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

Schneider, Uwe; Bode, Franziska; Schmidt, A.; Nowack, Samuel; Rudolph, Anja; Dölker, Eva-Maria; Götz, Theresa; Hoyer, Dirk

doi:10.1371/journal.pone.0202611

Cited by 6 publications

(9 citation statements)

References 1 publication

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“…Following those results, further evidence also suggests that preterm newborns exhibit lower parasympathetic modulation of the heart (35). According to Patural et al, high-frequency fetal dominance continues to increase until the last months of pregnancy, and preterm newborns manifest lower parasympathetic activity than fullterm newborns (36), which may have a decreased sympathetic influence owing to an increase in the vagal influence (37).…”

Section: Discussionmentioning

confidence: 79%

“…We extracted the R-R interbeat interval and uterine electrical activity (TOCO-like) signals from recorded transabdominal data of pregnant women during active labor at term (37-40 WG) and women at preterm labor (32)(33)(34)(35)(36). The length of the recordings was between 10 and 60 minutes.…”

Section: Dataset Description and Preprocessingmentioning

confidence: 99%

“…The fetal R-R interbeat interval signals with low quality were excluded from the analysis, including recordings with a high missing rate (> 10% of missed fetal beats) and recordings with less than 20 min. We selected for the analysis the recordings of fetuses up to 36 weeks of gestation (32)(33)(34)(35)(36) for the preterm group (PT group) and those at least 39 weeks of gestation (39-40 WG) for the term group (T group).…”

Section: Dataset Description and Preprocessingmentioning

confidence: 99%

“…Previous reports indicate that the FHRV power spectrum increase in both HF and LF throughout pregnancy (non-labor), which has been associated with fetal autonomic development (9,10). Along the same line, a study used power spectrum analysis of FHRV in post-term (≥42 WG) and near-term (36)(37) fetuses during the first stage of labor. The authors found that near-term fetuses showed a sympathetic predominance during the active state, while postterm fetuses showed higher parasympathetic modulation during the quiet state.…”

Section: Introductionmentioning

confidence: 99%

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Uterine activity modifies the response of the fetal autonomic nervous system at preterm active labor

et al. 2023

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BackgroundThe autonomic nervous system of preterm fetuses has a different level of maturity than term fetuses. Thus, their autonomic response to transient hypoxemia caused by uterine contractions in labor may differ. This study aims to compare the behavior of the fetal autonomic response to uterine contractions between preterm and term active labor using a novel time-frequency analysis of fetal heart rate variability (FHRV).MethodsWe performed a case-control study using fetal R-R and uterine activity time series obtained by abdominal electrical recordings from 18 women in active preterm labor (32−36 weeks of gestation) and 19 in active term labor (39−40 weeks of gestation). We analyzed 20 minutes of the fetal R-R time series by applying a Continuous Wavelet Transform (CWT) to obtain frequency (HF, 0.2−1 Hz; LF, 0.05−0.2 Hz) and time-frequency (Flux0, Flux90, and Flux45) domain features. Time domain FHRV features (SDNN, RMSSD, meanNN) were also calculated. In addition, ultra-short FHRV analysis was performed by segmenting the fetal R-R time series according to episodes of the uterine contraction and quiescent periods.ResultsNo significant differences between preterm and term labor were found for FHRV features when calculated over 20 minutes. However, we found significant differences when segmenting between uterine contraction and quiescent periods. In the preterm group, the LF, Flux0, and Flux45 were higher during the average contraction episode compared with the average quiescent period (p<0.01), while in term fetuses, vagally mediated FHRV features (HF and RMSSD) were higher during the average contraction episode (p<0.05). The meanNN was lower during the strongest contraction in preterm fetuses compared to their consecutive quiescent period (p=0.008).ConclusionThe average autonomic response to contractions in preterm fetuses shows sympathetic predominance, while term fetuses respond through parasympathetic activity. Comparison between groups during the strongest contraction showed a diminished fetal autonomic response in the preterm group. Thus, separating contraction and quiescent periods during labor allows for identifying differences in the autonomic nervous system cardiac regulation between preterm and term fetuses.

