Prenatal auditory stimulation and fetal cerebral circulation in humans: A narrative review

The human fetus is exposed to a heterogeneous sensory environment during gestation, and auditory perception is an important component of prenatal neurological development. Although neonatal hearing screening is established, directly assessing auditory function before birth remains challenging. This narrative review was based on searches of PubMed/MEDLINE, Google Scholar, and bibliographic sources from database inception through September 2026. We included human studies of prenatal acoustic stimulation using fetal middle cerebral artery (MCA) assessment, along with contextual literature on auditory development, fetal Doppler, and postnatal hearing screening. Changes in MCA pulsatility index after defined acoustic stimulation may reflect cerebrovascular reactivity, but available studies vary in population, gestational age, measurement timing, and statistical analysis. No study established a validated test threshold or permitted calculation of sensitivity and specificity against postnatal hearing impairment. This approach should therefore be regarded as an investigational assessment of fetal cerebrovascular reactivity rather than a validated prenatal hearing-screening test.