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Heart rate variability parameters and fetal movement complement fetal behavioral states detection via magnetography to monitor neurovegetative development.

Brändle J, Preissl H, Draganova R, Ortiz E, Kagan KO, Abele H, Brucker SY, Kiefer-Schmidt I - Front Hum Neurosci (2015)

Bottom Line: SDNN increased over gestation.Changes of HRV parameters between the fetal behavioral states, especially between 1F and 4F, were statistically significant.Increasing fetal activity was confirmed by a decrease in PE complexity measures.

View Article: PubMed Central - PubMed

Affiliation: University Women's Hospital and Research Institute for Women's Health, University of Tuebingen Tuebingen, Germany ; fMEG Center, University of Tuebingen Tuebingen, Germany ; Department of Obstetrics and Gynecology, University of Tuebingen Tuebingen, Germany.

ABSTRACT
Fetal behavioral states are defined by fetal movement and heart rate variability (HRV). At 32 weeks of gestational age (GA) the distinction of four fetal behavioral states represented by combinations of quiet or active sleep or awakeness is possible. Prior to 32 weeks, only periods of fetal activity and quiesence can be distinguished. The increasing synchronization of fetal movement and HRV reflects the development of the autonomic nervous system (ANS) control. Fetal magnetocardiography (fMCG) detects fetal heart activity at high temporal resolution, enabling the calculation of HRV parameters. This study combined the criteria of fetal movement with the HRV analysis to complete the criteria for fetal state detection. HRV parameters were calculated including the standard deviation of the normal-to-normal R-R interval (SDNN), the mean square of successive differences of the R-R intervals (RMSSD, SDNN/RMSSD ratio, and permutation entropy (PE) to gain information about the developing influence of the ANS within each fetal state. In this study, 55 magnetocardiograms from healthy fetuses of 24-41 weeks' GA were recorded for up to 45 min using a fetal biomagnetometer. Fetal states were classified based on HRV and movement detection. HRV parameters were calculated for each state. Before GA 32 weeks, 58.4% quiescence and 41.6% activity cycles were observed. Later, 24% quiet sleep state (1F), 65.4% active sleep state (2F), and 10.6% active awake state (4F) were observed. SDNN increased over gestation. Changes of HRV parameters between the fetal behavioral states, especially between 1F and 4F, were statistically significant. Increasing fetal activity was confirmed by a decrease in PE complexity measures. The fHRV parameters support the differentiation between states and indicate the development of autonomous nervous control of heart rate function.

No MeSH data available.


Related in: MedlinePlus

Distribution of the fetal behavioral states in percent of total recording time per GA group. Group 1: GA 24+0 to 32+0 weeks), Group 2: GA 32+1 to 35+0 weeks, and Group 3: GA 35+1 to 41 weeks.
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Figure 2: Distribution of the fetal behavioral states in percent of total recording time per GA group. Group 1: GA 24+0 to 32+0 weeks), Group 2: GA 32+1 to 35+0 weeks, and Group 3: GA 35+1 to 41 weeks.

Mentions: Starting at 24 weeks of GA, we performed measurements in 55 pregnant women (mean age 33 years) with a mean recording time of 32.5 min (range 10–45 min) divided into three groups by GA (group 1, n = 18; group 2, n = 15; and group 3, n = 22) as seen in Figure 2. State detection was possible in all 55 datastets (automatic state classification: n = 49; visual classification: n = 6). In 89% of all cases automatic state classification was used successfully. Only in 11% (n = 6) the algorithm failed and visual inspection was needed for classification. In this visual classification the two observers disagreed in two cases an a consensus was achieved by revision. In group 1 (GA < 32 weeks), fetuses were in the resting state and in activity cycles during 58.4 and 41.6% of the recording time, respectively. Group 2 (GA 32–35 weeks), exhibited 1F, 2F, and 4F during 16.2, 72, and 11.8% of the recording time. In the late gestation group 3, the occurrence of 1F increased to 31.8%, 2F decreased to 58.8% and 4F remained almost unchanged at 9.4% (Figure 2).


