Fetal heart rate and motor development in overweight and obese pregnant women

Abstract

Objective To determine the relationship between maternal prepregnancy body mass index (BMI) and fetal cardiac and motor activity and integration during the second half of pregnancy. Methods Longitudinal data were collected from 610 nonsmoking women with normally progressing pregnancies at three gestational periods (24, 30–32, and 36 weeks) across eight cohorts studied between 1997 and 2013. Fifty minutes of fetal heart rate and motor activity data were collected at each period via actocardiography in a laboratory setting. Data were digitized and analyzed using customized software. Standard BMI categories were computed from maternal prepregnancy weight and height. Participants were stratified into normal weight (n=401, 65.7%), overweight (n=137, 22.5%), or obese (n=72, 11.8%). Results Fetuses of obese women showed lower heart rate variability and fewer accelerations relative to fetuses of normal weight women. Fetuses of both obese and overweight women exhibited more vigorous motor activity than fetuses of normal weight women. Cardiac–somatic integration was reduced in both obese and overweight groups. Findings differed by gestational age at assessment. Conclusions Excess maternal prepregnancy weight in overweight and obese women alters the normal trajectory of fetal cardiac and motor development and their integration, with effects amplified as pregnancy progresses.

Maternal Weight, Weight Gain, and Metabolism are Associated with Changes in Fetal Heart Rate and Variability

“…Although the maternal weight gain group was computed according to prepregnancy BMI, we still observed a reduction in HRV in fetuses of mothers with high maternal weight gain. This is in contrast to a recent finding by Voegtline et al , in which maternal weight gain was reported to have no predictive power on fetal HR and fetal HRV beyond prepregnancy BMI. The reduction in fetal HRV in mothers with high weight gain could be interpreted as an adverse effect on the fetal ANS, since reduced fetal HRV has also been observed in intrauterine growth‐restricted and GDM fetuses .…”

“…Intrauterine environment, including maternal nutrition, could permanently alter and program the fetal autonomic nervous system (ANS) . The fetal ANS could be investigated by magnetic and electric recordings of the heart activity and the extraction of heart rate (HR) and heart rate variability (HRV).…”

Understanding the associations and significance of fetal movements in overweight or obese pregnant women: a systematic review

“…One study, Voegtline et al, compared fetal motor activity among 137 overweight, 72 obese and 401 normal weight women . There was moderate risk of bias for ascertainment of exposure and measurement of outcomes (Table ).…”

“…There was moderate risk of bias for ascertainment of exposure and measurement of outcomes (Table ). Higher motor activity was reported at 30–32 weeks and 36 weeks of gestation among fetuses of obese and overweight compared with normal weight women, but numerical data were not provided .…”

“…We were generally unable to find evidence that fetal movement is affected by increased maternal body size, although one study reported a delayed trajectory of development in fetuses of overweight and obese mothers compared with normal weight mothers . Delayed development of fetal behavioral states has been observed in fetuses of diabetic women , as has DFM .…”