The effect of antenatal steroid treatment on fetal autonomic heart rate regulation revealed by fetal magnetocardiography (fMCG)

Schneider, Uwe; Fiedler, Anja; Schröder, Beatrix; Jaekel, Susann; Stacke, Angelika; Hoyer, Dirk; Schleussner, Ekkehard

doi:10.1016/j.earlhumdev.2010.05.018

« PreviousEarly Human Development
Volume 86, Issue 5 , Pages 319-325, May 2010

The effect of antenatal steroid treatment on fetal autonomic heart rate regulation revealed by fetal magnetocardiography (fMCG)

Uwe Schneider
- Department of Obstetrics, Bachstrasse 18, University Hospital, Jena Germany
- Corresponding author. Department of Obstetrics, University Hospital, Friedrich-Schiller-University, Bachstrasse 18, Jena, D-07743, Germany. Tel.: +49 171 22 70 414; fax: +49 3641 933986.
Anja Fiedler
- Department of Obstetrics, Bachstrasse 18, University Hospital, Jena Germany
Beatrix Schröder
- Department of Obstetrics, Bachstrasse 18, University Hospital, Jena Germany
Susann Jaekel
- Department of Obstetrics, Bachstrasse 18, University Hospital, Jena Germany
- Biomagnetic Center, Hans Berger Clinic for Neurology, Erlanger Allee 101, University Hospital, Friedrich-Schiller-University, Jena, Gemany
Angelika Stacke
- Biomagnetic Center, Hans Berger Clinic for Neurology, Erlanger Allee 101, University Hospital, Friedrich-Schiller-University, Jena, Gemany
Dirk Hoyer
- Biomagnetic Center, Hans Berger Clinic for Neurology, Erlanger Allee 101, University Hospital, Friedrich-Schiller-University, Jena, Gemany
Ekkehard Schleussner
- Department of Obstetrics, Bachstrasse 18, University Hospital, Jena Germany

Received 21 July 2009; received in revised form 10 April 2010; accepted 13 May 2010.

Abstract

Background

Steroid administration to accelerate fetal lung maturation reduces neonatal morbidity and mortality in the case of preterm delivery. Behavioral observations suggest effects on fetal cardiovascular regulation.

Aim

We hypothesize that beat to beat heart rate variability (fHRV) derived from fetal magnetocardiography (fMCG) will reveal a direct, acute steroidal effect on fetal autonomic heart rate regulation.

Subjects

Eight patients between 29 and 34weeks of gestation at risk for preterm birth who were treated with betamethasone (2×12mg within 24h).

Study design

Subjects were studied prior to the first and within 6h after the second administration. Continuous fMCG was recorded with a 31-channel-SQUID biomagnetometer. Each dataset was processed by subtracting maternal cardiac artefacts and determining the time instants of the fetal heart beats. fHRV analysis was applied to periods of fetal quiescence of 4min length.

Outcome measures

We compared fHRV prior versus post steroid administration.

Results

Steroid exposure reduced all parameters of overall fHRV significantly. The fHRV parameters representing short term variability remained unaffected. Mean fetal heart rate significantly decreased. The complexity of the heart rate patterns increased.