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Four behavioural states are recognised in the human fetus and are comparable to those of the neonate: 1F (quiet sleep), 2F (active state), 3F (quiet awake), and 4F (active awake). State 5, or crying, is not considered to have a fetal correlate. In a study assessing the effects of exposure to tobacco and cocaine during pregnancy on fetal response and habituation to vibroacoustic stimulation, what appears to be the fetal homologue of crying was observed. These behaviours were seen on ultrasound, and have been captured on video recordings and include: an initial exhalation movement associated with mouth opening and tongue depression, followed by a series of three augmented breaths, the last breath ending in an inspiratory pause followed by an expiration and settling. This is the first report/video documenting these behaviours and suggests the possibility of a state 5F.
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ORIGINAL ARTICLE
Fetal homologue of infant crying
J L Gingras, E A Mitchell, K E Grattan
...............................................................................................................................
A video clip can be
downloaded from the
Archives of Disease in
Childhood website (http://
adc.bmjjournals.com/
supplemental/).
See end of article for
authors’ affiliations
.......................
Correspondence to:
Professor Mitchell,
Department of Paediatrics,
University of Auckland,
Private Bag 92019,
Auckland, New Zealand;
e.mitchell@auckland.ac.nz
Accepted 5 February 2005
Published Online First
27 April 2005
.......................
Arch Dis Child Fetal Neonatal Ed 2005;90:F415–F418. doi: 10.1136/adc.2004.062257
Four behavioural states are recognised in the human fetus and are comparable to those of the neonate: 1F
(quiet sleep), 2F (active state), 3F (quiet awake), and 4F (active awake). State 5, or crying, is not
considered to have a fetal correlate. In a study assessing the effects of exposure to tobacco and cocaine
during pregnancy on fetal response and habituation to vibroacoustic stimulation, what appears to be the
fetal homologue of crying was observed. These behaviours were seen on ultrasound, and have been
captured on video recordings and include: an initial exhalation movement associated with mouth opening
and tongue depression, followed by a series of three augmented breaths, the last breath ending in an
inspiratory pause followed by an expiration and settling. This is the first report/video documenting these
behaviours and suggests the possibility of a state 5F.
F
ive distinct behavioural states are recognised in the
neonate: 1, quiet sleep; 2, active sleep; 3, quiet awake; 4,
active awake; 5, crying. In the fetus, four distinct
behavioural states 1F, 2F, 3F, and 4F have been identified
and correspond to the neonatal behavioural states 1–4
(table 1).
12
State 5, or the crying state, has no reported fetal
correlate. We describe what we believe is the first documen-
tation of crying behaviours in the fetus. These behaviours
were elicited during vibroacoustic stimulation (VAS), which
was performed as a research study assessing the effect of
exposure to tobacco and cocaine during pregnancy on fetal
response and habituation to VAS.
3
METHOD
Fetal ultrasound assessments were performed on up to three
occasions (29–31, 32–35, and 36+ weeks gestation). These
assessments were made in a semidarkened room using B
mode ultrasonography (Corometrics Aloka 650 ultrasono-
graph). The ultrasound transducer was positioned for a
lateral-oblique view of the fetus. Fetal eye movements and
gross body movements were observed in real time by an
observer and were recorded on video. Fetal heart rate was
measured by continuous wave Doppler (Corometrics Fetal
Monitor 145) and recorded continuously on the built in, dual
channel, strip chart recorder. Behavioural state was assessed
from these sources.
The fetus was observed unperturbed for 20 minutes. After
this initial observation period, and when it appeared to be in
a stable state (quiet or active sleep), the fetus was challenged
with VAS. The VAS was provided by an artificial larynx
(model 5c; Western Electric) that emits fundamental tones of
about 100 Hz and 95 dB and was mechanically altered to
provide exactly 0.5 second of stimulation. This duration was
selected because longer stimulus durations have been
associated with excessive fetal movements and prolonged
tachycardia.
4
The physiological intrauterine noise intensity
has been reported to be about 85 dB.
5
No adverse effects have
been reported at this intensity, duration, and frequency.
4
After stimulation, the fetus was observed for a blink-startle
response for a duration of 10 seconds.
6
The study had ethical approval from the Charlotte Medical
Center institutional review board, and the parents gave
written informed consent for the study.
Case report
The mother was an African-American primigravida, who
smoked ,10 cigarettes a day. She did not abuse cocaine. The
female fetus was assessed at 33 weeks gestation when the
‘‘cry’’ behaviours were seen. There were no complications
during the pregnancy. At 40 weeks gestation there was
spontaneous onset of labour. There was a normal vaginal
delivery, and the infant’s birth weight was 3555 g.
