PMID- 33101059
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201028
IS  - 1664-042X (Print)
IS  - 1664-042X (Electronic)
IS  - 1664-042X (Linking)
VI  - 11
DP  - 2020
TI  - Fetal Heart Rate Variability Is Affected by Fetal Movements: A Systematic Review.
PG  - 578898
LID - 10.3389/fphys.2020.578898 [doi]
LID - 578898
AB  - Introduction: Fetal heart rate variability (FHRV) evaluates the fetal 
      neurological state, which is poorly assessed by conventional prenatal 
      surveillance including cardiotocography (CTG). Accurate FHRV on a beat-to-beat 
      basis, assessed by time domain and spectral domain analyses, has shown promising 
      results in the scope of fetal surveillance. However, accepted standards for these 
      techniques are lacking, and the influence of fetal breathing movements and gross 
      movements may be especially challenging. Thus, current standards for equivalent 
      assessments in adults prescribe rest and controlled respiration. The aim of this 
      review is to clarify the importance of fetal movements on FHRV. Methods: A 
      systematic review in accordance with the PRISMA guidelines based on publications 
      in the EMBASE, the MEDLINE, and the Cochrane Library databases was performed. 
      Studies describing the impact of fetal movements on time domain, spectral domain 
      and entropy analyses in healthy human fetuses were reviewed. Only studies based 
      on fetal electrocardiography or fetal magnetocardiography were included. PROSPERO 
      registration number: CRD42018068806. Results: In total, 14 observational studies 
      were included. Fetal movement detection, signal processing, length, and selection 
      of appropriate time series varied across studies. Despite these divergences, all 
      studies showed an increase in overall FHRV in the moving fetus compared to the 
      resting fetus. Especially short-term, vagal mediated indexes showed an increase 
      during fetal breathing movements including an increase in Root Mean Square of the 
      Successive Differences (RMSSD) and High Frequency power (HF) and a decrease in 
      Low Frequency power/High Frequency power (LF/HF). These findings were present 
      even in analyses restricted to one specific fetal behavioral state defined by 
      Nijhuis. On the other hand, fetal body movements seemed to increase parameters 
      supposed to represent the sympathetic response [LF and Standard Deviation of 
      RR-intervals from normal sinus beats (SDNN)] proportionally more than parameters 
      representing the parasympathetic response (RMSSD, HF). Results regarding entropy 
      analyses were inconclusive. Conclusion: Time domain analyses as well as spectral 
      domain analyses are affected by fetal movements. Fetal movements and especially 
      breathing movements should be considered in these analyses of FHRV.
CI  - Copyright (c) 2020 Zizzo, Kirkegaard, Hansen, Uldbjerg and Molgaard.
FAU - Zizzo, Anne Rahbek
AU  - Zizzo AR
AD  - Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, 
      Denmark.
FAU - Kirkegaard, Ida
AU  - Kirkegaard I
AD  - Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, 
      Denmark.
FAU - Hansen, John
AU  - Hansen J
AD  - Department of Health Science and Technology, Aalborg University, Aalborg, 
      Denmark.
FAU - Uldbjerg, Niels
AU  - Uldbjerg N
AD  - Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, 
      Denmark.
FAU - Molgaard, Henning
AU  - Molgaard H
AD  - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
LA  - eng
PT  - Systematic Review
DEP - 20200930
PL  - Switzerland
TA  - Front Physiol
JT  - Frontiers in physiology
JID - 101549006
PMC - PMC7554531
OTO - NOTNLM
OT  - autonomic nerous function
OT  - electrocardiagram
OT  - fetus (MeSH)
OT  - heart rate variabiity
OT  - pregnanant women
OT  - sinus arrhythmia
EDAT- 2020/10/27 06:00
MHDA- 2020/10/27 06:01
PMCR- 2020/09/30
CRDT- 2020/10/26 05:21
PHST- 2020/07/01 00:00 [received]
PHST- 2020/08/25 00:00 [accepted]
PHST- 2020/10/26 05:21 [entrez]
PHST- 2020/10/27 06:00 [pubmed]
PHST- 2020/10/27 06:01 [medline]
PHST- 2020/09/30 00:00 [pmc-release]
AID - 10.3389/fphys.2020.578898 [doi]
PST - epublish
SO  - Front Physiol. 2020 Sep 30;11:578898. doi: 10.3389/fphys.2020.578898. eCollection 
      2020.