Evolution of linear and nonlinear fetal heart rate indices throughout pregnancy in appropriate, small for gestational age and preterm fetuses: A cohort study

• Type: Article in International Scientific Journal
• Date: 2018

Authors

Hernani Goncalves (Author) FMUP; Amorim Costa, C (Author) FMUP; Ayres de Campos, D (Author) Other; Joao Bernardes (Author) FMUP

Journal

Title: Computer Methods and Programs in Biomedicine

Vol. 153

Pages: 191-199

ISSN: 0169-2607

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 15 Citations

Scopus - 17 Citations

Other information

Authenticus ID: P-00N-4TN

DOI: 10.1016/j.cmpb.2017.10.015

Abstract (EN): Background and objectives: To assess the evolution of linear and nonlinear fetal heart rate (FHR) analysis throughout pregnancy in appropriate (AGA), small for gestational age (SGA) and preterm (PTB) fetuses. Methods: A prospective cohort study was carried out in 171 singleton pregnancies divided in three groups: AGA (n = 147), SGA (n = 13) fetuses and spontaneous PTB (n = 11). FHR was recorded with an external sensor from the 24th to the 40th week of gestation. Linear time- and frequency-domain and nonlinear FHR indices were computed on 10-min segments. Longitudinal analysis of indices throughout pregnancy was performed with generalized estimating equations, and receiver operating characteristic (ROC) curves were calculated for the prediction of SGA and PTB fetuses. Results: Increasing gestational age significantly affected most FHR indices, with a general increase in variability and entropy indices, and a decrease in mean FHR. The PTB group exhibited a significantly lower short-term variation, and no monotonic increase in the sympatho-vagal balance as observed in the AGA group. The SGA group exhibited higher long-term irregularity and lower short-term irregularity than the AGA group throughout gestation. In prediction of SGA and PTB, the largest areas under the ROC curves obtained were 0.76 and 0.78, respectively. Conclusions: Linear and nonlinear FHR analysis provides useful information on the evolution of fetal autonomic nervous and complexity control systems throughout pregnancy, in relation with AGA, SGA and PTB fetuses, which may be helpful in clinical practice.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9