Babies’ kicks in the womb are good for their bones

One of the strangest things about growing a human being inside your body is the alien sensation of his movements. It’s wild to realize that these internal jabs and pushes are the work of someone else’s nervous system, skeleton and muscles. Someone with his own distinct, mysterious agenda that often includes taekwondoing your uterus as you try to sleep.

Around the 10-week mark, babies start to bend their heads and necks, followed by full-body wiggles, limb movement and breathing around 15 weeks. These earliest movements are usually undetectable by pregnant women, particularly first-timers who may not recognize the flutters until 16 to 25 weeks of pregnancy. These movements can be exciting and bizarre, not to mention uncomfortable. But for the developing baby, these kicks are really important, helping to sculpt muscles, bones and joints.

While pregnant women can certainly sense a jab, scientists have largely been left in the dark about how normal fetuses move. “It’s extremely difficult to investigate fetal movements in detail in humans,” says Stefaan Verbruggen, a bioengineer formerly at Imperial College London who recently moved to Columbia University in New York.

Now, using relatively new MRI measurements of entire fetuses wiggling in utero, researchers have tracked these kicks across women’s pregnancies. The results, published January 24 in the Journal of the Royal Society Interface, offer the clearest look yet at fetal kicking and provide hints about why these moves are so important.

Along with bioengineer Niamh Nowlan, of ICL, and colleagues, Verbruggen analyzed videos of fetal kicks caught on MRI scans. These scans, from multiple pregnant women, included clear leg kicks at 20, 25, 30 and 35 weeks gestation. Other MRI scans provided anatomical details about bones, joints and leg sizes. With sophisticated math and computational models, the researchers could estimate the strengths of the kicks, as well as the mechanical effects, such as stresses and strains, that those kicks put on fetal bones and joints.

Kicks ramped up and became more forceful from 20 to 30 weeks, the researchers found. During this time, kicks shifted the wall of the uterus by about 11 millimeters on average, the team found. But by 35 weeks, kick force had declined, and the uterus moved less with each kick, only about 4 millimeters on average. (By this stage, things are getting pretty tight and tissues might be stretched taut, so this decrease makes sense.) Yet even with this apparent drop in force, the stresses experienced by the fetus during kicks kept increasing, even until 35 weeks. Increasing pressure on the leg bones and joints probably help the fetus grow, the researchers write.

Other work has found that the mechanical effects of movement can stimulate bone growth, which is why weight-bearing exercises, such as brisk walking and step aerobics, are often recommended for people with osteoporosis. In animal studies, stationary chick and mouse fetuses have abnormal bones and joints, suggesting that movement is crucial to proper development.

The results highlight the importance of the right kinds of movements for fetuses’ growth. Babies born prematurely can sometimes have joint disorders. It’s possible that bone growth and joints are affected when babies finish developing in an environment dominated by gravity, instead of the springy, tight confines of a uterus. Even in utero position might have an effect. Head-up breech babies, for instance, have a higher risk of a certain hip disorder, a link that hints at a relationship between an altered kicking ground and development. In fact, the researchers are now looking at the relationship between fetal movements and skeletal stress and strain in these select groups.

Mechanical forces in utero might have long-lasting repercussions. Abnormal joint shapes are thought to increase the risk of osteoarthritis, says Verbruggen, “which means that how you move in the womb before you’re even born can affect your health much later in life.”

There’s a lot more work to do before scientists fully understand the effects of fetal movements, especially those in less than ideal circumstances. But by putting hard numbers to squirmy wiggles, this new study is kicking things off right.