The video clip (which can be found at http://adc.
bmjjournals.com/supplemental/) and figs 1–3 show what
we believe is the fetal homologue of crying. The video begins
with the quiet fetus before presentation of the VAS. The fetus
is initially seen in an oblique view. The stimulus is presented.
The fetus startles and turns her head to a lateral view, and is
seen in profile (fig 1). The fetus then initiates behaviours
consistent with crying. There is a brief expiration that is
followed by a deep inspiratory phase with a subsequent
pronounced expiratory phase. This expiration is associated
with jaw opening, taut tongue, and chest depression (fig 2).
It is immediately followed by three augmented breaths with
progressive increase in chest rise and head tilt (fig 3). Each
end inspiration is marked by chin quiver. The last augmented
breath ends in an inspiratory pause, followed by an
expiration and settling. Settling is associated with a turn of
F415
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the fetal head to the oblique position, mouthing, and
swallowing. This pattern of behaviour was seen again when
a repeat VAS was presented to the fetus at about one minute
after the initial cry. These behaviours are shown in the video
and presented in a conceptualised form in fig 4.
This behavioural response was not an isolated case. Once
recognised, more episodes of these behaviours were seen
during the VAS testing of other fetuses. Ten subjects showed
fetal crying behaviour, three of whom showed all of the
characteristics on two separate occasions. Fetal crying
behaviour was seen three times at the first assessment
(gestational age 28–31.9 weeks), four times at the second
assessment (32–35.9 weeks), and on six occasions at the
third assessment (.36 weeks). Four mothers smoked cigar-
ettes during pregnancy, three smoked and used cocaine, and
three neither smoked nor used cocaine. The study population
consisted of three groups of mother-fetal dyads: (1) cigarette
smokers (n = 54), (2) cocaine users (n = 30), and (3)
controls (n = 60). Only one infant had a low Apgar score at
one minute and none at five minutes. Six of the infants were
female, and four were male. Birth weight and gestation did
not differ from the sample as a whole (range 2637–4138 g
and 36.7–41.7 weeks).
DISCUSSION
Crying is a complex, rhythmical series of sounds that requires
precise coordination between various motor systems includ-
ing the musculature of the face, airway, and respiration.
7
Fundamental to postnatal cry is vocalisation. Thus newborn
and infant crying consists of both a vocal and non-vocal
component. Hopkins
8
suggests that the non-vocal accompa-
niments of crying are developed before birth, the vocal
component being established with transition to the extra-
uterine life. The observations recorded from fetal ultrasounds
support the concept that the fetus is capable of the complex
motor behaviours that accompany the crying state.
These observations may have further developmental
implications, as the expression of crying implies more than
execution of a motor pattern. Crying requires reception of a
stimulus, association of that stimulus with a negative
Table 1 Neonatal and fetal states
Neonatal
behavioural
state Descriptors Neonatal behaviours
Fetal state
correlate Fetal behaviours Fetal heart rate pattern
1 Quiet, asleep Regular respirations,
non-REM sleep
1F FB: regular, if present A: Variability (10 beats/min), isolated
accelerations associated with
movement
FBM: rare gross movements,
non-discriminatory
FEM: absent
2 Active, asleep Irregular respirations,
REM sleep, activity
non-discriminatory
2F FB: irregular, if present B: Variability (10–20 beats/min),
frequent accelerations of 10–
20 beats/min
FBM: small body movements,
gross, non-discriminatory, episodic
FEM: absent
3 Quiet, awake Regular respirations,
no gross activity
3F FB: regular, if present C: No accelerations, rate oscillates
more regularly than in BFBM: no gross movements
FEM: present
4 Active, awake Irregular respirations,
physically active
4F FB: irregular, if present D: ‘‘Unstable’’ rate, variability up to
25 beats/min, accelerations of 25–
30 beats/min, occasional sustained
tachycardia
FBM: gross and small movements,
continual
FEM: present
5 Crying Irregular respirations,
physically active
Described here
FB, Fetal breathing; FBM, fetal body movement; FEM, fetal eye movement.
Figure 1 The fetus is seen in profile. The upper position of the anterior
chest wall is marked with a horizontal line at baseline. The initial angle of
the chin is also shown.
Figure 2 The beginning of the ‘‘cry’’ is shown. The head is seen in
profile, the mouth is open, the anterior chest is below the original
position, indicating the initial expiratory movement.
