We propose to use ultrasound and non-invasive physiological monitoring to begin the process of documenting neurobehavioral development in normal human fetuses. We shall simultaneously study spontaneous body movements, heart rate, breathing/respiration movements, and behavioral state at selected periods of gestation and postnatally using a within-subjects design. In addition, we will begin the study of fetuses with documented, significant central nervous system anomaly to determine if, and how, their body movement, heart rate, breathing movement, and/or behavioral state patterns differ from these of normal fetuses. Results of the proposed research will determine the feasibility and utility of developing an objective neurobehavioral assessment of fetal nervous system function and integrity by: (1) determining the neurobehavioral measures associated with normal gestational and perinatal courses, (2) determining the neurobehavioral measures sensitive to documented CNS anomaly, and associated with abnormal gestational and perinatal courses, and (3) determining the predictive power of the fetal neurobehavioral assessment for long-term follow-up outcomes. This study should allow us to: (1) confirm normal neurological development of the human fetus, (2) ascertain the influence of maternal disease and treatment on fetal neurobehavioral status, (3) identify the neurologically compromised fetus, who might be missed by conventional ultrasound scanning, (4) determine the functional significance of previously identified fetal abnormalities, and (5) ultimately, evaluate the efficacy of future therapies for the compromised fetus.
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