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Fetal Attraction
A JHH research nurse shares her discoveries about life in utero

Kathleen Costigan's sonograms probe much more than the baby's image. About half of her study participants are employees or students, including Rachel Lee, a Hopkins Hospital dietitian.
Ever wonder just how much babies in utero are affected by their mothers’ emotions? If an active fetus becomes an active baby? If playing music during pregnancy makes for a musical child?

Nurse clinician Kathleen Costigan has made a career of finding answers to questions like these.

For the past 14 years, Costigan, a research nurse in the Department of Gyn/Ob, has collected data on 671 women who are at least 20 weeks’ pregnant.

Her studies, conducted and undertaken with principal investigator Janet DiPietro, a developmental psychologist and professor in population and family health sciences at the Bloomberg School of Public Health, have yielded 24 published papers in leading scientific journals.

Costigan and DiPietro don’t claim to have pioneered fetal research, but their lab boasts the largest number of fetal development protocols of any institution in the United States. Here, in the Fetal Assessment Center on Nelson 2, Costigan uses fetal heart monitoring, sonograms and other tests to investigate how fetuses respond to stimuli. She tracks their development and looks for clues to the personalities that will blossom in the months and years after birth. “Most studies end at birth because they’re looking at medical pregnancy outcomes,” explains DiPietro. “We continue our investigations beyond birth—so far, through age 3.”

Some findings: As early as 24 weeks, the fetus reacts at the moment its mother becomes stressed or relaxed. “What’s happening in the mother’s life is key,” Costigan says, adding that moderate stress may actually help the fetus adapt to the environment, often making the baby more resilient.

And more: Behavioral development is most dynamic at 32 weeks, not immediately after birth. After this time, a fetus behaves in a manner very similar to that of a newborn infant.

What about all those old wives tales? Can mothers, for example, really predict sex? If the mother has heartburn during pregnancy, will she, as some believe, have a baby with lots of hair? The two researchers heard so many claims like these, they felt compelled to investigate.

Turns out some of those old wives were right. In one study, 70 of 100 women correctly predicted their babies’ sex. In another, in almost every case where mothers reported severe heartburn, their babies emerged with a shock of hair. But there’s absolutely no evidence that blasting Mozart while the baby is in utero will make the child musical. In fact, says DiPietro, it’s a dangerous practice that can agitate a fetus.

Study participants make five or six visits, each one lasting up to two hours. Subjects complete questionnaires about their physical and mental health. They receive free sonograms and a nominal gift certificate to Target or similar stores. More than 50 study participants are second-time-around, and four have returned for a third round.


Rachel Lee, a dietitian at Hopkins Hospital who is pregnant with her first child, signed up for a study after seeing a flier. “Kathleen spends lots of time with me and gives me reassurance,” she says. Five days after the baby is born, Costigan will send a nurse practitioner to Lee’s home to chart the baby’s development.

When Costigan detects an abnormality on ultrasound, she asks permission to consult with the woman’s doctor. In one case she detected a kidney filled with fluid. Costigan referred the mother to a perinatologist, who confirmed the problem. The mother was able to consult with a pediatric urologist before the baby was born.

From the outset, these fetal studies caught the attention of the media. Though many stories have focused on myth-busting, Costigan hopes the hard science isn’t overlooked. Physiological monitoring is exhaustive, she explains, and includes fetal heart rate and movement, uterine contractions, maternal heart rate and respiration. Links between the mother and fetus are verified using cutting-edge technology.

Costigan’s investigations have breadth. Five years ago, she helped set up a similar lab at Hopkins Bayview in the Center for Addiction and Pregnancy in hopes of extending research to changing methadone dosing for addicted pregnant women. She also traveled to Lima, Peru, to set up a similar lab in a study looking at nutritional supplementation during pregnancy.

One of the perks of her job, says Costigan, is being able to tell mothers their baby’s sex—if the parents want to know. But withholding that information isn’t always easy. “I once had two soon-to-be grandmothers try to bribe me for the information,” Costigan recalls. Costigan wouldn’t budge.

What’s up next? Can babies learn in utero? How do sex hormones influence behavior? “We’re not running out of questions—that’s for sure.”

Judy Minkove

For info on joining a study: Kathleen Costigan, 410-614-5876


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