Doppler-based fetal heart rate analysis markers for the detection of early intrauterine growth restriction
Journal
Acta Obstetricia et Gynecologica Scandinavica
Journal Volume
96
Journal Issue
11
Pages
1322-1329
Date Issued
2017
Author(s)
Abstract
Introduction: One indicator for fetal risk of mortality is intrauterine growth restriction (IUGR). Whether markers reflecting the impact of growth restriction on the cardiovascular system, computed from a Doppler-derived heart rate signal, would be suitable for its detection antenatally was studied. Material and methods: We used a cardiotocography archive of 1163 IUGR cases and 1163 healthy controls, matched for gestation and gender. We assessed the discriminative power of short-term variability and long-term variability of the fetal heart rate, computed over episodes of high and low variation aiming to separate growth-restricted fetuses from controls. Metrics characterizing the sleep state distribution within a trace were also considered for inclusion into an IUGR detection model. Results: Significant differences in the risk markers comparing growth-restricted with healthy fetuses were found. When used in a logistic regression classifier, their performance for identifying IUGR was considerably superior before 34?weeks of gestation. Long-term variability in active sleep was superior to short-term variability [area under the receiver operator curve (AUC) of 72% compared with 71%]. Most predictive was the number of minutes in high variation per hour (AUC of 75%). A multivariate IUGR prediction model improved the AUC to 76%. Conclusion: We suggest that heart rate variability markers together with surrogate information on sleep states can contribute to the detection of early-onset IUGR. ? 2017 Nordic Federation of Societies of Obstetrics and Gynecology
Subjects
Article
cardiotocography
controlled clinical trial
controlled study
diagnostic value
early diagnosis
female
fetus
fetus heart rate
fetus risk
gestational age
heart rate variability
human
intrauterine growth retardation
major clinical study
male
mortality risk
pregnancy
prenatal period
priority journal
case control study
diagnostic imaging
fetus echography
risk assessment
Cardiotocography
Case-Control Studies
Female
Fetal Growth Retardation
Gestational Age
Heart Rate, Fetal
Humans
Male
Pregnancy
Risk Assessment
Ultrasonography, Prenatal
Type
journal article