Early 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

      Affiliations

    • Department of Obstetrics, Bachstrasse 18, University Hospital, Jena Germany
    • Corresponding Author InformationCorresponding 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

      Affiliations

    • Department of Obstetrics, Bachstrasse 18, University Hospital, Jena Germany
    • ,
  • Beatrix Schröder

      Affiliations

    • Department of Obstetrics, Bachstrasse 18, University Hospital, Jena Germany
    • ,
  • Susann Jaekel

      Affiliations

    • 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

      Affiliations

    • Biomagnetic Center, Hans Berger Clinic for Neurology, Erlanger Allee 101, University Hospital, Friedrich-Schiller-University, Jena, Gemany
    • ,
  • Dirk Hoyer

      Affiliations

    • Biomagnetic Center, Hans Berger Clinic for Neurology, Erlanger Allee 101, University Hospital, Friedrich-Schiller-University, Jena, Gemany
    • ,
  • Ekkehard Schleussner

      Affiliations

    • Department of Obstetrics, Bachstrasse 18, University Hospital, Jena Germany

Received 21 July 2009 ,Revised 10 April 2010 ,Accepted 13 May 2010.

References 

  1. NIH Consensus Development Panel on the Effect of Corticosteroids for Fetal Maturation on Perinatal Outcomes. Effect of corticosteroids for fetal maturation on perinatal outcomes. JAMA. 1995;273:413–418
  2. Crowley P. Prophylactic corticosteroids for preterm birth (Cochrane Review). In: The Cochrane Library. 2002;Issue 4
  3. Leviton A, Kuban KC, Pagano M, Allred EN, Van Marter L. Antenatal corticosteroids appear to reduce the risk of postnatal germinal matrix hemorrhage in intubated low birth weight newborns. Pediatrics. 1993;91:1083–1088
  4. Canterino JC, Verma U, Visintainer PF, Elimian A, Klein SA, Tejani N. Antenatal steroids and neonatal periventricular leukomalacia. Obstet Gynecol. 2001;97:135–139
  5. Agarwal R, Chiswick ML, Rimmer S, Taylor GM, McNally RJ, Alston RD, et al. Antenatal steroids are associated with a reduction in the incidence of cerebral white matter lesions in very low birthweight infants. Arch Dis Child Fetal Neonatal. 2001;86:F96–F101
  6. Alfirevic Z, Allen-Coward H, Molina F, Vinuesa CP, Nicolaides K. Targeted therapy for threatened preterm labor based on sonographic measurement of the cervical length: a randomized controlled trial. Ultrasound Obstet Gynecol. 2007;29:47–50
  7. Mulder EJ, Derks JB, Visser GH. Antenatal corticosteroid therapy and fetal behaviour: a randomised study of the effects of betamethasone and dexamethasone. Br J Obstet Gynaecol. 1997;104:1239–1247
  8. Dawes GS, Serra-Serra V, Moulden M, Redman CW. Dexamethasone and fetal heart rate variation. Br J Obstet Gynaecol. 1994;101:675–679
  9. Lunshof MS, Boer K, Wolf H, Koppen S, Velderman JK, Mulder EJH. Short term (0-48h) effects of maternal betamethasone administration on fetal heart rate and its variability. Pediatr Res. 2005;57:545–549
  10. Mulder EJ, Koenen SV, Blom I, Visser GH. The effects of antenatal betamethasone administration on fetal heart rate and behaviour depend on gestational age. Early Hum Dev. 2004;76:65–77
  11. Nijhuis JG, Prechtl HFR, Martin CB, Bots RSG. Are there behavioral states in the human fetus?. Early Hum Dev. 1982;6:177–195
  12. Pillai M, James D. Behavioural states in the normal mature human fetus. Arch Child Disease. 1990;39–43
  13. Schneider U, Schleussner E, Fiedler A, Jaekel S, Liehr M, Haueisen J, et al. Fetal heart rate variability reveals differential dynamics in the intrauterine development of the sympathetic and parasympathetic branches of the autonomic nervous system. Physiol Meas. 2009;30:215–226
  14. Pillai M, James D. The development of fetal heart rate patterns during normal pregnancy. Obstet Gynecol. 1990;76:812–816
  15. Peters M, Crowe J, Pieri JF, Quartero H, Hayes-Gill B, James D, et al. Monitoring the fetal heart non-invasively: a review of methods. J Perinat Med. 2001;29:408–416
  16. Task Force. Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Eur Heart J. 1996;17:354–381
  17. Van Leeuwen P, Lange S, Bettermann H, Groenemeyer D, Hatzmann W. Fetal heart rate variability and complexity in the course of pregnancy. Early Hum Dev. 1999;54:259–269
