2,403 research outputs found

    Impulsive aggressiveness of pregnant women affects the development of the fetal heart

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    Mounting evidence indicates that the development of the fetus is heavily influenced by the intra-uterine milieu during pregnancy, and that such influence may have life-long consequences for the individual. The intra- uterine milieu is not only influenced by nutritional factors, but also by maternal endocrine and autonomic activity. Such activity is prone to be affected by an individual's personality, but only little is known about influences of maternal personality on the development of the fetus. We tested pregnant women for their propensity for impulsive, uncontrollable outbursts of temper (referred to here as moderate Intermittent Explosive Disorder, mIED). After the women gave birth, we measured electrocardiograms (ECGs) from their newborn infants to compare ECGs between newborns of women with and without mIED. The data show that infants of women with mIED have larger QRS complexes in the electrocardiogram, and lower heart rate variability, compared to infants of women without mIED. These results reveal effects of maternal mIED on the fetal heart development. These effects may predispose the individual to increased risk for later cardio-vascular disease. The findings open perspectives for better risk prevention models for the unborn child

    Fetal autonomic brain age scores, segmented heart rate variability analysis, and traditional short term variability

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    Disturbances of fetal autonomic brain development can be evaluated from fetal heart rate patterns (HRP) reflecting the activity of the autonomic nervous system. Although HRP analysis from cardiotocographic (CTG) recordings is established for fetal surveillance, temporal resolution is low. Fetal magnetocardiography (MCG), however, provides stable continuous recordings at a higher temporal resolution combined with a more precise heart rate variability (HRV) analysis. A direct comparison of CTG and MCG based HRV analysis is pending. The aims of the present study are: (i) to compare the fetal maturation age predicting value of the MCG based fetal Autonomic Brain Age Score (fABAS) approach with that of CTG based Dawes-Redman methodology; and (ii) to elaborate fABAS methodology by segmentation according to fetal behavioral states and HRP. We investigated MCG recordings from 418 normal fetuses, aged between 21 and 40 weeks of gestation. In linear regression models we obtained an age predicting value of CTG compatible short term variability (STV) of R2 = 0.200 (coefficient of determination) in contrast to MCG/fABAS related multivariate models with R2 = 0.648 in 30 min recordings, R2 = 0.610 in active sleep segments of 10 min, and R2 = 0.626 in quiet sleep segments of 10 min. Additionally segmented analysis under particular exclusion of accelerations (AC) and decelerations (DC) in quiet sleep resulted in a novel multivariate model with R2 = 0.706. According to our results, fMCG based fABAS may provide a promising tool for the estimation of fetal autonomic brain age. Beside other traditional and novel HRV indices as possible indicators of developmental disturbances, the establishment of a fABAS score normogram may represent a specific reference. The present results are intended to contribute to further exploration and validation using independent data sets and multicenter research structures

    Use of Multiscale Entropy to Characterize Fetal Autonomic Development

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    The idea that uterine environment and adverse events during fetal development could increase the chances of the diseases in adulthood was first published by David Barker in 1998. Since then, investigators have been employing several methods and methodologies for studying and characterizing the ontological development of the fetus, e.g., fetal movement, growth and cardiac metrics. Even with most recent and developed methods such as fetal magnetocardiography (fMCG), investigators are continuously challenged to study fetal development; the fetus is inaccessible. Finding metrics that realize the full capacity of characterizing fetal ontological development remains a technological challenge. In this thesis, the use and value of multiscale entropy to characterize fetal maturation across third trimester of gestation is studied. Using multiscale entropy obtained from participants of a clinical trial, we show that MSE can characterize increasing complexity due to maturation in the fetus, and can distinguish a growing and developing fetal system from a mature system where loss of irregularity is due to compromised complexity from increasing physiologic load. MSE scales add a nonlinear metric that seems to accurately reflect the ontological development of the fetus and hold promise for future use to investigate the effects of maternal stress, intrauterine growth restriction, or predict risk for sudden infant death syndrome

    Diagnostic opportunities of transabdominal fetal electrocardiography

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    Sleep-Related Arousal and Spontaneous Movement Properties in Methadone-Exposed Neonates: A Videographic Assessment On the First or Second Postnatal Night

