Biochemical and Anthropometric Parameters for the Early Recognition of the Intrauterine Growth Restriction and Preterm Neonates at Risk of Impaired Neurodevelopment

Aisa, Maria Cristina; Cappuccini, Benito; Favilli, Alessandro; Datti, Alessandro; Nardicchi, Vincenza; Coata, Giuliana; Gerli, Sandro

doi:10.3390/ijms241411549

Cited by 3 publications

(1 citation statement)

References 66 publications

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“…Як лінійні (SDNN), так і нелінійні (TP) показники загального рівня ВСР були знижені на тлі ЗРП. Це свідчило про пригнічення автономної нервової регуляції у даної категорії плодів і підтверджувало думку про затримку неврологічного розвитку при ЗРП [24][25][26].…”

Section: результати дослідження та їх обговоренняunclassified

The value of some indices of heart rate variability in the diagnosis of fetal growth retardation

Lakhno,

Martynenko,

Raimondi

et al. 2023

RHW

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Fetal growth retardation (FGR) is one of the most serious problems in current perinatology. This pathology leads not only to the deterioration of perinatal outcomes but also significantly increases morbidity during adult life. FGR is known to be featured by its delayed “neurological maturation”. This is manifested in a decrease in autonomic nervous regulation according to the fetal heart rate variability (HRV) scores and indices. The objective: to study HRV in fetuses with normal biometric indices compared to similar parameters of growth retarded fetuses. Materials and methods. The 47 pregnant women who had fetuses with normal biometric indices (I group) and 33 patients with fetal growth retardation (II group) were included in the study. The investigation of the fetal HRV was performed by processing the R–R intervals obtained via non-invasive electrocardiogram (ECG) and involved the following indices: STV (short term variations), LTV (long term variations), AC/DC (acceleration capacity/deceleration capacity), TP (total power), SI (stress index), SDNN (standard deviation of normal to normal intervals), EnRE (entropy of the time series), D2 (correlation dimension of the time series), Z (temporary irreversibility) і FL (measure of fuzzy logic, integrated measure of HRV). Results. The obtained data indicated that the indices of fetal HRV were reduced in the patients with FGR. These indices have utility in screening programs for the detection of fetal intrauterine nutrition and growth disturbances. The results of the study allow us to believe that the ability to accelerate heart rate patterns is partly preserved even during FGR. This may indicate a very ancient phylogenetic nature of the reaction of the heart system of the fetus to its motile activity. However, decelerations according to the DC were typical for FGR. A non-invasive fetal ECG could become a useful supplementary method in the current methods’ spectrum used in perinatal medicine. Conclusions. Therefore, the development of algorithms for the diagnosis of FGR requires the inclusion of the following HRV indices: STV, LTV, DC, TP, SI, SDNN, D2, Z, and FL. These biophysical markers of FGR can be used as a screening program in conditions of lack of access to high-quality ultrasound diagnostics or be a valuable addition to existing perinatal strategies.

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Section: результати дослідження та їх обговоренняunclassified

The value of some indices of heart rate variability in the diagnosis of fetal growth retardation

Lakhno,

Martynenko,

Raimondi

et al. 2023

RHW

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Evaluating neuronal damage biomarkers at birth for predicting neurodevelopmental risks in foetal growth restriction

Benítez‐Marín,

Blasco‐Alonso,

de Rodríguez de Fonseca

et al. 2024

Acta Paediatrica

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AimThis study was based on the need to predict neurodevelopmental outcomes of children with foetal growth restriction. The aim was to systematically review the correlation between biomarkers of neural injury in children with foetal growth restriction and their neurodevelopment.MethodFollowing Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines, the review included studies on growth‐restricted foetuses that measured biomarkers of postpartum brain injury and assessed neurodevelopment in childhood. Studies published between 1 January 2014 and 31 March 2024 were identified through PubMed and Embase, with the study protocol registered in PROSPERO (CRD42024520254).ResultsOnly five met the inclusion criteria. Results showed that urinary S100B levels were significantly elevated in foetal growth restriction, negatively correlating with neurological development at 7 days of life. Neuron‐specific enolase negatively correlated with cognitive, motor and socio‐emotional development. Urinary nerve growth factor levels were significantly lower in neonates with foetal growth restriction, correlating with poor neurodevelopment. No alterations in BDNF levels were observed. Tau protein levels were lower in children with foetal growth restriction and adverse outcomes.ConclusionThe study emphasised the need for further research on biomarkers and predictive models of neurodevelopment in children with foetal growth restriction.

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Prospects for the study of some electrophysiological parameters in the diagnosis of fetal growth restriction

Lakhno,

Martynenko,

Raimondi

et al. 2023

ЕМ

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Background. Fetal growth restriction is a clinical syndrome that has adverse effects on both perinatal outcomes and human health in adulthood. Traditional approaches to the diagnosis of this syndrome are based on ultrasound biometry and dopplerometry of uteroplacental and fetal-umbilical blood flow. The equipment used for such research is very expensive, and the training of a qualified specialist takes a long time. Non-invasive electrocardiography makes it possible to evaluate fetal heart rate variability and morphological parameters of the pQRST complex. The purpose: to determine indices of heart rate variability and morphological parameters based on the data of fetal non-invasive electrocardiography, which can be used to diagnose fetal growth restriction. Materials and methods. Two hundred and twenty pregnant women aged 18 to 40 years on 24–41 weeks of gestation were enrolled in the study. All of them were divided into two groups: 108 women with fetal growth restriction were included in group I, and 112 patients with healthy fetuses in group II. The fetal electrocardiogram was recorded in abdominal lead for 30–60 minutes. Results. The performed work made it possible to detect statistically significant changes in some indices of heart rate variability on the background of fetal growth restriction: SI, TP, AC/DC, LF, LF/HF ratio, as well as morphological parameters: QTc duration, QRS complex width and T/QRS ratio. The obtained data demonstrated a violation of autonomic regulation following fetal growth restriction and reflected the tension of regulatory systems, namely, the degree of dominance of the activity of central regulatory mechanisms over autonomous ones. Impaired de- and repolarization processes were a consequence of fetal myocardium remodeling due to ischemia. Conclusions. The development of algorithms for the diagnosis of fetal growth restriction using non-invasive electrocardiography requires further research of the following parameters: SI, TP, AC/DC, LF, LF/HF ratio, QTc duration, QRS complex width, and T/QRS ratio.

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Biochemical and Anthropometric Parameters for the Early Recognition of the Intrauterine Growth Restriction and Preterm Neonates at Risk of Impaired Neurodevelopment

Cited by 3 publications

References 66 publications

The value of some indices of heart rate variability in the diagnosis of fetal growth retardation

The value of some indices of heart rate variability in the diagnosis of fetal growth retardation

Evaluating neuronal damage biomarkers at birth for predicting neurodevelopmental risks in foetal growth restriction

Prospects for the study of some electrophysiological parameters in the diagnosis of fetal growth restriction

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