’s gestation; 2 to 3 weeks later, a number of movement patterns including general movements, isolated limb and head movements, hiccup, and breathing movements, appear. Some movements (e.g. yawning, smiling, ‘pointing’; we show these in eight videos in this review) precede life‐long patterns; others have intrauterine functions, such as sucking/swallowing for amniotic fluid regulation, breathing movements for lung development, or eye movements for retinal cell diversity. In cases of developmental brain dysfunction, fetal general movements alter their sequence and gestalt, which suggests a dysfunction of the developing nervous system. The scarcity of longitudinal studies calls for further comprehensive research on the predictive value of prenatal functional deviations. Motor output can occur in the absence of sensory input. Structural development is activity‐dependent. Fetal general movements are among the first movement patterns to occur. Pregnancy‐related and maternal factors impact quantity and modulation of fetal general movements. Prenatal general movement assessment has not yet brought the expected breakthrough.

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Section: The Role Of Fetal General Movement Assessmentmentioning

confidence: 99%

Fetal movements: the origin of human behaviour

Einspieler

Prayer

Marschik

2021

Develop Med Child Neuro

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“…Future studies that directly measure the severity of injury are needed to further elucidate whether the risk of CP is linked to injury severity, as shown for other maternal and fetal outcomes . Current guidelines for the management of injury in pregnant patients focus only on monitoring the fetal condition immediately after the injury with little attention to its long-term effects on offspring . By providing evidence of potential long-term harmful associations of exposure to injuries during pregnancy, these results suggest that monitoring of children exposed to maternal injury in utero may contribute to early detection of adverse neurodevelopmental outcomes and thus to the provision of optimal management and needed support.…”

Section: Discussionmentioning

confidence: 99%

In Utero Exposure to Maternal Injury and the Associated Risk of Cerebral Palsy

et al. 2023

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ImportanceAlthough maternal unintentional injury during pregnancy has shown negative impacts on the mother and fetus, the evidence on its long-term associations with children’s neurodevelopment is limited.ObjectiveTo examine the association between maternal unintentional injury and cerebral palsy (CP) in offspring.Design, Setting, and ParticipantsThis was a population-based, longitudinal, cohort study of all in-hospital live births born between April 1, 2002, and March 31, 2017, in a publicly funded health care system setting of Ontario, Canada. Infants born more than 20 weeks’ gestation were included and followed up until March 31, 2018. Excluded from the analysis were stillbirths, infants with missing or invalid records, and births with missing or invalid birth characteristics. Data were analyzed from March 1 to June 30, 2021.ExposuresMaternal unintentional injury during pregnancy ascertained based on inpatient or emergency department diagnoses.Main Outcomes and MeasuresCP diagnosis between birth and the end of follow-up in 2018 with the CP case definition of a single inpatient or 2 or more outpatient diagnoses at least 2 weeks apart between birth and age 16 years.ResultsOf 2 110 177 children included in this study (mean [SD] gestational age, 38.8 [1.9] weeks; 1 082 520 male [51.3%]), 81 281 (3.9%) were exposed in utero to maternal unintentional injury. During a median (IQR) follow-up time of 8 (4-12) years, 5317 children (0.3%) were diagnosed with CP (292 CP cases [5.5%] were exposed to maternal unintentional injury). The mean incidence rates of CP were 4.36 and 2.93 per 10 000 child-years in the exposed and the unexposed group, respectively. Children exposed to maternal unintentional injury had a modest increase in the risk of CP, compared with those unexposed (hazard ratio [HR], 1.33; 95% CI, 1.18-1.50) after adjusting for maternal sociodemographic and clinical characteristics. Severe injuries that resulted in hospitalization and delivery within 1 week from the injury conferred higher risks of CP (adjusted HR, 2.18; 95% CI, 1.29-3.68 and adjusted HR, 3.40; 95% CI, 1.93-6.00, respectively). Results were robust in multiple bias analyses.Conclusions and RelevanceIn this Canadian population-based birth cohort study, in utero exposure to maternal unintentional injury was associated with an increased risk of CP, with a higher risk with more severe injuries. These findings fill an important gap in knowledge on the potential role of maternal injury on children’s neurodevelopment outcomes. Public health professionals and stakeholders should be aware of these potential long-term consequences on offspring when designing programs and providing recommendations about safety during pregnancy. Early monitoring and developmental assessment of children exposed to maternal injury might be warranted.

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“…Maternal stress in the form of trauma (motor vehicle and cycling accidents, falls) showed no effect on the quality of GM, and normal neurodevelopmental outcomes at 12 months. 107 However, this sample contained a heterogeneous gestational age range and restricted mechanism of injury, and so presents difficulties in generalisability particularly if the physiological stress response of the mother was not sufficiently induced as suggested by the lack of hypercortisolaemia.…”

Section: A C C E P T E Dmentioning

confidence: 99%

Neuroimaging perspectives on fetal motor behavior

Hayat

Rutherford

2018

Neuroscience & Biobehavioral Reviews

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We are entering a new era of understanding human development with the ability to perform studies at the earliest time points possible. There is a substantial body of evidence to support the concept that early motor behaviour originates from supraspinal motor centres, reflects neurological integrity, and that altered patterns of behaviour precede clinical manifestation of disease. Cine Magnetic Resonance Imaging (cineMRI) has established its value as a novel method to visualise motor behaviour in the human fetus, building on the wealth of knowledge gleaned from ultrasound based studies. This paper presents a state of the art review incorporating findings from human and preclinical models, the insights from which, we propose, can proceed a reconceptualisation of fetal motor behaviour using advanced imaging techniques. Foremost is the need to better understand the role of the intrauterine environment, and its inherent unique set of stimuli that activate sensorimotor pathways and shape early brain development. Finally, an improved model of early motor development, combined with multimodal imaging, will provide a novel source of in utero biomarkers predictive of neurodevelopmental disorders.

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Effect of (minor or major) maternal trauma on fetal motility: A prospective study

Cited by 9 publications

References 44 publications

Fetal movements: the origin of human behaviour

Fetal movements: the origin of human behaviour

In Utero Exposure to Maternal Injury and the Associated Risk of Cerebral Palsy

Neuroimaging perspectives on fetal motor behavior

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