Human fetal heart rate variability-characteristics of autonomic regulation in the third trimester of gestation
-
Uwe Schneider
Abstract
Aim: To describe developmental aspects of the sympatho-vagal heart rate regulation in the human fetus by applying numerics to visual descriptions of fetal heart rate patterns throughout the third trimester of pregnancy. The focus is to determine potential benefits of this alternative means of assessing the maturation of the fetal autonomic nervous system by analysis of fetal heart rate variability (fHRV).
Subjects and methods: The magnetocardiograms of 103 normal fetuses between 24+1 and 41+6 weeks of gestation were studied. Fetal heart beat intervals were determined with a temporal precision of 1 ms. The levels of fetal activity were estimated according to characteristic heart rate patterns (I–III) prior to 32, between 32–35 and beyond 35 (groups 1–3) completed weeks. Mean heart rate (mHR), standard deviation of normal-to-normal beat intervals (SDNN) and root mean square of successive differences of normal beats (RMSSD) served as fHRV indices, mean permutation entropy (PE_Mean) as complexity measure. SDNN/RMSSD was introduced as a potential marker for sympatho-vagal balance.
Results: Low activity fHRP (I) were characterized by significantly lower level fHRV indices and higher PE_Mean when compared to fHRP II. We found that SDNN/RMSSD decreases with gestation in fHRP I, which suggests increasing vagal influence. In fHRP III (assigned to active awake fetuses only after 32 weeks), highest level SDNN and mHR are associated with a dramatically reduced complexity. fHRV indices cluster characteristically with the activity levels.
Conclusions: We conclude that a combined analysis of fHRV, based on SDNN/RMSSD and PE_Mean, and fHRP is advantageous in the assessment of maturation of the fetal autonomic nervous system.
©2008 by Walter de Gruyter Berlin New York
Articles in the same Issue
- Original articles – Obstetrics
- Premature labor: a state of platelet activation?
- Soluble receptor for advanced glycation end products (sRAGE) and endogenous secretory RAGE (esRAGE) in amniotic fluid: modulation by infection and inflammation
- Detection of feto-maternal infection/inflammation by the soluble receptor for advanced glycation end products (sRAGE): results of a pilot study
- Weight gain in pregnancy according to maternal height and weight
- A randomized trial of tight vs. less tight control of mild essential and gestational hypertension in pregnancy
- Pregnancy outcome of women who developed proteinuria in the absence of hypertension after mid-gestation
- Anxiety symptoms during late pregnancy and early parenthood following assisted reproductive technology
- Original article – Fetus
- Human fetal heart rate variability-characteristics of autonomic regulation in the third trimester of gestation
- Original articles – Newborn
- Bronchopulmonary dysplasia and early prophylactic inhaled nitric oxide in preterm infants: current concepts and future research strategies in animal models
- Side effects of angiotensin converting enzyme inhibitor (captopril) in newborns and young infants
- Letters to the editor
- Mirror syndrome due to coxackie B virus associated to maternal peripartum cardiomyopathy
- Non-cardiogenic lung edema in a woman treated with atosiban for preterm labor
- Commentary: A case of non-cardiogenic lung edema in a woman treated with atosiban for preterm labor
- Congress Calendar
- 10.1515/JPM.2008.095
- Erratum
- Total body water in small- and appropriate - for gestational age newborns
- Announcement
- Calling European Pediatric Research Networks
- WAPM-Newsletter
- WAPM-Newsletter No 1/2008
Articles in the same Issue
- Original articles – Obstetrics
- Premature labor: a state of platelet activation?
- Soluble receptor for advanced glycation end products (sRAGE) and endogenous secretory RAGE (esRAGE) in amniotic fluid: modulation by infection and inflammation
- Detection of feto-maternal infection/inflammation by the soluble receptor for advanced glycation end products (sRAGE): results of a pilot study
- Weight gain in pregnancy according to maternal height and weight
- A randomized trial of tight vs. less tight control of mild essential and gestational hypertension in pregnancy
- Pregnancy outcome of women who developed proteinuria in the absence of hypertension after mid-gestation
- Anxiety symptoms during late pregnancy and early parenthood following assisted reproductive technology
- Original article – Fetus
- Human fetal heart rate variability-characteristics of autonomic regulation in the third trimester of gestation
- Original articles – Newborn
- Bronchopulmonary dysplasia and early prophylactic inhaled nitric oxide in preterm infants: current concepts and future research strategies in animal models
- Side effects of angiotensin converting enzyme inhibitor (captopril) in newborns and young infants
- Letters to the editor
- Mirror syndrome due to coxackie B virus associated to maternal peripartum cardiomyopathy
- Non-cardiogenic lung edema in a woman treated with atosiban for preterm labor
- Commentary: A case of non-cardiogenic lung edema in a woman treated with atosiban for preterm labor
- Congress Calendar
- 10.1515/JPM.2008.095
- Erratum
- Total body water in small- and appropriate - for gestational age newborns
- Announcement
- Calling European Pediatric Research Networks
- WAPM-Newsletter
- WAPM-Newsletter No 1/2008
