Fetal Behaviour Assessment as a Predictor of Future Neurological Development in Children: A Review

The development and implementation of three- and four-dimensional ultrasound in clinical practice have enabled both qualitative and quantitative assessment of fetal movements, including analysis of the fetal face. Ultrasound studies of fetal behavior, compared with morphological assessments, have demonstrated that fetal behavioral patterns directly reflect the developmental and maturational processes of the fetal brain. This suggests that changes in fetal movements may allow the prenatal identification of neurological impairment. Recently, a four-dimensional ultrasound-based prenatal screening approach for assessing fetal behavior has been introduced. In this context, the Kurjak Antenatal Neurodevelopmental Test (KANET) has emerged as a 4D ultrasound-based scoring system for evaluating fetal neurobehavior and identifying fetuses at risk of later neurodevelopmental impairment. This study presents a narrative review of the literature, based on a structured literature search, on fetal behavior in normal and high-risk pregnancies, with particular emphasis on the potential for prenatal prediction of neurological development using this screening approach. The findings suggest that four-dimensional ultrasound-based prenatal assessment may be associated with postnatal neurodevelopment. However, scoring systems such as KANET should be interpreted with caution, as they remain promising but not yet definitive predictive tools.