Human fetal heart rate: a unique opportunity to assess the fetal programming hypothesis

Abstract

AbstractThe study of the human fetus presents several unique challenges. Methods of the measurement and procedures for exploring the functional capability of the fetus coupled with the perceived fragility of the maternal/fetal dyad have been barriers for the study of the human fetus. The studies reported here by Kisilevesky and Hains (2009) and those conducted by others indicate that the psychology of the human fetus is not only important, but also clearly feasible. Kisilevsky and Hains (2009) provide compelling evidence from their own well‐designed studies and the growing number of studies from other investigators that by the middle of the second trimester the human fetus is able to detect ex utero stimulation and by the early third trimester can discriminate and learn associations. The review provides important technical information and physiological rationale for measuring human fetal heart rate as an index of cognition. Other measures of fetal behavior are only briefly discussed. Some, such as MEG and MRI are dismissed as impractical and only feasible near term. Other measures that can be used to assess fetal cognition, such as fetal movement and the elegant studies of fetal movement patterns Salisbury et al. (2005) are not discussed but see articles by Di Pietro, van den Bergh, James, Kawai, Sheridan et al., Huoutilainen, Hata et al. and Emory (this issue). This commentary will focus on the application of the human fetal heart rate measures that both support and broaden the conclusions of Kisilevsky and Hains (2009). Copyright © 2010 John Wiley & Sons, Ltd.