F416 Gingras, Mitchell, Grattan
www.archdischild.com
connotation, and incorporation of an appropriate motor
response that itself recruits a complex pattern of more
primitive motor sequences. The sensory aspect of the cry
response—that is, reception of the sound—implies intact
afferent processes. Recognition of the stimulus as negative
indicates development of more rostral brain sites that
mediate affect and further integrate that affect with a motor
response. The expression of crying thus indicates a several
stage maturation of sensory reception, processing of signals
as potentially deleterious, a dimension of affect, and
recruitment of an appropriate response. Of this sequence,
demonstration of affective integration, which incorporates
limbic structures, implies more rostral neural maturation.
The ability of the fetus to show affective integration of motor
responses is supported by the observation that the fetal
crying behaviours were seen only after VAS.
Crying consists of a sequence of vocal and non-vocal
behaviours. Although crying is phenomenologically self
evident in both the term and preterm infant, there is
no unified or accepted definition that incorporates all
aspects of the cry behaviour. Well described are the facial
accompaniments of cry: grimace or frown, trembling of the
chin, swallowing, and eye closure.
8
Others describe move-
ment of the extremities.
79
These behaviours are tightly linked
to the respiratory cycle.
10
In the newborn, each cry cycle
displays a consistent displacement of respiratory volume,
suggesting a precise coordination between various motor
systems and that of the respiratory system.
11
Cries are
produced primarily in the expiratory phase; however, the
newborn is capable of inspiratory ‘‘voicing’’.
12
Thus Wolff’s
13
classic description of infant cry as a rhythmic repetition
consisting of an expiratory sound lasting 0.6–1.3 seconds, a
brief pause of 0.2 second, and an inspiratory sound or whistle
of about 0.1–0.2 second followed by another pause of
0.2 second before the next sound made on expiration,
continues to provide the most comprehensive description of
the infant cry. The behaviours shown in the video correspond
to the neonatal cry with the vocalisation component
occurring during the expiratory phases.
By 20 weeks gestation, the fetus possesses the complete
motor repertoire necessary for cry behaviours: coordinated
breathing efforts, jaw opening, mouthing, chin quiver,
tongue extension, and swallowing.
14–16
Furthermore, it is
well known that the preterm infant of about 24 weeks
gestational age is capable of producing crying sounds
17 18
and
can respond to environmental noise.
19
Thus the fetus is
capable of responding to sound and other perturbations with
highly coordinated movements that mimic the temporal and
behavioural components of the extrauterine cry. This
phenomenon suggests a prenatal origin of crying, and sup-
ports the contention that the fetus does have a comparable
state 5—that is, state 5F. This concept provides a develop-
mental continuity between the prenatal and postnatal life.
The method of Nijhuis et al
2
for determining fetal state
required that the three state variables (body movements, eye
movements, and heart rate pattern) are maintained for three
minutes. This process follows the strategy used for the
assessment of state in the newborn.
20
Periods of less than
three minutes are referred to as periods of coincidence, and
may represent chance occurrence. It may be inappropriate to
apply the three minute criterion to 5F, as crying in the
neonate is often of shorter duration. In our case, the observed
cry behaviours lasted 15–20 seconds.
The fetal ‘‘cry’’ behaviour, or state 5F, was seen in our
study only after VAS. This observation may suggest that the
‘‘fetal cry’’ is elicited only when the fetus is disturbed. The
20
Time (seconds)
Prolonged expiration
with jaw opening
3 augmented breaths
Settling
Transducer
movement
Short
expiration
Initial inspiration
Baseline
Chest movement
InspirationExpiration
0 5 10 15
Figure 4 Graphic representation of the movement of the anterior chest wall during one cry cycle. The notations identify the associated behaviours. The
asterisk shows when the chin quiver occurred.
Figure 3 The notations mark the increase in chest elevation and head
tilt during the three augmented breaths.
Fetal crying F417
www.archdischild.com
behaviours were seen in all gestational ages studied,
indicating that the behaviour occurs as early as 28 weeks
gestation, and possibly earlier. The behaviour was observed
equally in controls (non-smokers and no cocaine use),
suggesting that these behaviours are not specific to tobacco
or cocaine exposure.
Finally, what we have observed is similar to the rare, but
well authenticated, phenomenon of vagitus uterinus, a term
used to describe the audible cry of the fetus in utero.
21
Cases
of vagitus uterinus are generally found at term, are associated
with ruptured membranes that have allowed air to enter the
uterus, and some operative intervention usually has occurred
which has stimulated the fetus. Our case occurred seven
weeks before delivery, and, although the body and facial
movements were consistent with crying, an audible cry was
not heard.