Heart rate variability parameters and fetal movement complement fetal behavioral states detection via magnetography to monitor neurovegetative development.

Brändle J, Preissl H, Draganova R, Ortiz E, Kagan KO, Abele H, Brucker SY, Kiefer-Schmidt I - Front Hum Neurosci (2015)

Distribution of the fetal behavioral states in percent of total recording time per GA group. Group 1: GA 24+0 to 32+0 weeks), Group 2: GA 32+1 to 35+0 weeks, and Group 3: GA 35+1 to 41 weeks.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4388008&req=5

Figure 2: Distribution of the fetal behavioral states in percent of total recording time per GA group. Group 1: GA 24+0 to 32+0 weeks), Group 2: GA 32+1 to 35+0 weeks, and Group 3: GA 35+1 to 41 weeks.
Mentions: Starting at 24 weeks of GA, we performed measurements in 55 pregnant women (mean age 33 years) with a mean recording time of 32.5 min (range 10–45 min) divided into three groups by GA (group 1, n = 18; group 2, n = 15; and group 3, n = 22) as seen in Figure 2. State detection was possible in all 55 datastets (automatic state classification: n = 49; visual classification: n = 6). In 89% of all cases automatic state classification was used successfully. Only in 11% (n = 6) the algorithm failed and visual inspection was needed for classification. In this visual classification the two observers disagreed in two cases an a consensus was achieved by revision. In group 1 (GA < 32 weeks), fetuses were in the resting state and in activity cycles during 58.4 and 41.6% of the recording time, respectively. Group 2 (GA 32–35 weeks), exhibited 1F, 2F, and 4F during 16.2, 72, and 11.8% of the recording time. In the late gestation group 3, the occurrence of 1F increased to 31.8%, 2F decreased to 58.8% and 4F remained almost unchanged at 9.4% (Figure 2).

Bottom Line: SDNN increased over gestation.Changes of HRV parameters between the fetal behavioral states, especially between 1F and 4F, were statistically significant.Increasing fetal activity was confirmed by a decrease in PE complexity measures.

View Article: PubMed Central - PubMed

Affiliation: University Women's Hospital and Research Institute for Women's Health, University of Tuebingen Tuebingen, Germany ; fMEG Center, University of Tuebingen Tuebingen, Germany ; Department of Obstetrics and Gynecology, University of Tuebingen Tuebingen, Germany.

ABSTRACT
Fetal behavioral states are defined by fetal movement and heart rate variability (HRV). At 32 weeks of gestational age (GA) the distinction of four fetal behavioral states represented by combinations of quiet or active sleep or awakeness is possible. Prior to 32 weeks, only periods of fetal activity and quiesence can be distinguished. The increasing synchronization of fetal movement and HRV reflects the development of the autonomic nervous system (ANS) control. Fetal magnetocardiography (fMCG) detects fetal heart activity at high temporal resolution, enabling the calculation of HRV parameters. This study combined the criteria of fetal movement with the HRV analysis to complete the criteria for fetal state detection. HRV parameters were calculated including the standard deviation of the normal-to-normal R-R interval (SDNN), the mean square of successive differences of the R-R intervals (RMSSD, SDNN/RMSSD ratio, and permutation entropy (PE) to gain information about the developing influence of the ANS within each fetal state. In this study, 55 magnetocardiograms from healthy fetuses of 24-41 weeks' GA were recorded for up to 45 min using a fetal biomagnetometer. Fetal states were classified based on HRV and movement detection. HRV parameters were calculated for each state. Before GA 32 weeks, 58.4% quiescence and 41.6% activity cycles were observed. Later, 24% quiet sleep state (1F), 65.4% active sleep state (2F), and 10.6% active awake state (4F) were observed. SDNN increased over gestation. Changes of HRV parameters between the fetal behavioral states, especially between 1F and 4F, were statistically significant. Increasing fetal activity was confirmed by a decrease in PE complexity measures. The fHRV parameters support the differentiation between states and indicate the development of autonomous nervous control of heart rate function.

No MeSH data available.


Related in: MedlinePlus