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Delayed rhythm formation of normal-structured, growth-restricted fetuses using fetal heart rate monitoring patterns

Kaeko Sumiyoshi1, Yasuyuki Kawagoe1, Masanao Ohhashi1

  • 1Department of Obstetrics and Gynecology and Center for Perinatal Medicine, University of Miyazaki Faculty of Medicine, Japan.

The Journal of Obstetrics and Gynaecology Research
|May 29, 2020
PubMed

Insights

Fetal growth restriction delays the development of fetal heart rate rhythm by 1-2 weeks. This study confirms that growth-restricted fetuses exhibit delayed rhythm formation compared to appropriate-for-date fetuses.

Area of Science:

  • Perinatology
  • Fetal Physiology
  • Neurodevelopment

Background:

  • Fetal growth restriction (FGR) is associated with altered in utero development.
  • The awake-sleep cycle in fetal heart rate patterns is considered a marker of fetal rhythm development.
  • Previous observations suggest delayed rhythm formation in growth-restricted fetuses.

Purpose of the Study:

  • To investigate if rhythm formation on fetal heart rate patterns is delayed in fetuses with FGR compared to appropriate-for-date (AFD) fetuses.
  • To determine the timing of emergence of rhythm formation in relation to FGR.
  • To identify FGR as an independent predictor of delayed fetal rhythm formation.

Main Methods:

  • Retrospective cohort study of 75 singleton fetuses.
  • Comparison between 21 FGR fetuses and 54 AFD fetuses.
  • Analysis of fetal heart rate patterns to determine the timing of rhythm formation, adjusting for confounding factors.

Main Results:

  • Rhythm formation was significantly delayed by 1-2 weeks in FGR fetuses (<10th percentile) compared to AFD fetuses (10-90th percentile).
  • Fetal growth restriction was identified as the sole independent variable associated with delayed fetal rhythm formation after adjustment.
  • No statistically significant difference in the incidence of neurodevelopmental disorders was observed between the groups.

Conclusions:

  • Growth-restricted fetuses demonstrate a 1-2 week delay in rhythm formation based on fetal heart rate pattern analysis.
  • This delay in rhythm formation is a distinct characteristic of FGR.
  • Early identification of rhythm formation delays may offer insights into fetal well-being in FGR pregnancies.
Abstract

Keywords:
antepartum FHR testingfetal growth restrictionfetal heart rate monitoringfetal physiologic changes in pregnancyrhythm formation

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