ACKNOWLEDGEMENTS
We thank the Education Media Centre, University of Auckland for
the production of the video clip and figs 1–3, and Professor Ron
Harper for helpful comments on the manuscript. EAM is supported
by the Child Health Research Foundation, Auckland, New Zealand.
Authors’ affiliations
.....................
J L Gingras, K E Grattan, The SIDS CARE Center, Carolinas Medical
Center, Charlotte, NC, USA
J L Gingras, University of North Carolina-Chapel Hill, Chapel Hill, NC,
USA
E A Mitchell, Department of Paediatrics, University of Auckland,
Auckland, New Zealand
The project was funded by NICHD (National Institutes of Child Health
and Development) and NIDA (National Institute on Drug Addiction)
(RO1: DA05949).
Competing interests: none declared
To access the video clip mentioned in this paper please ensure that you
have QuickTime installed on your computer.
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What is already known on this topic
Four behavioural states are recognised in the human fetus
and are comparable to those of the neonate: 1F (quiet sleep),
2F (active state), 3F (quiet awake), and 4F (active awake).
State 5, or crying, is not considered to have a fetal correlate.
What this study adds
In a study assessing the effects of exposure to tobacco and
cocaine during pregnancy on fetal response to vibroacoustic
stimulation, we observed what appears to be the fetal
homologue of crying. This is the first report/video document-
ing these behaviours and suggests the possibility of a fetal
state 5F.
F418 Gingras, Mitchell, Grattan
www.archdischild.com
... A fetus is also able to produce different rhythmic patterns: cardiac pulsations, breathing movements, hiccups, sucking, arm and leg movements, and even crying [47]. All these rhythmic patterns have a spontaneous motor tempo (SMT); for a review, see [2]. ...
Article
Full-text available
The fetal environment provides the fetus with multiple potential sources of rhythmic stimulation that are not present in the NICU. Maternal breathing, heartbeats, walking, dancing, running, speaking, singing, etc., all bathe the fetus in an environment of varied rhythmic stimuli: vestibular, somatosensory, tactile, and auditory. In contrast, the NICU environment does not offer the same proportion of rhythmic stimulation. After analyzing the lack of rhythmic stimulation in the NICU, this review highlights the different proposals for vestibular and/or auditory rhythmic stimulation offered to preterm infants alone and with their parents. The focus is on the beneficial effects of auditory and vestibular stimulation involving both partners of the mother–infant dyad. A preliminary study on the influence of a skin-to-skin lullaby on the stability of maternal behavior and on the tonic emotional manifestations of the preterm infant is presented as an example. The review concludes with the importance of introducing rhythmic stimulations in the NICU.
... Therefore, the mother's voice seems to be the most important acoustic speech source from which the fetus can learn how to cry [14][15][16]. Even though obstetrical ultrasound studies of the fetus have shown facial mimics which are similar to infant crying, there is evidence that linguistic and prosodic language properties are processed by distinct neuronal arcs during the first day after birth [17,18]. The learning process of crying in the fetus might thus include inputs from language specific influences that may affect the characteristics of crying outputs. ...
... Les nouveaunés reconnaissent et préfèrent la voix de leur mère à celle d'un tiers (De Casper, Fifer, 1980), ils sont capables de discriminer les expressions faciales de joie, de tristesse et de surprise chez l'adulte (Field, Woodson, Greenberg, Cohen, 1982). Enfin, il a été évoqué les capacités du foetus à pleurer in utero (Gingras, Mitchell, Grattan, 2005) lors d'événements traumatiques (Chamberlain, 2004). Devant ses compétences ainsi que ses réponses aux expériences émotionnelles de sa mère et aux stimulations intra et extra-utérine, Pier-Luigi Riguetti (2000) évoque l'hypothèse d'un moi prénatal. ...
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... Des chercheurs é tudient de plus en plus les circuits neurophysiologiques impliqué s dans les pleurs, lesquels interviennent bien en dessous du seuil de conscience, de notre volonté . Par exemple, nous savons maintenant que les bé bé s pleurent dé jà in utero à partir de la 28 e semaine (Gingras, Mitchell, & Grattan, 2005). Cette existence pré natale des pleurs a probablement pour fonction d'activer une fonction vitale et né cessaire à la survie de l'espè ce humaine : celle de l'attachement. ...