  18. Van Leeuwen P, Geue D, Lange S, Hatzmann W, Groenemeyer D. Changes in the frequency power spectrum of fetal heart rate in the course of pregnancy. Prenat Diagn. 2003;23:909–916
  19. Zhuravlev Y, Rassi D, Mishoin AA, Emery SJ. Dynamic analysis of beat-to-beat fetal heart rate variability recorded by SQUID magnetometer: quantification of sympatho-vagal balance. Early Hum Dev. 2002;66:1–10
  20. Akselrod S, Gordon D, Ubel FA, Shannon DC, Berger AC, Cohen RJ. Power spectrum analysis of heart rate fluctuations: a quantitative probe of beat-to-beat cardiovascular control. Science. 1981;213:220–222
  21. David M, Hirsch M, Karin J, Toledo E, Akselrod S. An estimate of fetal autonomic state by time-frequency analysis of fetal heart rate variability. J Appl Physiol. 2007;102(3):1057–1064
  22. Schneider U, Frank B, Fiedler A, Kaehler C, Hoyer D, Liehr M, et al. Human fetal heart rate variability-characteristics of autonomic regulation in the third trimester of gestation. J Perinat Med. 2008;36:433–441
  23. Frank B, Pompe B, Schneider U, Hoyer D. Permutation entropy improves fetal behavioural state classification based on heart rate analysis from biomagnetic recordings in near term fetuses. Med Biol Eng Comp. 2006;44:179–187
  24. Hoyer D, Heinicke E, Jaekel S, Tetschke F, Di Pietro Paolo D, Haueisen J, et al. Indices of fetal development derived from heart rate patterns. Early Hum Dev. 2009;85:379–386
  25. Schneider U, Schleussner E, Haueisen J, Nowak H, Seewald HJ. Signal analysis of auditory evoked cortical fields in fetal magnetoencephalography. Brain Topogr. 2001;14:69–80
  26. Rotmensch S, Lev S, Kovo M, Efrat Z, Zahavi Z, Lev N, et al. Effect of betamethasone administration on fetal heart rate tracing: a blinded longitudinal study. Fetal Diagn Ther. 2005;20:371–376
  27. Rotmensch S, Liberati M, Vishne TH, Celentano C, Ben-Rafael Z, Bellati U. The effect of betamethasone and dexamethasone on fetal heart rate patterns and biophysical activities. A prospective randomized trial. Acta Obstet Gynecol Scand. 1999;78:493–500
  28. Magee LA, Dawes GS, Moulden M, Redman CW. A randomised controlled comparison of betamethasone with dexamethasone: effects on the antenatal fetal heart rate. Br J Obstet Gynaecol. 1997;104:1233–1238
  29. Lange S, van Leeuwen P, Geue D, Hatzmann W, Groenemeyer D. Influence of gestational age, heart ay on fetal heart brate variability. Med Biol Eng Comp. 2005;43:481–486
  30. Derks JB, Giussani DA, Jenkins SL, Wentworth RA, Visser GHA, Padbury JF, et al. A comparative study of cardiovascular, endocrine and behavioural effects of betamethasone and dexamethasone administration to fetal sheep. J Physiol. 1997;499(1):217–226
  31. de Kloet ER, Reul JM, Sutanto W. Corticosteroids and the brain. J Steroid Biochem Mol Biol. 1990;37:387–394
  32. Koenen SV, Mulder EJH, Wunderberger LD, Visser GHA. Transient loss of the diurnal rhythms of fetal movements, heart rate and its variation after maternal betamethasone administration. Ped Res. 2005;57:662–666
  33. Fletcher AJ, Goodfellow MR, Forhead AJ, et al. Low doses of dexamethasone suppress pituitary-adrenal function but augment the glycemic response to acute hypoxemia in fetal sheep in late gestation. Pediatr Res. 2000;47:684–691
  34. Karlsson R, Kallio J, Toppari J, et al. Antenatal and early postnatal dexamethasone treatment decreases cortisol secretion in pre-term infants. Horm Res. 2000;53:170–176
  35. Pardey J, Moulden M, Redman WD. A computer system for the numerical analysis of non-stress tests. Am J Obstet Gynecol. 2002;186:1095–1103
  36. Schaeffer L, Luzi F, Burkhardt T, Rauh M, Beinder E. Antenatal betamethasone administration alters stress physiology in healthy neonates. Obstet Gynecol. 2009;113:1082–1088
  37. Bandt C, Pompe B. Permutation entropy: a natural complexity measure for time series. Phys Rev Lett. 2002;88:174102
  38. Cao Y, Tung WW, Gao JB, Protopopescu VA, Hively LM. Detecting dynamical changes in time series using the permutation entropy. Phys Rev E Stat Nonlin Soft Matter Phys. 2004;70:046217
  39. Kullback S. Information Theory and Statistics' Mineola. New York: Dover Publications, Inc; 1968;

PII: S0378-3782(10)00116-7

doi: 10.1016/j.earlhumdev.2010.05.018

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

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