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Section: Discussionmentioning

confidence: 79%

Section: Dataset Description and Preprocessingmentioning

confidence: 99%

Section: Dataset Description and Preprocessingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Uterine activity modifies the response of the fetal autonomic nervous system at preterm active labor

et al. 2023

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“…Its regulation depends inter alia on the function of autonomic cardiac nerves and neurotransmitters. Although the anatomical pathways appear early, the sympathetic and parasympathetic elements develop their functionality independently, with the sympathetic nervous system being formed in the first weeks of pregnancy and the parasympathetic nervous system being established later [17][18][19]. This difference in the pace of development could be the reason why lower FHR was noticed at the 25 th week of gestation, characterized by a more significant vagal tone, than in the 18 th week of gestation, with a more sympathetic tone [20].…”

Section: Discussionmentioning

confidence: 99%

Normal ranges of fetal heart rate values for healthy fetuses in Poland, as determined by ultrasound between weeks 18 and 29 of gestation

Sylwestrzak¹,

Nowakowska²,

Murlewska³

et al. 2021

Kardiol Pol

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Background: Fetal heart rate (FHR) is commonly used to assess fetal well-being. Aims:The aim was to establish normal ranges of FHR during pregnancy by umbilical artery (UMB-A) Doppler analysis in a healthy Polish population. Methods:The study was conducted in a tertiary center for fetal cardiology. Data on gestational age (GA), FHR measured on UMB-A, cardiac problems, and extracardiac problems were collected. All fetuses underwent echocardiographic examination. The inclusion criteria comprised normal fetal biometry and biophysical profile, labels of "normal heart anatomy and normal heart function", "no extracardiac malformations", and no "extracardiac anomalies".Results: Based on the data from 258 healthy fetuses, a scatter graph with regression line giving a prognosis of normal values for FHR during pregnancy was prepared (95% confidence interval). The regression equation for FHR, as function of GA in weeks, was found to be: FHR (beats/minute) = 149 -GA according to biometry (weeks) × 0.22; (r = -0.1032; P = 0.098); FHR (beats/ /minute) = 148 -GA according to the last menstrual period (weeks) × 0.16; (r = -0.0722; P = 0.253). The 5 th , 50 th , 95 th percentiles, mean and standard deviation of FHR between weeks 18 and 29 of gestation were calculated. Conclusions:We present the normal ranges for FHR measured on UMB-A for weeks 18 to 29 of gestation in healthy fetuses with normal heart function and anatomy. The obtained values may be of value to departments of obstetrics and should be considered important elements of the basic fetal ultrasound report.

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Maternal corticosteroids and depression during gestation and decreased fetal heart rate variability

Hunter¹,

Freedman²,

Law³

et al. 2021

NeuroReport

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Objective Maternal depression during gestation is an adverse factor in fetal brain development that manifests in later childhood behavioral problems. Fetal heart rate variability (FHRV) mediated by parasympathetic input is a marker of gestational nervous system development. Biological mediators of adverse effects of maternal depression may involve the mother's corticosteroids; however, links between depression, corticosteroids, and early nervous system development remain inconclusive.Methods Heart rate was recorded in 23 fetuses by transabdominal Doppler at 28-33 weeks gestation. The SD of interbeat intervals over 20 min assessed FHRV. Maternal depression ratings and hair concentrations of cortisol and cortisone were assayed. An auditory sensory gating paradigm assessed newborn development of cerebral inhibition. Parents rated their infant's temperament characteristics on the Infant Behavior Questionnaire-Revised Short Form (IBQ-R). ResultsMaternal depression was associated with lower FHRV, especially for male fetuses, β = −0.633, P = 0.045. Maternal depression was associated with lower cortisol to total corticosteroids ratios, β = −0.519, P = 0.033. Lower cortisol ratios were associated with decreased FHRV, β = 0.485, P = 0.019. Decreased FHRV was associated with increased newborn sensory gating deficits, β = −0.992, P = 0.035, indicating poorer development of cerebral inhibition. Higher FHRV was related to increased infant IBQ-R self-regulatory behaviors, r = 0.454, P = 0.029. ConclusionMaternal depression is associated via corticosteroids with decreased development of nervous system control of fetal heart rate. Decreased FHRV indicates developmental alterations in gestation that correlate with altered brain function and subsequent regulatory challenges in early infancy.

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

Cited by 6 publications

References 1 publication

Uterine activity modifies the response of the fetal autonomic nervous system at preterm active labor

Uterine activity modifies the response of the fetal autonomic nervous system at preterm active labor

Normal ranges of fetal heart rate values for healthy fetuses in Poland, as determined by ultrasound between weeks 18 and 29 of gestation

Maternal corticosteroids and depression during gestation and decreased fetal heart rate variability

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