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Résumé Les pleurs des tout-petits restent un domaine méconnu, le plus souvent négligé pendant la formation initiale des professionnels de la petite enfance et de santé. Reliant cet oubli à une forme d’amnésie infantile, nous partons de l’hypothèse que la dissociation est une stratégie d’adaptation primitive chez le tout-petit en accordage avec un état dissociatif parental. Ces états dissociatifs précoces apparaissent dans le cerveau du tout-petit en pleine maturation quand, pendant des périodes critiques répétées – avec des pleurs – où son système d’attachement est sollicité, l’adulte ne répond pas à ses besoins affectifs. La réaction des adultes réprimant les pleurs d’un tout-petit est de ce point de vue une situation traumatique chronique et prototypique où l’on peut constater l’absence répétée d’une capacité à réguler l’intensité et la durée de la détresse d’un tout-petit. Nous verrons comment d’un point de vue phénoménologique la genèse de ces traumatismes relationnels précoces peut alors réinterroger la notion de dissociation. En ne la considérant plus seulement comme un système d’action défensif, une hypothèse alternative serait de considérer les phénomènes dissociatifs comme l’expression d’une répétition d’une expérience relationnelle précoce pathologique. Cette réflexion phénoménologique nécessite d’ouvrir un débat épistémologique mettant en perspective de façon dialectique différents champs théoriques faisant référence aux phénomènes dissociatifs. Enfin, l’importance d’explorer les pleurs de la petite enfance avec des patients adultes souffrant de troubles dissociatifs sera aussi discutée.
... Dies zeigt, dass intrauterines Hören offenbar bereits eine Verknüpfung zwischen Gehörtem und orofazialen Gesten herstellt. Ähnliches fanden Gingras, Mitchell et al. (2005) ...
Thesis
Frühkindliche Lautäußerungen lassen sich aus entwicklungsdiagnostischer Perspektive am besten anhand unterschiedlicher Melodieeigenschaften charakterisieren. Eine Analyse dieser Eigenschaften bei unauffälligen Kindern am ZVES dient dazu, Referenzwerte für geeignete Messgrößen zu erarbeiten und diese für Vergleiche mit Risikokindern für Sprech-/Sprachstörungen zu nutzen. Intervallartige Strukturen könnten aufgrund der Stabilität ihrer Eigenschaften geeignete Kandidaten für die Entwicklung potentieller Risikomarker sein. Ziel der vorliegenden Arbeit war es, intervallartige Strukturen in spontanen Lautproduktionen gesunder Säuglinge zu identifizieren und quantitativ zu analysieren. Es wurden Lautäußerungen über einen Zeitraum der ersten 16 Lebenswochen von Säuglingen längsschnittlich ausgewertet. Die Lautaufnahmen lagen in Form anonymisierter Audiofiles im Datenarchiv am Zentrum für vorsprachliche Entwicklung und Entwicklungsstörungen (ZVES) vor. Eine Vorauswahl geeigneter Vokalisationen erfolgte anhand einer audio-visuellen Auswertung ihrer Frequenzspektren. Vokalisationen (spontanes Weinen) mit klarer, ungestörter (noise-free) Melodie wurden mit Hilfe des Programms CDAP (pw-project©) bezüglich ihrer Intervallphänomene analysiert. Es zeigte sich, dass in fast der Hälfte aller untersuchten Melodien Intervallstrukturen identifiziert werden konnten. Den Hauptanteil bildete die Gruppe der isolierten Einzelintervalle, gefolgt von der Gruppe der Vokalisationen mit zwei zusammenhängenden Intervallen in der Melodie. Beide machten knapp ¾ der Gesamtzahl aus. Intervalle wurden bezüglich ihrer Intervallrichtung (steigend bzw. fallend), der zeitlichen Längen einzelner Elemente sowie der mittleren Grundfrequenz der beiden Plateaus untersucht. Auffällig war der höhere Anteil fallender Intervalle gegenüber steigenden Intervallen. Dies wurde hypothetisch mit einer Tendenz zum deutschen fallenden Intonationsmuster interpretiert. Die zeitlichen Längen der fallenden Intervalle zeigten auch eine geringere Variabilität. Insgesamt ließ sich bezüglich der zeitlichen Längen einzelner Intervallelemente (vorderes/ hinteres Plateau, Übergang) eine erstaunliche Stabilität über den Untersuchungszeitraum feststellen. Die Konstanz der zeitlichen Größen stützt die Annahme, dass Intervallphänomene geeignete Risikomarker liefern könnten. Dazu sind entsprechende Vergleichsuntersuchungen in nachfolgenden Arbeiten notwendig. Auch die Beobachtung des „Isochronie-Phänomens“ der vorderen und hinteren Plateaulängen stützt die sehr geringe Variabilität der Zeitgrößen, die der Intervallerzeugung zu Grunde liegen. Alle Phänomene traten unabhängig von der individuellen Tonlage der Säuglinge beim Weinen auf. In hoher Übereinstimmung mit Vorarbeiten zu Intervallstrukturen bei Neugeborenen und Untersuchungen von Sprechmelodien und deren Wahrnehmung wurde ein enger Bereich um den musikalischen Halbton als präferiertes Intervall identifiziert. Auch zeigte sich eine stabile Verteilung der Intervalle mit einer Abnahme vom Halbton zu größeren Intervallen im gesamten Untersuchungszeitraum. Um die Befunde besser erklären zu können, sind weitere Untersuchungen notwendig. Dabei wäre ein noch größerer Datensatz wünschenswert. Eine Betrachtung eines noch längeren Zeitraums würde klären, ob sich das Vorherrschen fallender Intervalle auch in Komfortvokalisationen (Babbeln) zeigt oder sich sogar noch deutlicher darstellt. Dies würde die Annahme eines Zusammenhangs mit der späteren Sprachintonation stützen. Nicht berücksichtigt wurde in der Arbeit der Zusammenhang der Intervallbildung mit der Intensität. Da die Intervallperzeption intensitätsabhängig ist, wird die Einbeziehung dieser Größe in zukünftigen Untersuchungen vorgeschlagen.
