Longitudinal evaluation of computerized cardiotocographic parameters throughout pregnancy in normal fetuses: a prospective cohort study

Amorim-Costa, Célia; Costa-Santos, Cristina; Ayres-de-Campos, Diogo; Bernardes, João

doi:10.1111/aogs.12932

Cited by 26 publications

(16 citation statements)

References 47 publications

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“…FHR significantly decreases and FHRV significantly increases across GA (Amorim‐Costa et al, ; DiPietro et al, ; Lange et al, ) indicating that higher FHRV and lower FHR is a more mature pattern. We did not find that GA was correlated with FHR and FHRV, perhaps due to low power and the small range for gestational age (36–39 weeks).…”

Section: Discussionmentioning

confidence: 99%

“…Fetal heart rate (FHR) and heart rate variability (FHRV) provide indicators of brain development in the human fetus. Specifically, the gradual increase in FHRV and decrease in FHR as a function of gestational age, are indicative of a healthy developing fetus (Amorim‐Costa, Costa‐Santos, Ayres‐de‐Campos, & Bernardes, ; DiPietro et al, ; Lange, Van Leeuwen, Geue, Hatzmann, & Grönemeyer, ).…”

Section: Introductionmentioning

confidence: 99%

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Assessment of autonomic function in the late term fetus: The effects of sex and state

Zavala

Ecklund‐Flores

Myers

et al. 2019

Developmental Psychobiology

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Researchers have reported associations between fetal sex and heart rate (FHR) and heart rate variability (FHRV) but rarely in the context of fetal behavioral sleep state. We examined differences in measures of fetal autonomic function by sex and sleep state. Fetal abdominal ECG monitoring technology was used to measure FHR and two measures of FHRV—standard deviation of FHR (SD) and beat‐to‐beat variability (RMSSD). FHR and movement patterns were also recorded with standard Doppler ultrasound monitor technology employed to code sleep states. Data were collected from 82 healthy fetuses ranging from 36 to 39 weeks gestation. A one‐way MANOVA showed that FHR was significantly lower and SD was significantly higher for males than females. Independent samples t tests found that these sex differences were only in the active sleep state. There were no significant differences in RMSSD by sex. Repeated measures MANOVA for a subset that exhibited more than one state (N = 22) showed that SD was significantly different by state. RMSSD showed a marginally significant sleep state difference. In conclusion, fetal sex differences in HR and HRV may indicate more mature autonomic functioning in near‐term males than females and fetal sleep state can influence abdominal fECG derived measures of FHR and FHRV.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessment of autonomic function in the late term fetus: The effects of sex and state

Zavala

Ecklund‐Flores

Myers

et al. 2019

Developmental Psychobiology

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“…Tracings with signal loss above 33%, or signal quality (percentage of points identified by the fetal monitor as having good or very good signal quality) below 80% were excluded (Amorim-Costa et al 2016). The fetal behavioral states were classified similar to that of fMCG recordings mentioned above in the Jena study group ‘Prenatal Monitoring of Fetal Maturation’.…”

Section: Validation Of Mcg Based Age Score Fabas In Ctg Recordingmentioning

confidence: 99%

Monitoring fetal maturation—objectives, techniques and indices of autonomic function

et al. 2017

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Objective Monitoring the fetal behavior does not only have implications for acute care but also for identifying developmental disturbances that burden the entire later life. The concept, of ‘fetal programming’, also known as ‘developmental origins of adult disease hypothesis’, e.g. applies for cardiovascular, metabolic, hyperkinetic, cognitive disorders. Since the autonomic nervous system is involved in all of those systems, cardiac autonomic control may provide relevant functional diagnostic and prognostic information. Approach The fetal heart rate patterns (HRP) are one of the few functional signals in the prenatal period that relate to autonomic control and, therefore, is key to fetal autonomic assessment. The development of sensitive markers of fetal maturation and its disturbances requires the consideration of physiological fundamentals, recording technology and HRP parameters of autonomic control. Main Results Based on the ESGCO2016 special session on monitoring the fetal maturation we herein report the most recent results on: (i) functional fetal autonomic brain age score (fABAS), Recurrence Quantitative Analysis and Binary Symbolic Dynamics of complex HRP resolve specific maturation periods, (ii) magnetocardiography (MCG) based fABAS was validated for cardiotocography (CTG), (iii) 30 min recordings are sufficient for obtaining episodes of high variability, important for intrauterine growth restriction (IUGR) detection in handheld Doppler, (iv) novel parameters from PRSA to identify Intra IUGR fetuses, (v) evaluation of fetal electrocardiographic (ECG) recordings, (vi) correlation between maternal and fetal HRV is disturbed in pre-eclampsia. Significance The reported novel developments significantly extend the possibilities for the established CTG methodology. Novel HRP indices improve the accuracy of assessment due to their more appropriate consideration of complex autonomic processes across the recording technologies (CTG, handheld Doppler, MCG, ECG). The ultimate objective is their dissemination into routine practice and studies of fetal developmental disturbances with implications for programming of adult diseases.

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“…Decreases in fetal heart rate (FHR) and increases in heart rate variability (HRV) during gestation have been well documented (1–7). HRV is the variation in the heart’s beat-to-beat intervals as a result of autonomic regulation of HR (8).…”

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confidence: 99%

Fetal heart rate, heart rate variability, and heart rate/movement coupling in the Safe Passage Study

Shuffrey

et al. 2019

J Perinatol

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Structured Abstract Objective: To determine normative values for heart rate patterns in healthy fetuses. Methods: This research is from the Safe Passage Study conducted by the Prenatal Alcohol and SIDS and Stillbirth (PASS) Network. A standardized protocol assessed fetal heart rate (FHR), heart rate variability (HRV), and movement from 1,655 fetuses at three time points during gestation (20–24 weeks, 28–32 weeks, 34–38 weeks gestation). Results: FHR decreased while HRV increased over gestation. At the latter two ages, males had significantly lower FHR than females while there were no sex differences in FHR at 20–24 weeks. When accounting for fetal state during late gestation (34–28 weeks), we found that males had significantly lower FHR than females in the active fetal state only. Conclusion: Results demonstrate significant state, gestational age, and sex related changes in cardiac activity, somatic activity, and autonomic function as the fetus approaches birth.

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Longitudinal evaluation of computerized cardiotocographic parameters throughout pregnancy in normal fetuses: a prospective cohort study

Cited by 26 publications

References 47 publications

Assessment of autonomic function in the late term fetus: The effects of sex and state

Assessment of autonomic function in the late term fetus: The effects of sex and state

Monitoring fetal maturation—objectives, techniques and indices of autonomic function

Fetal heart rate, heart rate variability, and heart rate/movement coupling in the Safe Passage Study

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