| Literature DB >> 25904855 |
Johanna Brändle1, Hubert Preissl2, Rossitza Draganova2, Erick Ortiz2, Karl O Kagan3, Harald Abele3, Sara Y Brucker4, Isabelle Kiefer-Schmidt1.
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.Entities:
Keywords: autonomic nervous system (ANS); fetal behavioral states; fetal magnetocardiography (fMCG); fetal maturation; heart rate variability (HRV)
Year: 2015 PMID: 25904855 PMCID: PMC4388008 DOI: 10.3389/fnhum.2015.00147
Source DB: PubMed Journal: Front Hum Neurosci ISSN: 1662-5161 Impact factor: 3.169
Criteria of the automatic state classification based on the original Nijhuis criteria.
| State/fHRP | 1F/fHRP1 quiet sleep | 2F/fHRP2 active sleep | 4F/fHRP4 active awake |
|---|---|---|---|
| Original criteria | • Quiescence which can be regularly interrupted by brief body movements (startles) | • Frequent gross body movement | • Vigorous activity with many trunk rotations |
| Baseline | <160 bpm | <160 bpm | >160 bpm possible |
| Oscillation bandwith | <±7.5 bpm | ±7.5–±15 bpm | >±15 bpm |
| Accelerations | No | >15 bpm/>15 s | >30 bpm/>30 s |
| Movement | No | Yes | Yes |
Post hoc analysis (U =Mann–Whitney test) of the HRV parameters and the age groups.
| Group | mHR | SDNN | RMSSD | SDNN/RMSSD ratio | PE |
|---|---|---|---|---|---|
| 1–2 | 0.032 ( | 0.217 ( | 0.041 ( | 0.165 ( | |
Distribution of the measured parameters of fHRP divided in groups regarding GA [Mean (STD)].
| Group 1 | Rest: | Active: | |
|---|---|---|---|
| Mean HR | 142.76 (5.10) | 148.72 (7.36) | |
| SDNN | 7.48 (0.82) | 18.77 (4.38) | |
| RMSSD | 3.23 (1.13) | 13.15 (9.78) | |
| Ratio SDNN/RMSSD | 2.55 (0.82) | 1.99 (1.26) | |
| Perm. entropy | 0.93 (0.03) | 0.92 (0.03) | |
| Mean HR | 136.34 (6.80) | 141.02 (6.77) | 156.92 (10.63) |
| SDNN | 8.84 (1.22) | 22.59 (3.93) | 26.99 (10.39) |
| RMSSD | 4.57 (1.44) | 7.82 (3.57) | 6.99 (2.04) |
| Ratio SDNN/RMSSD | 2.10 (0.58) | 3.33 (1.04) | 4.06 (1.17) |
| Perm. Entropy | 0.95 (0.02) | 0.94 (0.02) | 0.93 (0.03) |
| Mean HR | 134.21 (7.45) | 137.83 (6.03) | 150.82 (4.97) |
| SDNN | 7.43 (1.57) | 25.43 (4.87) | 34.04 (10.83) |
| RMSSD | 4.29 (1.14) | 8.83 (3.46) | 7.29 (4.55) |
| Ratio SDNN/RMSSD | 1.84 (0.59) | 3.28 (1.28) | 5.41 (2.21) |
| PE | 0.95 (0.02) | 0.94 (0.02) | 0.90 (0.03) |
Post hoc analysis (U = Mann–Whitney test) of the HRV parameter and the fetal behavioral states.
| State changes | mHR | SDNN | RMSSD | SDNN/RMSSD ratio | PE |
|---|---|---|---|---|---|
| 1F–2F | 0.057 ( | 0.721 ( | |||
| 1F–4F | |||||
| 2F–4F | 0.030 ( | 0.713 ( | 0.042 ( |