Chapter
For some women and families, pregnancy is a time of excitement and anticipation; however, for others, pregnancy can induce feelings of worry, anxiety, and stress. The human body is designed to respond to acute forms of stress biochemically, which allows for resolution or escape from a perceived threat. However, when a stressor is perceived as unrelenting, the system designed to manage stressors can become dysregulated, resulting in toxic systemic inflammation that is believed to contribute to many disease states. In pregnancy, this process can also affect the uterine environment and the developing baby, which may affect health and wellbeing across the baby’s lifespan. In contrast to the actions of a perceived stressor, love, connection, and attachment result in a health-promoting and anxiety-reducing neuroendocrinological cascade that not only assists in bonding but promotes wellbeing. In this chapter, we review the stress responses in humans and the effects of chronic stress and attachment in preconception, pregnancy, and the postnatal period and examine mindfulness and meditation in stress management during pregnancy.
Article
Les études à propos de la douleur fœtale et de ses conséquences font suite à celles menées à propos de la douleur néonatale et de sa prise en charge dans les années 1980. Les définitions classiques de la douleur ne peuvent pas être appliquées au foetus. La douleur fœtale est définie actuellement comme la réponse à une stimulation nociceptive. Les nocicepteurs sont largement présents au niveau cutané chez le foetus. La stimulation nociceptive ne veut pas dire que le foetus a la capacité de « ressentir ». Le foetus possède l’équipement nécessaire pour percevoir des stimulations nociceptives, la question est de savoir si ce système est opérationnel. La maturation du système nerveux central est un processus complexe et difficile à étudier. La pratique de gestes invasifs potentiellement douloureux pour le foetus a activé la recherche à propos de l’analgésie fœtale dès les années 1990. Différentes situations ont été identifiées comme potentiellement douloureuses pendant la période anténatale. Même si le foetus n’expérimente pas la douleur comme un être conscient, il manifeste une réponse adaptée au stress lors d’une stimulation nociceptive entraînant des modifications hémodynamiques et hormonales. Ces modifications, si elles surviennent à un stade critique du développement du SNC, pourraient entraîner des conséquences immédiates mais peut-être aussi à long terme. Les nouvelles techniques d’imagerie ouvrent des voies de recherche dans la précision du développement cérébral à chaque âge gestationnel mais aussi dans une approche fonctionnelle. La complexité du développement cérébral et la compréhension des conséquences de l’environnement foetal, les conséquences des différents stimuli dont la douleur, nécessitent une recherche transdisciplinaire.
Chapter
Contactless human-computer systems could be a noticeable advance in Intelligent Systems and Computing, fostering the development of future technologies with applications in various areas from AI to Medicine. In contactless human-computer systems, shared intentionality should play a key role in the deep learning of artificial neural networks that would provide adequate replacement of missing body parts. This concept design introduces a possible trend of further research on shared intentionality. The paper’s central idea is that any biological system tends to goal-directed coherence–shared intentionality is an essential quality of humans. The article presents a hypothesis of the neurobiological foundations of shared intentionality. The paper reviews studies of different biological systems and suggests the main qualities of goal-directed coherence that are common to all: instantaneousness in time, independence from a distance, insensitivity to sensory perception. The article also notes recent findings in physics. The integrated analysis poses the research question: can a single harmonic oscillator induce quantum entanglement between neurons and a computer interface. The author believes that an answer to the problem gives us an understanding of whether the human brain can directly govern the computer without introducing artificial elements into the nervous system. A valuable outcome of this ongoing research project about possible contactless brain-computer interaction may be direct or indirect evidence of (i) contactless brain-computer interaction; (ii) the synergy of this interaction. This synergy is an additional outcome that cannot be achieved separately by both sides of this interaction.
