Autonomic regulation in fetuses with congenital heart disease.
Early Hum Dev
; 91(3): 195-8, 2015 Mar.
Article
em En
| MEDLINE
| ID: mdl-25662702
ABSTRACT
BACKGROUND:
Exposure to antenatal stressors affects autonomic regulation in fetuses. Whether the presence of congenital heart disease (CHD) alters the developmental trajectory of autonomic regulation is not known. AIMS/STUDYDESIGN:
This prospective observational cohort study aimed to further characterize autonomic regulation in fetuses with CHD; specifically hypoplastic left heart syndrome (HLHS), transposition of the great arteries (TGA), and tetralogy of Fallot (TOF).SUBJECTS:
From 11/2010 to 11/2012, 92 fetuses were enrolled 41 controls and 51 with CHD consisting of 19 with HLHS, 12 with TGA, and 20 with TOF. Maternal abdominal fetal electrocardiogram (ECG) recordings were obtained at 3 gestational ages 19-27 weeks (F1), 28-33 weeks (F2), and 34-38 weeks (F3). OUTCOMEMEASURES:
Fetal ECG was analyzed for mean heart rate along with 3 measures of autonomic variability of the fetal heart rate interquartile range, standard deviation, and root mean square of the standard deviation of the heart rate (RMSSD), a measure of parasympathetic activity.RESULTS:
During F1 and F2 periods, HLHS fetuses demonstrated significantly lower mean HR than controls (p<0.05). Heart rate variability at F3, as measured by standard deviation, interquartile range, and RMSSD was lower in HLHS than controls (p<0.05). Other CHD subgroups showed a similar, though non-significant trend towards lower variability.CONCLUSIONS:
Autonomic regulation in CHD fetuses differs from controls, with HLHS fetuses most markedly affected.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Sistema Nervoso Autônomo
/
Coração Fetal
/
Cardiopatias Congênitas
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
Limite:
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
Early Hum Dev
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Estados Unidos