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Fetal growth restriction: From Polyvagal theory to developmental impairments?

Vania Aldrete-Cortez1, Adrián Poblano2, Silvia A Tafoya3

  • 1Neuroscience and Cognitive Developmental Laboratory, School of Psychology, Universidad Panamericana, Mexico City, Mexico.

Brain & Development
|May 7, 2019
PubMed

Insights

Fetal growth restriction (FGR) in newborns alters sleep patterns and heart rate, potentially impacting neurodevelopment. Polysomnography reveals these changes, suggesting FGR intensifies preterm birth effects.

Area of Science:

  • Neonatal Physiology
  • Developmental Neuroscience
  • Autonomic Nervous System Regulation

Background:

  • Polyvagal theory posits that autonomic regulation is crucial for behavioral modulation and neurodevelopment.
  • Fetal growth restriction (FGR) is a condition that can impact fetal development and subsequent health outcomes.
  • Understanding autonomic regulation in FGR newborns is key to identifying potential neurodevelopmental risks.

Purpose of the Study:

  • To investigate sleep architecture in newborns with FGR using polysomnography.
  • To assess polysomnography findings as indicators related to Polyvagal theory in FGR infants.
  • To compare sleep patterns and heart rate modulation between FGR and appropriate for gestational age (AGA) newborns.

Main Methods:

  • Polysomnography recordings were analyzed from 68 preterm infants (34 FGR, 34 AGA), matched for corrected age (CA).
  • Key sleep parameters including total sleep time, arousals, sleep stage percentages (quiet, active, indeterminate), and heart rate were compared.
  • Linear multiple regression analyses were employed to evaluate polysomnography data in relation to FGR and CA.

Main Results:

  • Newborns with FGR exhibited significantly lower average heart rates compared to AGA infants.
  • Effect sizes indicated notable differences in several sleep responses between FGR and AGA groups.
  • Corrected age (CA) significantly explained heart rate differences, modulated by FGR. Sleep states showed trends toward increased quiet/indeterminate sleep and decreased active sleep when CA was controlled for FGR.

Conclusions:

  • Fetal growth restriction (FGR) appears to exacerbate the negative impacts of preterm birth on polysomnography-evaluated responses.
  • FGR is associated with altered sleep regulation and distinct heart rate modulation patterns in newborns.
  • These alterations may represent an energy conservation strategy in FGR infants, potentially underlying neurodevelopmental impairments.
Abstract

Keywords:
Fetal growth restrictionNeonatalNeurodevelopmentPolysomnographyPolyvagal theorySleep

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