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

Hoyer, Dirk; Schmidt, Alexander; Gustafson, Kathleen M.; Lobmaier, Silvia M.; Лахно, И. В.; Leeuwen, P. van; Cysarz, Dirk; Preisl, Hubert; Schneider, Uwe

doi:10.1088/1361-6579/ab205f

Cited by 22 publications

(31 citation statements)

References 45 publications

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“…According to Hoyer et al (2019), some AMP and COMP metrics correlate with maternal lifestyle (smoking and physical activity), intrauterine growth restriction (IUGR), and gestational diabetes. Despite the maternal and fetal circulation being distinct systems, HRV fluctuations could represent a coupling mechanism between the two: indeed, maternal HR, TP, and HF correlate with some fHRV metrics, especially during active sleep and when GA > 32 weeks.…”

Section: The Ans Development and Its Relationship With Hrvmentioning

confidence: 99%

“…This focused review is divided into three sections: (1) the first section describes briefly the HRV metrics and examines the relationship between ANS and HRV in fetuses and newborns; (2) the second section examines the technology available in the NICU, how to monitor HRV efficiently, and the usefulness of real-time HRV; and (3) the third and final section will summarize the main findings and outline future perspectives for the clinical use of real-time HRV in the neonatal field, with a brief subsection about its usefulness in low-income countries. (Hoyer et al, 2013(Hoyer et al, , 2019Uhrikova et al, 2015;Pichot et al, 2016;Massaro et al, 2017;Shaffer and Ginsberg, 2017;Herry et al, 2019;Oliveira et al, 2019b;Patural et al, 2019;Frasch et al, 2020). From the work of the Task Force for HRV analysis in 1996, which constitutes the foundation for the majority of the papers on HRV, many metrics are developed to describe HRV, and they can be classified into three categories: time-domain, frequency-domain, and non-linear metrics ( Table 1).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Heart Rate Variability in the Perinatal Period: A Critical and Conceptual Review

Chiera¹,

Cerritelli²,

Casini³

et al. 2020

Front. Neurosci.

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Neonatal intensive care units (NICUs) greatly expand the use of technology. There is a need to accurately diagnose discomfort, pain, and complications, such as sepsis, mainly before they occur. While specific treatments are possible, they are often timeconsuming, invasive, or painful, with detrimental effects for the development of the infant. In the last 40 years, heart rate variability (HRV) has emerged as a noninvasive measurement to monitor newborns and infants, but it still is underused. Hence, the present paper aims to review the utility of HRV in neonatology and the instruments available to assess it, showing how HRV could be an innovative tool in the years to come. When continuously monitored, HRV could help assess the baby's overall wellbeing and neurological development to detect stress-/painrelated behaviors or pathological conditions, such as respiratory distress syndrome and hyperbilirubinemia, to address when to perform procedures to reduce the baby's stress/pain and interventions, such as therapeutic hypothermia, and to avoid severe complications, such as sepsis and necrotizing enterocolitis, thus reducing mortality. Based on literature and previous experiences, the first step to efficiently introduce HRV in the NICUs could consist in a monitoring system that uses photoplethysmography, which is low-cost and non-invasive, and displays one or a few metrics with good clinical utility. However, to fully harness HRV clinical potential and to greatly improve neonatal care, the monitoring systems will have to rely on modern bioinformatics (machine learning and artificial intelligence algorithms), which could easily integrate infant's HRV metrics, vital signs, and especially past history, thus elaborating models capable to efficiently monitor and predict the infant's clinical conditions. For this reason, hospitals and institutions will have to establish tight collaborations between the obstetric, neonatal, and pediatric departments: this way, healthcare would truly improve in every stage of the perinatal period (from conception to the first years of life), since information about patients' health would flow freely among different professionals, and high-quality research could be performed integrating the data recorded in those departments.

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Section: The Ans Development and Its Relationship With Hrvmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Heart Rate Variability in the Perinatal Period: A Critical and Conceptual Review

Chiera¹,

Cerritelli²,

Casini³

et al. 2020

Front. Neurosci.

