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Fetal heart rate during maternal sleep.
Janet A DiPietro1, Radhika S Raghunathan1, Hau-Tieng Wu2
1Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Developmental Psychobiology
|March 25, 2021
Summary
Maternal sleep patterns influence fetal heart rate, particularly during awakenings. Fetal heart rate and variability decrease overnight, with notable changes during maternal sleep disruptions.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Sleep Medicine
Background:
- Maternal sleep during pregnancy is crucial for fetal development.
- Limited understanding exists regarding the specific fetal responses to maternal sleep states and disruptions.
- Obesity in pregnancy may further influence maternal sleep quality and fetal well-being.
Purpose of the Study:
- To investigate the relationship between maternal sleep patterns and fetal heart rate (fHR) and fetal heart rate variability (fHRV).
- To examine how different maternal sleep stages and awakenings affect fetal cardiovascular responses.
- To explore potential implications for fetal development given typical pregnancy-related sleep fragmentation.
Main Methods:
- Eighty-four pregnant women with obesity underwent polysomnography (PSG) and continuous fetal electrocardiogram monitoring at 36 weeks gestation.
- Multilevel modeling and cross-correlation analyses were used to assess maternal and fetal heart rate (mHR/fHR) and variability (mHRV/fHRV) patterns.
- Sleep stages, maternal waking after sleep onset (WASO), and temporal coupling were analyzed.
Main Results:
- Both maternal and fetal heart rate and variability declined overnight, with steeper declines before 01:00.
- Fetal heart rate decreased upon maternal sleep onset but was otherwise unassociated with maternal sleep stage; fHRV differed between maternal REM and NREM sleep.
- Elevated fHRV and mHRV occurred during frequent maternal WASO episodes, with minimal temporal coupling between maternal and fetal heart rates except during WASO.
Conclusions:
- Maternal sleep context significantly impacts fetal heart rate patterns, especially during awakenings.
- Observed associations between maternal and fetal heart rates during sleep likely stem from shared physiological processes rather than direct sleep stage influence.
- Pregnancy-related sleep fragmentation may have consequences for fetal development, warranting further investigation.
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