Article
Some doubts on the necessity and safety of providing analgesia to the fetus during prenatal surgery were raised 10 years ago. They were related to four matters: fetal sleep due to neuroinhibitors in fetal blood, the immaturity of the cerebral cortex, safety, and the need for fetal direct analgesia. These objections now seem obsolete. This review shows that neuroinhibitors give fetuses at most some transient sedation, but not a complete analgesia, that the cerebral cortex is not indispensable to feel pain, when subcortical structures for pain perception are present, and that maternal anesthesia seems not sufficient to anesthetize the fetus. Current drugs used for maternal analgesia pass through the placenta only partially so that they cannot guarantee a sufficient analgesia to the fetus. Extraction indices, that is, how much each analgesic drug crosses the placenta, are provided here. We here report safety guidelines for fetal direct analgesia. In conclusion, the human fetus can feel pain when it undergoes surgical interventions and direct analgesia must be provided to it. Fetal pain is evident in the second half of pregnancy. Progress in the physiology of fetal pain, which is reviewed in this report, supports the notion that the fetus reacts to painful interventions during fetal surgery. Evidence here reported shows that it is an error to believe that the fetus is in a continuous and unchanging state of sedation and analgesia. Data are given that disclose that drugs used for maternal analgesia cross the placenta only partially, so that they cannot guarantee a sufficient analgesia to the fetus. Safety guidelines are given for fetal direct analgesia.
Article
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Two approaches to understanding roots of social behavior-biological universalism and cultural relativism-have been opposing each other for several decades. Numerous studies in different disciplines have been attempting to understand origins of social behavior, studying also fetal movements. This review explores the origins of social interaction, by studying whether embryos inherit some genetic mechanism of social behavior or their social responses are acquired as a result of social interaction. The articles were included in the review as they studied fetal voice recognition, emotion expression, and twin fetuses co-movement. Analyzing these data, the study found no contradictions that prevent the identification of such fetal actions with the notion of social behavior. The existing data on the genetic determination of brain development were discussed and the hypothesis of an innate mechanism of social behavior was questioned. The study found no evidence of a genetic mechanism for social behavior that could link a particular mental state to a specific situation of social reality. However obviously, fetuses may not exhibit social behavior on their own due to a lack of understanding of social reality, and knowledge of the connection between a particular social situation and corresponding social signs. The disadvantage of their cognitive skills in the period of gestation also cannot help them to behave socially. This article supports the core role of social interaction in shaping of social behavior in fetuses and substantiates the assumption that their social behavior emerges from and is guided by mental collaboration with mother.
Article
Previous investigations have established that reliable differences exist between normal infants and those suffering from diffuse brain damage with regard to crying behavior: normal infants generally require (a) less paidul stimulation to provide a specific amount of crying activity (Karelitz & Fisichelli, 1962), (b) they respond more quickly, and (c) as a group, a greater number of them respond to such stimulation than do infants suffering from brain damage (Fisichelli & Karelitz, 1963). Since mongolism is a form of diffuse brain abnormality, it was postulated that quantitative measures of crying activity would reflect differences between normal and mongoloid infants not only in sensitivity, as measured by threshold and latency, but also along two dimensions. (Output) Normal infants would produce more crying sounds than the mongoloid infants. (Duration) Within uniform test sessions the time spent in actual crying (cumulative time) would be greater for the normal infants.
Article
The area of functional human fetal brain development is largely terra incognita for obvious technical reasons. There have been several elegant fetal anatomical studies, but these have been simple point samplings of necropsy material with a potential bias on studies of fetal or maternal—fetal conditions associated with early delivery. A large number of neuro-developmental observations have been accumulated for exteriorized fetal animals (chiefly the sheep) but it is not clear that these can be extrapolated to human development either temporally or organizationally. Finally, vast clinical progress in neonatology has enabled sequential observations of premature infants, beginning at the start of the third trimester. However, intensive-care nursery conditions are quite different from those of the intact intrauterine environment, and because of the clinical fragility of these infants and the circumstances resulting in their premature delivery, asphyxial brain injury or intracranial hemorrhage may complicate the analysis and interpretation of those data. Ultrasound imaging has provided a means of making non-invasive sequential fetal observations. This capability has been extended by technical advances that have occurred within the past two years, providing some new possibilities for monitoring CNS development.
