“The movements of the developing human skeleton in utero have never previously been characterised – it gives us a new baseline”

Dr Niamh Nowlan
Senior Lecturer in the Department Of Bioengineering


A baby’s kick from inside its expectant mother is arguably one of the most awe-inspiring aspects of pregnancy. But, far from simply being an emotional high point, one Imperial researcher has set out to demonstrate that the kick could have a fundamental story to tell about the baby’s development.


Dr Niamh Nowlan, Senior Lecturer in the Department of Bioengineering, has begun a ground-breaking study into the impact of fetal movements – the baby kicking in the womb – by analysing what actually happens during that kicking process. These fetal movements are essential for the health of the baby, and, in particular, for the normal development of the bones, joints and spine. Yet little is known about how much movement is necessary for normal skeletal development, when movement is most important, and whether the effects of reduced movement on the skeleton can be mitigated.


Nowlan and research colleagues from Imperial, Great Ormond Street Hospital and King’s College London set out, for the first time, to explore how fetal movements affect the formation and development of the bones and joints, and may be indicative of the health and development of the unborn baby. They used scans from a range of pregnant women at 20, 25, 30 and 35 weeks to produce a computer model that calculated the stresses fetal movement puts on the uterine wall. From this they created a musculoskeletal model that could then compute the level of stress and strain experienced by the fetus.


“The movements of the developing human skeleton in utero have never previously been characterised,” says Nowlan.

“We discovered that the stress stimulation – the kicking – actually plays a role in the development of the skeleton, with the amount of stimulation increasing as the baby grows, and as the bones, such as the limbs and pelvis, are created.

“Quantifying those biomechanical movements over the second half of gestations gives us a new baseline of what is normal development. It advances our understanding of the biomechanical environment of the uterus, and ultimately allows for better screening. Our research also increases our understanding of other developmental problems, such as hip dysplasia, where ball and joint sockets fail to form properly.


“These achievements form part of the aims of a three-year grant from Arthritis Research UK,” says Nowlan. “We are not just pushing back those boundaries now, but creating an environment that enables us to answer the questions of the future.” They also reflect Imperial’s five-year strategy to attain enduring excellence in science, medicine, engineering and business.

“Our results will, for the first time, help identify environments that increase the risk of joint malformations, helping clinicians to consider interventions prenatally, to perform more intensive screening on at-risk infants after birth and to prescribe suitable postnatal physiotherapy.

“They may also inform future preventative measures for neonatal joint conditions, thereby potentially reducing the risk of osteoarthritis in later life. With this understanding of what is normal, we can create better-quality monitoring, which is of huge benefit to our advancement of knowledge, medical staff and, most importantly of course, the health of mothers-to-be and their babies.”