Validation of functional fetal autonomic brain age score fABAS in 5 min short recordings

Abstract

With the objective of evaluating the functional maturation age and developmental disturbances we have previously introduced the fetal autonomic brain age score (fABAS) using 30 min fetal magnetocardiographic recordings (fMCG, Jena). The score is based on heart rate pattern indices that are related to universal principles of developmental biology. The present work aims at the validation of the fABAS methodology on 5 min recordings from an independent database (fMCG, Bochum).We found high agreement of fABAS obtained from Jena normal fetuses (5 min subsets, n = 364) and Bochum recordings (n = 322, normal fetuses). fABAS of 48 recordings from fetuses with intra-uterine growth restriction (IUGR, Bochum) was reduced in most of the cases, a result consistent with IUGR fetuses from Jena previously reported. fABAS calculated from 5 min snapshots only partly covers the accuracy when compared to fABAS from 30 min recordings. More precise diagnosis requires longer recordings.fABAS obtained from fMCG recordings is a strong candidate for standardized assessment of functional maturation age and developmental disturbances. Even 5 min recordings seem to be valuable for screening for maturation problems.

Developmental milestones of the autonomic nervous system revealed via longitudinal monitoring of fetal heart rate variability

“…Recently, HRV indices that reflect general principles of maturation, adaptation and self-organization, such as increasing fluctuation amplitude, increasing complexity and the formation of characteristic patterns, have been investigated. [ 4 , 14 , 15 ].…”

“…Rest/activity cycles have been described from about 23 WGA onwards with progressing discernibility between 26 and 32 WGA. Synchronization of neuro-behavioral variables like fHRP, body movements and eye-movements are markers of the developmental integrity of the fetus [ 15 – 17 ]. From 32 WGA onwards state synchronization was observed in up to 80% of observation times.…”

Heart rate variability categories of fluctuation amplitude and complexity: diagnostic markers of fetal development and its disturbances

“…Normal reference group: MCG recordings lasting 5 min of the Bochum study data base (Grönemeyer Institute for Microtherapy, University Witten/Herdecke, Bochum). For methodological details see (Hoyer et al, 2015).…”

“…Influence of IUGR reference group 1: MCG recordings from the Bochum data base and respective normal controls. For details see (Hoyer et al, 2015).…”

Fetal Developmental Deviations Reflected in a Functional Autonomic Brain Age Score

“…But effects on the fetal functional autonomic brain age were mainly not yet investigated. First results showed reduced fABAS values in intrauterine growth restricted fetuses [2,5]. A comprehensive evaluation of the diagnostic value of fABAS with respect to different developmental influences as well as its comparison to traditional fHRV indices is pending.…”