Article
This chapter is written in an effort to deal with these questions: When does behavior begin? How does behavior develop during the early weeks and months of life? The material brought together here concerns itself not only with facts about early human development but also with relevant facts about the development of infrahuman animals. Much more is known in certain respects concerning the early development of life in the animals below man than in man himself, and much of this information has direct bearing upon an understanding of human development. In this chapter an effort is made to summarize some of the many scientific facts and some of the theories which relate to the onset and development of early behavior in organisms. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
During the third trimester of pregnancy there is a gradual development of fetal behavioral states. These states are distinct and discontinuous modes of neural activity; they reflect a certain degree of maturity and/or integrity of the fetal brain and are homologous with those seen in newborn infants. Abnormal state development has been found in growth retarded fetuses and in fetuses of women with type-1 diabetes. Behavioral state organization is not easily influenced by external factors and most stimuli fail to induce a state change when the fetus is in quiet sleep (state 1F). However, fetuses do react to vibro-acoustic stimulation (VAS) with an electronic artificial larynx. This stimulus induces excessive fetal movements, prolonged tachycardia, disorganization of behavioral states, and state transitions normally not seen in healthy fetuses. The backgrounds for these excessive and unusual reactions are largely unknown. For the time being, it seems better not to use this device in clinical practice. In this review paper, data on the development of behavioral states and on fetal reactions to VAS are discussed. © 1993 Wiley-Liss, Inc.
Article
Background: Cigarette smoking and cocaine use in pregnancy are common in the US and both are risk factors for sudden infant death syndrome (SIDS). Although the cause of SIDS is not known, one postulated mechanism involves abnormalities of arousal and arousal regulation. Cigarette smoking and cocaine use may cause deficits of arousal. Many believe arousal deficits occur prenatally. Aims: The aim of this study was to assess the effects of cigarette smoke and cocaine exposure during pregnancy on measures of fetal arousal and arousal competency: 1) the fetal response to vibroacoustic stimulation (VAS) and 2) habituation to VAS. Hypothesis: Maternal cigarette smoking and cocaine use in pregnancy are associated with altered arousal and arousal regulation in the fetus. Methods: Three groups of mother-fetal dyads were enrolled: 1) cigarette smokers (n = 54), 2) cocaine users (n = 30), and 3) controls (n = 60). One hundred eight fetuses were tested at 29-31 wk gestation, 119 at 32-35 wk, and 118 at 36+ wk. The fetal response to VAS was assessed using real-time ultrasound and a paradigm of arousal responsiveness. Responders were tested with repeated VAS to assess habituation. Also, the quality of fetal reactivity to repeated stimuli was assessed as a measure of arousal and arousal regulation competence (Behavioral Reactivity Scale). Results: The control group had a larger proportion of fetuses who were too active to initiate testing ("too active to test") (p = 0.013); the proportion of fetuses too active to test decreased with increasing gestational age. The majority of the fetuses who could be tested responded to the initial VAS, and there were no group differences. The proportion of fetuses that habituated and the rate of habituation did not differ between the groups. Behavioral reactivity did not differ between groups. Conclusions: The original hypotheses were not confirmed. However, the chosen assessment paradigms may have lacked sensitivity. The proportion of fetuses that were "too active to test" decreased with gestational age. The control group had a larger proportion of fetuses that were "too active to test" compared with the exposure groups. We speculate that these findings indicate that prenatal exposure to these neuroteratogens may have produced an acceleration of the behavioral response to vibroacoustic stimulation.
Article
A series of attempts to develop a behavioural classification system for use in a first stage analysis of infant vocalization data are reported. The data were cross-sectional and obtained from 11 different infants between the ages of 1 and 40 weeks. A set of terms and definitions were developed by two judges and their reliability assessed by having a third judge classify the data, using the terms and definitions in written form only. Implifications of the findings with respect to inter-judge agreement and disagreement and usefulness of system for further studies of infant vocalization are discussed.
Article
Fetal acoustic stimulation is becoming a common modality for antepartum testing. The purpose of this study was to review the available literature on the subject to establish whether safety and efficacy have been determined. Safety could not be substantiated. The frequency, intensity, duration, and number of stimuli varied greatly among publications. There is no uniform nomenclature to score test results, and even the definition of the fetal acoustic stimulation test is not uniform. Data on the efficacy of the test are limited. Before fetal acoustic stimulation becomes part of standard obstetric care, rigorous clinical testing is required.