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Original Article
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| Do small for gestational age fetuses' exhibit circadian changes in fetal heart rate parameters as do appropriate for gestational age fetuses? | ||||||
| Habiba Kapaya1, Emma R. Dimelow2, Dilly Anumba3 | ||||||
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1Clinical Lecturer (NIHR), Department of Oncology and Metabolism, Academic Unit of Reproductive & Developmental Medicine, 4th Floor Jessop Wing, Tree Root Walk, Sheffield S102SF, UK, the University of Sheffield.
24th year medical student, The University of Sheffield. 3Consultant in Obstetrics & Gynaecology, Department of Oncology andMetabolism, Academic Unit of Reproductive & Developmental Medicine, 4th Floor Jessop Wing Tree Root Walk, Sheffield S102SF, UK, the University of Sheffield. | ||||||
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| How to cite this article |
| Kapaya H, Dimelow ER, Anumba D. Do small for gestational age fetuses' exhibit circadian changes in fetal heart rate parameters as do appropriate for gestational age fetuses? Edorium J Matern Child Health 2017;2:1–8. |
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Abstract
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Aims:
Circadian changes in basal fetal heart rate (FHR) and fetal heart rate variation are observed in appropriate for gestational age (AGA) fetuses. Small for gestational age (SGA) fetuses are at greater risk of complications and may not demonstrate similar changes. This study was undertaken to investigate circadian changes in FHR in SGA fetuses in ambulatory patients in home environment using a portable fetal electrocardiogram recording device.
Methods: Prospective study on 31 singleton pregnancy >24 weeks gestation, no evidence of fetal malformation and an estimated fetal weight below tenth gestational centile on ultrasound scan. Fetal heart rate recordings were collected up to 17 h, averaged over 90 min intervals, and compared between day and night data from the same individual. Results: Basal FHR reduced at night-time (p<0.001) and with gestation (p=0.013), whereas FHR variation remained unchanged (p >0.5). Fetal gender did not influence variation in day:night FHR parameters. Conclusion: Unlike AGA fetuses, SGA fetuses demonstrated significant circadian changes only in basal FHR. The day-night difference in basal FHR was more pronounced with advancing gestation, implying a significant fetal role in controlling the circadian pattern. In contrast to AGA fetuses, FHR-variability in SGA fetuses did not increase with gestation, suggesting under-development of fetal autonomic nervous system. Clinicians need to consider these differences when interpreting FHR data in these two clinical settings. | |
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Keywords:
Circadian, Fetal heart rate, Fetal electrocardiogram, Pregnancy
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Author Contributions:
Habiba Kapaya – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Emma Dimelow – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Dilly Anumba – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2017 Kapaya H et al et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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