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Developmental milestones of the autonomic nervous system revealed via longitudinal monitoring of fetal heart rate variability
BACKGROUND: Fetal heart rate variability (fHRV) of normal-to-normal (NN) beat intervals provides high-temporal resolution access to assess the functioning of the autonomic nervous system (ANS). AIM: To determine critical periods of fetal autonomic maturation. The developmental pace is hypothesized t...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6049949/ https://www.ncbi.nlm.nih.gov/pubmed/30016343 http://dx.doi.org/10.1371/journal.pone.0200799 |
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author | Schneider, Uwe Bode, Franziska Schmidt, Alexander Nowack, Samuel Rudolph, Anja Doelcker, Eva-Maria Schlattmann, Peter Götz, Theresa Hoyer, Dirk |
author_facet | Schneider, Uwe Bode, Franziska Schmidt, Alexander Nowack, Samuel Rudolph, Anja Doelcker, Eva-Maria Schlattmann, Peter Götz, Theresa Hoyer, Dirk |
author_sort | Schneider, Uwe |
collection | PubMed |
description | BACKGROUND: Fetal heart rate variability (fHRV) of normal-to-normal (NN) beat intervals provides high-temporal resolution access to assess the functioning of the autonomic nervous system (ANS). AIM: To determine critical periods of fetal autonomic maturation. The developmental pace is hypothesized to change with gestational age (GA). STUDY DESIGN: Prospective longitudinal observational study. SUBJECTS: 60 healthy singleton fetuses were followed up by fetal magnetocardiographic heart rate monitoring 4–11 times (median 6) during the second half of gestation. OUTCOME MEASURE: FHRV parameters, accounting for differential aspects of the ANS, were studied applying linear mixed models over four predefined pregnancy segments of interest (SoI: <27; 27+0–31+0; 31+1–35+0; >35+1 weeks GA). Periods of fetal active sleep and quiescence were accounted for separately. RESULTS: Skewness of the NN interval distribution VLF/LF band power ratio and complexity describe a saturation function throughout the period of interest. A decreasing LF/HF ratio and an increase in pNN5 indicate a concurrent shift in sympathovagal balance. Fluctuation amplitude and parameters of short-term variability (RMSSD, HF band) mark a second acceleration towards term. In contrast, fetal quiescence is characterized by sequential, but low-margin transformations; ascending overall variability followed by an increase of complexity and superseded by fluctuation amplitude. CONCLUSIONS: An increase in sympathetic activation, connected with by a higher ability of parasympathetic modulation and baseline stabilization, is reached during the transition from the late 2nd into the early 3rd trimester. Pattern characteristics indicating fetal well-being saturate at 35 weeks GA. Pronounced fetal breathing efforts near-term mirror in fHRV as respiratory sinus arrhythmia. |
format | Online Article Text |
id | pubmed-6049949 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-60499492018-07-26 Developmental milestones of the autonomic nervous system revealed via longitudinal monitoring of fetal heart rate variability Schneider, Uwe Bode, Franziska Schmidt, Alexander Nowack, Samuel Rudolph, Anja Doelcker, Eva-Maria Schlattmann, Peter Götz, Theresa Hoyer, Dirk PLoS One Research Article BACKGROUND: Fetal heart rate variability (fHRV) of normal-to-normal (NN) beat intervals provides high-temporal resolution access to assess the functioning of the autonomic nervous system (ANS). AIM: To determine critical periods of fetal autonomic maturation. The developmental pace is hypothesized to change with gestational age (GA). STUDY DESIGN: Prospective longitudinal observational study. SUBJECTS: 60 healthy singleton fetuses were followed up by fetal magnetocardiographic heart rate monitoring 4–11 times (median 6) during the second half of gestation. OUTCOME MEASURE: FHRV parameters, accounting for differential aspects of the ANS, were studied applying linear mixed models over four predefined pregnancy segments of interest (SoI: <27; 27+0–31+0; 31+1–35+0; >35+1 weeks GA). Periods of fetal active sleep and quiescence were accounted for separately. RESULTS: Skewness of the NN interval distribution VLF/LF band power ratio and complexity describe a saturation function throughout the period of interest. A decreasing LF/HF ratio and an increase in pNN5 indicate a concurrent shift in sympathovagal balance. Fluctuation amplitude and parameters of short-term variability (RMSSD, HF band) mark a second acceleration towards term. In contrast, fetal quiescence is characterized by sequential, but low-margin transformations; ascending overall variability followed by an increase of complexity and superseded by fluctuation amplitude. CONCLUSIONS: An increase in sympathetic activation, connected with by a higher ability of parasympathetic modulation and baseline stabilization, is reached during the transition from the late 2nd into the early 3rd trimester. Pattern characteristics indicating fetal well-being saturate at 35 weeks GA. Pronounced fetal breathing efforts near-term mirror in fHRV as respiratory sinus arrhythmia. Public Library of Science 2018-07-17 /pmc/articles/PMC6049949/ /pubmed/30016343 http://dx.doi.org/10.1371/journal.pone.0200799 Text en © 2018 Schneider et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Schneider, Uwe Bode, Franziska Schmidt, Alexander Nowack, Samuel Rudolph, Anja Doelcker, Eva-Maria Schlattmann, Peter Götz, Theresa Hoyer, Dirk Developmental milestones of the autonomic nervous system revealed via longitudinal monitoring of fetal heart rate variability |
title | Developmental milestones of the autonomic nervous system revealed via longitudinal monitoring of fetal heart rate variability |
title_full | Developmental milestones of the autonomic nervous system revealed via longitudinal monitoring of fetal heart rate variability |
title_fullStr | Developmental milestones of the autonomic nervous system revealed via longitudinal monitoring of fetal heart rate variability |
title_full_unstemmed | Developmental milestones of the autonomic nervous system revealed via longitudinal monitoring of fetal heart rate variability |
title_short | Developmental milestones of the autonomic nervous system revealed via longitudinal monitoring of fetal heart rate variability |
title_sort | developmental milestones of the autonomic nervous system revealed via longitudinal monitoring of fetal heart rate variability |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6049949/ https://www.ncbi.nlm.nih.gov/pubmed/30016343 http://dx.doi.org/10.1371/journal.pone.0200799 |
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