Indices of fetal development derived from heart rate patterns

Background: The fetal precursors of mental and cardiovascular disease caused by adverse prenatal environmental influences and manifesting in later age are an important issue of developmental medicine. However the number of measurable functional parameters of a fetus is limited. Evaluation of key parameters involving fetal autonomic control could permit an earlier detection of developmental problems and improved therapeutic strategies. Thus far, however, even the maturation of normal autonomic control has not been sufficiently assessed. Aim: The objective of the present work is to describe normal fetal maturation based on indices of autonomic heart rate modulation. Study design: Heart beat interval series were magnetocardiographically recorded with 1 kHz sampling rate over 30 min in 78 normal fetuses, gestational age (GA) 23-40 weeks. Indices considered were: number of accelerations (AC) and decelerations (DC). RMSSD, SDNN, and short-term/long-term autonomic information flows (Alf_NN. Alf_fVLF). These were measured from the entire 30 min data sets and from activity-specific subsets (10 min). Results: In the 30 min recordings: the number of AC increased, number of DC decreased, rMSSD and SDNN increased and Alf_fVLF increased with CA, but Alf_NN remained constant. In the 10 min subsets: SDNN increased in the active state but remained constant in the quiet state and AlF_NN decreased with CA in the quiet state. Conclusion: Heart rate patterns from 30 min biomagnetic recordings may provide new indices with which to assess the normal and abnormal maturation of fetal autonomic control and to identify risk of possible disorders in later life. (C) 2009 Elsevier Ireland Ltd. All rights reserved.