Fetal Heart Rate Accelerations and the Risk of Cerebral Lesions and Poor Neurodevelopmental Outcome in Very Low Birthweight Neonates

Vlastos, Emanuel; Tomlinson, Tracy M.; Bildirici, İbrahim; Sreenarasimhaiah, Sreedevi; Yusuf, Kamran; Sadovsky, Yoel; Levy, Rivka

doi:10.1055/s-2006-958161

Cited by 11 publications

(7 citation statements)

References 29 publications

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“…Vlastos et al [22] found that fetuses with absent fetal heart rate reactivity prior to delivery had higher risks of brain injury and low Bayley scores. In a ventilation trial of children born before 28 weeks gestation, factors associated with lower vocabularies at age 2 included severe neurosensory impairment, male gender, length of hospital stay, and weight at 12 months [23].…”

Section: Cognition and Academic Achievementmentioning

confidence: 99%

Neurodevelopmental outcomes of preterm infants

Allen

2008

Current Opinion in Neurology

340

222

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A 2007 report from the Institute of Medicine emphasizes preterm birth as an increasingly common complex condition with multiple risk factors resulting from multiple gene-environmental interactions, leading to birth before 37 weeks gestation, neonatal complications and a disproportionately high contribution to neurodevelopmental disability rates. The increased risk of cerebral palsy with decreasing gestational age categories is well documented, but recent studies highlight the range and severity of cognitive, sensory, language, visual-perceptual, attention and learning deficits in very preterm children. Combined with increasingly sophisticated neuroimaging studies to identify perinatal risk factors, neurodevelopmental follow-up of neonatal intensive care unit trials offers the potential to really improve our understanding of how the preterm brain develops, is injured and recovers from injuries. Knowledge of what influences neurodevelopmental outcomes is key to developing better treatment strategies.

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Section: Cognition and Academic Achievementmentioning

confidence: 99%

Neurodevelopmental outcomes of preterm infants

Allen

2008

Current Opinion in Neurology

340

222

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“…Continuity has been reported between fetal heart rate and movement patterns and infant mental and motor development [24-29], infant temperament [19, 21, 29, 30] and infant autonomic function [3, 31]. This suggests an opportunity for early detection of impaired development.…”

Section: Introductionmentioning

confidence: 99%

Maturation of the human fetal startle response: Evidence for sex-specific maturation of the human fetus

Buß

Davis

Class

et al. 2009

Early Human Development

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Despite the evidence for early fetal experience exerting programming influences on later neurological development and health risk, very few prospective studies of human fetal behavior have been reported. In a prospective longitudinal study, fetal nervous system maturation was serially assessed by monitoring fetal heart rate (FHR) responses to vibroacoustic stimulation (VAS) in 191 maternal/ fetal dyads. Responses were not detected at 26 weeks gestational age (GA). Sex-specific, agecharacteristic changes in the FHR response to VAS were observed by 31 weeks' GA. Males showed larger responses and continued to exhibit maturational changes until 37 weeks' GA, females however, presented with a mature FHR startle response by 31 weeks' GA. The results indicate that there are different rates of maturation in the male and female fetus that may have implications for sex-specific programming influences.

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“…Fetal heart rate (FHR) monitoring has been used for more than 30 years to assess fetal well-being [Vlastos et al, 2007]. Measures of human FHR responses are accepted indicators of fetal maturity [Kisilevsky et al, 1992, 1999; Goome et al, 1993], reflecting the maturation and integrity of neural pathways through the cerebral cortex, midbrain, brainstem, vagus nerve and the cardiac conduction system [Van Leeuwen et al, 1999].…”

Section: Introductionmentioning

confidence: 99%

Low Levels of Corticotropin-Releasing Hormone during Early Pregnancy Are Associated with Precocious Maturation of the Human Fetus

et al. 2008

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Elevation in placental corticotropin-releasing hormone (pCRH) during the last trimester of pregnancy has been associated with an increased risk for preterm delivery. Less is known about the consequences for the human fetus exposed to high levels of pCRH early in pregnancy. pCRH levels were measured in 138 pregnant women at least once at 15, 20 and 25 weeks of gestation. At 25 weeks of gestation, fetal heart rate (FHR) responses to a startling vibroacoustic stimulus (VAS) were recorded as an index of maturity. pCRH levels at 15 weeks of gestation, but at no later point, predicted FHR responses to the VAS. Fetuses exposed to the lowest concentrations of pCRH at 15 weeks of gestation exhibited a distinguishable response to the VAS, whereas fetuses exposed to higher levels of pCRH did not respond. The findings suggest that exposure to low levels of pCRH early in gestation may be optimal and associated with a response pattern indicating greater maturity.

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Fetal Heart Rate Accelerations and the Risk of Cerebral Lesions and Poor Neurodevelopmental Outcome in Very Low Birthweight Neonates

Cited by 11 publications

References 29 publications

Neurodevelopmental outcomes of preterm infants

Neurodevelopmental outcomes of preterm infants

Maturation of the human fetal startle response: Evidence for sex-specific maturation of the human fetus

Low Levels of Corticotropin-Releasing Hormone during Early Pregnancy Are Associated with Precocious Maturation of the Human Fetus

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