Estimating Fetal Age by Fetal Maternal Heart Rate Coupling Parameters

Area of Science:

• Cardiology
• Maternal-Fetal Medicine
• Biomedical Engineering

Background:

• Beat-by-beat maternal-fetal heart couplings are observed during fetal development.
• The relationship between these coupling parameters and fetal development remains unclear.

Purpose of the Study:

• To investigate the association of maternal-fetal heartbeat coupling parameters with fetal gestational age.
• To explore interrelationships between coupling parameters and fetal development.

Main Methods:

• Collected 10-minute maternal and fetal ECG signals from 16 healthy singleton pregnancies (19-32 weeks).
• Calculated Maternal and Fetal Heart Rate Variability (MHRV and FHRV) and maternal-fetal heart rate coupling parameters at various ratios.
• Constructed stepwise multivariate regression models validated against crown-rump length for gestational age.

Main Results:

• The best regression model, incorporating MHRV, FHRV, and coupling parameters, showed a strong association with gestational age (RMSE=1.92).
• Key predictors included mean fetal heart rate, mean maternal heart rate, standard deviation of maternal heart rate, and specific coupling ratios (λ[1:3], λ[2:3], λ[2:4]).
• A model using only coupling parameters demonstrated good performance (RMSE=2.50), but was less accurate than the combined model.

Conclusions:

• Combining maternal-fetal heart rate variability and coupling parameters provides a more accurate assessment of fetal development compared to using either alone.
• These findings highlight the potential of maternal-fetal heart coupling as a non-invasive biomarker for monitoring fetal development.