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    Prenatal substance exposure such as alcohol, nicotine, and opiates is known to modulate autonomic regulatory function during sleep, and to decrease arousability and spontaneous movements (SM). SM during sleep may reflect a protective mechanism for immature patterns of arousals. Neurodevelopmental compromise in sleep and arousal systems may underlie sudden infant death syndrome (SIDS) risk in which infants expire during sleep. Previous studies from our laboratory found abnormal patterns of neonatal arousal, sleep fragmentation, and deficits in sleep-related SM in infants with prenatal alcohol exposure. In this study, prenatal exposure to methadone was hypothesized to disrupt the development of sleep and arousal neural circuitry, which have been found for other high-risk samples. Neonatal Abstinence Syndrome (NAS) is a common consequence of prenatal methadone exposure that may appear within 24 - 72 hours postbirth, and is known to disrupt sleep due to hyperarousability. As a secondary hypothesis, the neonatal age (day 1 or 2 of life) was expected to affect infant sleep and arousal outcomes in methadone-exposed neonates particularly on day 2 when NAS symptoms increase. Additionally, single nucleotide polymorphism (SNP) in the catechol-O-methyltransferase (COMT) gene was found to associate with the severity of NAS in our previous study. NAS severity has been associated with sleep disorders. Therefore, the second hypothesis of this thesis study is that the minor allelic variants (AG/GG) of the COMT gene previously identified as protective of NAS severity may also associate with better sleep organization and more robust SM than the carriers of the AA genotype. Rural, disadvantaged Caucasian mothers and infants (N=58 dyads: methadone=37, comparison=21) were recruited from multiple narcotic treatment sites and prenatal clinic at Eastern Maine Medical Center (EMMC). Mothers were interviewed to determine demographics, psychiatric status, and substance abuse history during the 3rd trimester. Biweekly maternal urinalysis screens and neonatal meconium were applied to verify comorbid alcohol, tobacco, and other drug use. Finnegan scores determined symptoms of withdrawal in opioid exposed newborns. Videosomnographic recordings of behavioral states were collected in the newborn nursery of EMMC overnight, and recordings between 2400-0500h were analyzed for frequency and duration of sleep, wake, arousal, and SM. Saliva samples for genetic study was collected using OrageneTM kits. Results from behavioral state analysis (n=50) showed that methadone-exposed neonates were significantly hyper-aroused and crying more on both day 1 and 2 of life (p\u3c.05); and both the frequency and duration of these parameters increased significantly in the methadoneexposed neonates on day 2 of life, as expected. In the genetic study (n=20), neonates with NAS protective AG/GG genotypes showed better behavioral sleep, fewer arousals, and robust SM than infants with NAS risk AA genotype (p\u3c.05). These findings support evidence of sleep fragmentation in the exposed neonates that is exacerbated by the passage of time since birth when withdrawal symptoms compound the intensity of sleep disturbance and infant distress. Consistent with other findings from other SIDS-risk samples, these findings indicate that arousal and SM regulation may be disrupted in methadone-exposed neonates, suggesting that prenatal methadone may increase risk for SIDS

    Diagnostic opportunities of transabdominal fetal electrocardiography

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    Genetics and Etiology of Down Syndrome

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    This book provides a concise yet comprehensive source of current information on Down syndrome. Research workers, scientists, medical graduates and paediatricians will find it an excellent source for reference and review. This book has been divided into four sections, beginning with the Genetics and Etiology and ending with Prenatal Diagnosis and Screening. Inside, you will find state-of-the-art information on: 1. Genetics and Etiology 2. Down syndrome Model 3. Neurologic, Urologic, Dental & Allergic disorders 4. Prenatal Diagnosis and Screening Whilst aimed primarily at research workers on Down syndrome, we hope that the appeal of this book will extend beyond the narrow confines of academic interest and be of interest to a wider audience, especially parents and relatives of Down syndrome patients

    The role of the vagus nerve during fetal development and its relationship with the environment

