Fetal Responsivity: Who's at Risk? Predicting Birth and Neurobehavioral Outcomes Open Access

Beckwith, Joy D. (2014)

Permanent URL: https://etd.library.emory.edu/concern/etds/ht24wk09d?locale=en
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Abstract

Abstract Fetal Responsivity: Who's at Risk? Predicting Birth and Neurobehavioral Outcomes

By: Joy D. Beckwith

The primary goal of the current study was to examine the ability of fetal responses, fetal heart rate (FHR) and fetal movement (FM), to predict adverse birth and neurobehavioral outcomes in relation to maternal stress during pregnancy. It was hypothesized that abnormal fetal responses, presumed to be due to maternal distress during pregnancy, would predict those at risk for low birth weight, gestational age, and Apgar scores, as well as less optimal neurobehavioral profiles on the Neonatal Behavioral Assessment Scale. Pregnant women (N=152) completed self-report measures of distress and underwent fetal monitoring at two prenatal time points, followed by two post-natal probes of newborn behavior at birth and one month postpartum. Regression analyses generally failed to demonstrate that fetal responses of heart rate and movement predicted adverse postnatal outcomes. However, baseline fetal heart rate did significantly predict postnatal abnormal reflexes and self-regulation. Maternal perception of stress also had modest correlations with fetal heart rate and movement post-stimulation, abnormal reflexes, and alertness. Methodological factors limiting the interpretation of these findings were discussed. Exploratory analyses suggested that continued exploration of maternal distress, fetal responses, and post-natal outcomes might be warranted, with particular attention given to potency of stimuli, measurement and perception of distress, and timing of experience. Reliable identification of pregnant women at risk for adverse post-natal outcomes remains an important objective as the field looks to provide prevention and early intervention efforts that have the potential to buffer the adverse effects of stress.

Table of Contents

Table of Contents

Introduction...1

The Clinical Picture of Maternal Distress...3
Stress During Pregnancy...3
Animal Studies...4
Human Studies...5
Depression and Anxiety During Pregnancy...7
Fetal Responsivity and Maternal Distress...8
Fetal Heart Rate...9
Fetal Movement...11
The Fetal Programming Hypothesis...13

Method...22

Overview...22
Inclusion/Exclusion...22
Participants...23
Procedure...24
Measures...26

Results...29
Discussion...36

Predicting Postnatal Outcomes...36
Limitations of the Current Study...46
Future Directions...46

References...48
Tables...72
Figures...82
Appendix...84

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