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Does ethnicity have an effect on fetal behavior? A comparison of Asian and Caucasian populations

  • Uiko Hanaoka , Toshiyuki Hata EMAIL logo , Kenji Kanenishi , Mohamed Ahmed Mostafa AboEllail , Rina Uematsu , Yukihiko Konishi , Takashi Kusaka , Junko Noguchi , Genzo Marumo , Oliver Vasilj and Asim Kurjak


Aim: This study aimed to evaluate the ethnic difference in fetal behavior between Asian and Caucasian populations.

Methods: Fetal behavior was assesed by Kurjak’s antenatal neurodevelopmental test (KANET) using four-dimensional (4D) ultrasound between 28 and 38 weeks of gestation. Eighty-nine Japanese (representative of Asians) and seventy-eight Croatian (representative of Caucasians) pregnant women were studied. The total value of KANET score and values of each parameter (eight parameters) were compared.

Results: The total KANET score was normal in both populations, but there was a significant difference in total KANET scores between Japanese (median, 14; range, 10–16) and Croatian fetuses (median, 12; range, 10–15) (P<0.0001). When individual KANET parameters were compared, we found significant differences in four fetal movements (isolated head anteflexion, isolated eye blinking, facial alteration or mouth opening, and isolated leg movement). No significant differences were noted in the four other parameters (cranial suture and head circumference, isolated hand movement or hand to face movements, fingers movements, and gestalt of general movements).

Conclusion: Our results suggest that ethnicity should be considered when evaluating fetal behavior, especially during assessment of fetal facial expressions. Although there was a difference in the total KANET score between Japanese and Croatian populations, all the scores in both groups were within normal range. Our results indicate that ethnical differences in fetal behaviour do not affect the total KANET score, but close follow-up should be continued in some borderline cases.

Corresponding author: Toshiyuki Hata, MD, PhD, Department of Perinatology and Gynecology, Kagawa University Graduate School of Medicine, 1750-1 Ikenobe, Miki, Kagawa 761-0793, Japan, Tel.: +81-(0)87-891-2174, Fax: +81-(0)87-891-2175, E-mail:


The work reported in this paper was supported by a Grant-in-Aid for Scientific Research on Innovative Areas “Constructive Developmental Science” (No. 24119004), and Research Grant (No. 25462561) from The Ministry of Education, Culture, Sports, Science and Technology, Japan.


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The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2015-1-23
Accepted: 2015-5-6
Published Online: 2015-6-2
Published in Print: 2016-3-1

©2016 by De Gruyter

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