Are Fetus and Neonate the Same Individual in Terms of Behavior?

Abstract

The aim of the paper is to present continuity of behavior from prenatal to postnatal life. As the development of the brain is a unique and continuing process throughout gestation and after birth, it is expected that there is also the continuity of fetal and neonatal movements, which are the best functional indicator of the developmental processes of the brain. Although we have very powerful imaging and other methods to find out the consequences of brain damage, there is no doubt that clinical methods like history and clinical assessment are of utmost importance. Cranial ultrasound (US) has been used to determine the type and evolution of brain damage. Magnetic resonance imaging (MRI), functional MRI, and near-infrared spectroscopy (NIRS) of the brain have also been used to detect antenatal, perinatal, and neonatal abnormalities and timing of the damage on the basis of standardized assessment of brain maturation. Besides the structure, it is important to investigate the function of the brain, which can be assessed by observation of general movements (GMs). All endogenously generated movement patterns from the unstimulated central nervous system (CNS) could be observed as early as from 7 to 8 weeks of postmenstrual age, with developing a reach repertoire of movements within the next 2 or 3 weeks, continuing to be present for 5–6 months postnatally. Classical postnatal assessment of GMs is well developed and established, while prenatal assessment needs sophisticated real-time four-dimensional ultrasonographic (4D US) or other technology in order to enable a more precise assessment of GMs’ quality in fetuses. It is being speculated that intrauterine detection of neurological disability would improve the outcome. Although many fetal behavioral studies have been conducted, it is still questionable whether the assessment of continuity from fetal to neonatal behavior could improve our ability of early detection of brain pathology. Early detection could possibly raise an opportunity to intervene and even prevent the expected damage. Early intervention programs for preterm infants have a positive influence on cognitive outcomes in short to medium term.