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    The autonomic nervous system (ANS) regulatory capacity begins before birth as the sympathetic and parasympathetic activity contributes significantly to the fetus' development. Several studies have shown how vagus nerve is involved in many vital processes during fetal, perinatal and postnatal life: from the regulation of inflammation through the anti-inflammatory cholinergic pathway, which may affect the functioning of each organ, to the production of hormones involved in bioenergetic metabolism. In addition, the vagus nerve has been recognized as the primary afferent pathway capable of transmitting information to the brain from every organ of the body. Therefore, this hypothesis paper aims to review the development of ANS during fetal and perinatal life, focusing particularly on the vagus nerve, to identify possible "critical windows" that could impact its maturation. These "critical windows" could help clinicians know when to monitor fetuses to effectively assess the developmental status of both ANS and specifically the vagus nerve. In addition, this paper will focus on which factors (i.e. fetal characteristics and behaviors, maternal lifestyle and pathologies, placental health and dysfunction, labor, incubator conditions, and drug exposure) may have an impact on the development of the vagus during the above-mentioned "critical window" and how. This analysis could help clinicians and stakeholders define precise guidelines for improving the management of fetuses and newborns, particularly to reduce the potential adverse environmental impacts on ANS development that may lead to persistent long-term consequences. Since the development of ANS and the vagus influence have been shown to be reflected in cardiac variability, this paper will rely in particular on studies using fetal heart rate variability (fHRV) to monitor the continued growth and health of both animal and human fetuses.Comment: Word count: 16,009 Tables: 1 Figures:

    Hypothalamic-pituitary-adrenal axis and autonomic nervous system reactivity in children prenatally exposed to maternal depression:A systematic review of prospective studies

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    Depression is a common condition affecting up to 20% of all pregnant women, and is associated with subsequent developmental and behavioral problems in children, such as conduct disorder and ADHD. One proposed mechanism underlying these associations is modification of the fetal hypothalamic pituitary adrenal (HPA)-axis and the autonomic nervous system (ANS), resulting in altered responses to stress. This review examined the evidence regarding altered HPA-axis and ANS reactivity in children prenatally exposed to high maternal depressive symptoms. A systematic search was conducted in the electronic databases MEDLINE, EMBASE and PsycINFO, for studies published till 25 July 2017. A total of 13 studies comprising 2271 mother-infant dyads were included. None of the studies were suitable for meta-analysis. Risk of bias assessment showed low risk for four studies. Only three studies described an independent association between exposure to high maternal prenatal depressive symptoms and altered stress reactivity in children. There is limited evidence of an independent association between prenatal exposure to maternal depression and altered HPA or ANS reactivity in children

    Birth Weight and Its Relationship with the Cardiac Autonomic Balance in Healthy Children

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    Several studies indicate that the fetal environment plays a significant role in the development of cardiometabolic disease later in life. However, a few studies present conflicting data about the correlation between birth weight and the impairment of cardiac autonomic modulation. The purpose of the present study was to provide further knowledge to elucidate this contradictory relationship. One hundred children aged 5 and 14 years had anthropometric parameters, body composition and blood pressure levels determined. Heart rate variability (HRV) was evaluated by heart rate monitoring, including measurements of both the time and frequency domains. The results showed inverse correlation between the HRV parameters with BMI (RMSSD: P = 0.047; PNN50: P = 0.021; HF: P = 0.041), systolic (RMSSD: P = 0.023; PNN50: P = 0.032) and diastolic (PNN50: P = 0.030) blood pressure levels. On the other hand, there were consistent positive correlations between the HRV parameters and birth weight (RMSSD: P = 0.001; PNN50: P = 0.001; HF: P = 0.002). To determine the effect of birth weight on HRV parameters, we perform multivariate linear regression analysis adjusted for potentially confounding factors (prematurity, gender, age, BMI, physical activity index and SBP levels). These findings were preserved even after adjusting for these confounders. Our results suggested that impaired cardiac autonomic modulation characterized by a reduction in the parasympathetic activity occurs in children with low birth weight. One possible interpretation for these data is that a vagal withdrawal, rather than a sympathetic overactivity, could precede the development of hypertension and other cardiometabolic diseases in children with low birth weight. However, long-term studies should be performed to investigate this possibility.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Univ Fed Sao Paulo, Div Nephrol, Sao Paulo, BrazilUniv Fed Alagoas, Dept Nutr, Alagoas, BrazilUniv Fed Sao Paulo, Dept Pediat, Sao Paulo, BrazilUniv Fed Sao Paulo, Div Nephrol, Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Pediat, Sao Paulo, BrazilFAPESP: 2013/03139-0Web of Scienc
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