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Observing foetal behaviour in the womb; A window into development

Authored by Jenna Pfeifer

Do facial expressions develop before birth? Is foetal hand gesture a sign of maternal stress?

How do twin’s experience touch differently to singletons and does this affect somatosensory development? At the forefront of these questions is the Foetal development group within Durham University’s Psychology department led by Dr. Nadja Reissland. The Foetal lab utilises a method pioneered by Dr. Reissland; the Foetal Observable Movement system (FOMS), to score and encode foetal movement via fine-grained 4D ultrasound scans (Figure 1). Observing and interpreting foetal behaviour in the womb can give an indication of foetal health, leading to a better understanding of overall development which can facilitate assessment of CNS integrity. In this line, there is potential for FOMS to be used in clinical practise. For example it has recently been used to confirm the diagnosis of the complex neuro-genetic disorder, Prader-Willi-syndrome (Reissland, Makhmud and Froggatt, 2019). The study examined a PWS foetus’s response to light and sound stimulation, developing a movement profile that was significantly different to healthy foetuses. This stimulation could serve as a pre-natal test to warrant further genetic testing and highlights how early diagnosis is crucial to early intervention.

Figure 1. 4D ultrasound images depicting the progression of development over gestational age from (a) one action unit (AU) at 24 weeks, to (b) Two AUs at 27.5 weeks and (c) and (d) Four AUs at 32 weeks (Reissland et al., 2011).

Current projects within the lab cover issues from pre-natal development in relation to maternal stress and depression to the effects of smoking on prenatal and postnatal attachment. One in particular focus is foetal reaction to light stimulation, how important this visual experience is and what this may mean for visual development postnatally. New-born infants are able to respond to visual stimuli as demonstrated by imitation of mouth movements immediately after birth indicative of a visual capacity established in the womb (Reissland, 1988). Moreover, there is a brain area specifically specialised in processing faces (Haxby et al., 2000) and it has been argued that only upright faces are processed in this region, whilst inverted faces are treated similarly to everyday objects. Recently, it has been demonstrated that foetuses show preference for face-like as opposed to inverted patterns (Reid et al., 2017). The study found that light configurations projected through the abdomen wall elicited more head turns towards the upright shape. Following findings of Reid et al. (2017) the present pilot study is investigating foetal reaction to light stimuli featuring face-like characteristics. In order to test whether face-like configurations are acknowledged before birth and therefore suggest a preparedness for faces, or whether foetuses just track movement rather than face like or non-face like stimuli, the current study is testing the hypothesis that foetuses at 32 and 36 weeks gestation will respond differently to face-like compared to inverted face stimuli or the no face control. Behavioural measures of head turn and eye blink will be utilised to gauge response to external light stimulation. This research will provide further insight into the foetal visual development process, and attempt to elucidate what purpose visual experience plays during this period, as it has been reported that it is possible but not universal or necessary to post-natal development of the visual system (Del Giudice, 2011).

There are multiple factors that can influence prenatal development. A few examples are alcohol and drug use, disease, maternal mental and physical well-being, and environmental toxins. Using FOMs, the consequences of these factors on foetal development can be observed and perhaps used to assess health by discriminating normal from abnormal cases. Moreover, this system provides a means to better understand the developmental profile of foetuses, connecting this to the neural substrates of growth in utero, highlighting the origin of such processes, and shedding light on developmental trends.


Del Giudice, M. (2011). Alone in the dark? Modeling the conditions for visual experience in human fetuses. Developmental psychobiology53(2), 214-219.

Haxby, J. V., Hoffman, E. A., & Gobbini, M. I. (2000). The distributed human neural system for face perception. Trends in cognitive sciences, 4(6), 223-233.

Reid, V. M., Dunn, K., Young, R. J., Amu, J., Donovan, T., & Reissland, N. (2017). The human fetus preferentially engages with face-like visual stimuli. Current Biology, 27(12), 1825-1828.

Reissland, N., Makhmud, A., & Froggatt, S. (2019). Comparing a foetus diagnosed with Prader-Willi-syndrome with non-affected foetuses during light and sound stimulation using 4D ultrasound. Acta paediatrica., 108(2), 375-376.

Reissland, N., Froggatt, S., Reames, E., & Girkin, J. (2018). Effects of maternal anxiety and depression on fetal neuro-developemnt. Journal of Affective Disorders. 241, 460-474.IF 3.8

Reissland, N., Francis, B., Mason, J., & Lincoln, K. (2011). Do facial expressions develop before birth?. PLoS One, 6(8), e24081.

Reissland, N. (1988). Neonatal imitation in the first hour of life: Observations in rural Nepal. Developmental Psychology, 24(4), 464.

Reid, VM, Dunn, K., Young, RJ., Amu, J., Donovan, T., Reissland, N. (2017). The human fetus preferentially engages with face-like visual stimuli. Current Biology, 27, –4.e1–e3 IF 8.98