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“…Тобто його неможливо відтворити штучно. Вивчення біологічних осциляцій дає змогу дізнатися про стан створених еволюційно регуляторних механізмів, що керують станом організму людини [11,13].…”

Section: современные подходы к оценке состояния плода ив лахноunclassified

“…Існує думка, що у період неврологічного дозрівання плід є дуже чутливим до гострих або хронічних впливів, які мають довготривалі наслідки. Безумовно, що будь-які порушення розвитку плода можуть мати прояв у змінах функціонального стану автономної нервової системи [11]. Концепція «плодового програмування», яка також відома як «гіпотеза виникнення хвороб дорослого віку в період розвитку» має підтвердження у патогенезі серцево-судинних захворювань, метаболічних, гіперкінетичних, когнітивних і поведінкових розладів [12,13].…”

Section: современные подходы к оценке состояния плода ив лахноunclassified

The modern approaches for the assessment of fetal well-being

Лахно

2020

RHW

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Харківська медична академія післядипломної освіти Затримка росту плода відома як внутрішньоутробний патологічний стан, який пов'язаний з деякими захворюваннями у подальшому житті. Дистрес плода-супутник затримки його росту. Своєчасна і вірогідна діагностика дистресу плода все ще залишається проблемою у перинатології. Дослідження продемонструвало, що неінвазивна електрокардіографія може сприяти кращій діагностиці дистресу плода. «Удар до удару»-варіації, показники варіабельності серцевої діяльності плода і автономне число віку мозку плода можна вважати біофізичними маркерами стану плода. Ключові слова: затримка росту плода, дистрес плода, варіабельність серцевого ритму плода. The modern approaches for the assessment of fetal well-being I.V. lakhno Fetal growth restriction is known as an intrauterine pathological condition that is associated with some diseases in a further lifetime. Fetal distress is a satellite of fetal growth restriction. Timely and true diagnosing of fetal distress is still an issue in perinatology. This case study showed that non-invasive fetal electrocardiography could contribute to better diagnosing of fetal distress. The variables of beat-to-beat variations, fetal heart rate variability and fetal autonomic brain age score should be investigated as the biophysical markers of fetal deterioration.

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“…Other HRV measures which have shown interesting usage include the scattering transform for intrapartum fetal monitoring (n=45) [32] and entropy measures (approximate and sample entropy) for IUGR screening (n=59) [33]. A good summary of HRV measures used in the context of fetal HRV analysis for diagnosis and monitoring is available in Hoyer et al [34].…”

Section: Heart Rate Variability Measuresmentioning

confidence: 99%

Special Session on Computational Fetal Monitoring

Behar¹,

Weiner²,

Warrick³

2019

2019 Computing in Cardiology Conference (CinC)

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Despite the improvements made in perinatal medicine during the 20th century, stillbirths still occur for 1 in 160 pregnancies in the US which represents a total of 26,000 fetal deaths each year. In addition, approximately 1 in 1000 fetuses experience oxygen deprivation during labor which is severe enough to cause brain injury. It is estimated that half of these cases of birth-related injury are preventable. Incorrect cardiotocography (CTG) interpretation is leading the list of causes. Intrapartum CTG is used routinely to measure maternal uterine pressure and fetal heart rate (FHR). Antepartum CTG monitoring is used to identify fetuses at risk of intrauterine hypoxia and acidaemia. As early as 28 weeks of gestation, analysis of the FHR trace is used as a nonstress test to assess the fetal well-being. In the perinatal period, timely, appropriate intervention can avoid fetal neurological damage or death. The CTG is visually assessed by a clinician or interpreted by computer analysis. In the context of labor monitoring, the CTG is used for continuous fetal monitoring. An abnormal heart rate will lead the clinician to perform a cesarean. With the recent advances in machine learning and statistical signal analysis new algorithms for assessing fetal antepartum or intrapartum health status are being elaborated. These algorithms process signals recorded by CTG monitors or alternative monitoring techniques such as scalp electrocardiography or non-invasive fetal electrocardiography. This session discusses the history of fetal monitoring, its current challenges and the prospects opened by recent algorithmic development.

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

Cited by 22 publications

References 45 publications

Heart Rate Variability in the Perinatal Period: A Critical and Conceptual Review

Heart Rate Variability in the Perinatal Period: A Critical and Conceptual Review

The modern approaches for the assessment of fetal well-being

Special Session on Computational Fetal Monitoring

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