Neonatal Aspects: Is There Continuity?

Abstract

During the 9 months between conception and birth, the fetal brain is transformed from instructions in genes to a complex, highly differentiated organ. The human central nervous system (CNS) changes from a microscopic band of embryonic neuroblasts to a 350 gm mass with more than 109 interconnected highly differentiated neurons in the cortex alone. How this extraordinary growth results in sensomotor, cognitive, affective and behavioral development is still unexplored. The development of voluntary, cognitive and purposive activity from fetal to neonatal period is to analyze the developmental transformations of the brain expressed by development of movement patterns from prenatal through postnatal period. As the development of the brain is unique and continuing process throughout the gestation and after birth, it is expected that there is also continuity of fetal to neonatal movements which are the best functional indicator of developmental processes of the brain. Concerning the complexity, voluntary control and stereotype, there are at least four groups of movements: Reflexes, fixed action patterns, rhythmic motor patterns, and directed movements. Substantial indications suggest that spontaneous activity is a more sensitive indicator of brain dysfunction than reactivity to sensory stimuli in reflex testing. It was proved that assessment of general movements in high-risk newborns has significantly higher predictive value for later neurological development than neurological examination. Nutritional stress at critical times during fetal development can have persistent and potentially irreversible effects on organ function. Impaired intrauterine growth and development may antecede insufficient postnatal growth. Thus, it may be a marker of impaired central nervous system integrity because of adverse intrauterine conditions. Unfavorable intrauterine environment can affect adversely fetal growth. There is an association between postnatal growth and neurodevelopmental outcome. Concerning the continuity from fetus to neonate in terms of neurobehavior, it could be concluded that fetus and neonate are the same persons in different environment. While in the womb, fetus is protected from the gravity which is not so important for its neurodevelopment, postnatally the neonate is exposed to the gravity during the labor and from the first moments of autonomous life. Development of motor control is highly dependent on antigravity forces enabling erect posture of infant or young child. These environmental differences should be kept on mind during prenatal as well as postnatal assessment. How to cite this article Stanojevic M. Neonatal Aspects: Is There Continuity? Donald School J Ultrasound Obstet Gynecol 2012;6(2):189-196.