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Mercado L, Rose S, Escalona-Vargas D, Siegel ER, Whittington JR, Preissl H, Helmich M, Eswaran H. Correlation of fetal heart rate dynamics to inflammatory markers and brain-derived neurotrophic factor during pregnancy. J Perinat Med 2024; 52:399-405. [PMID: 38404246 PMCID: PMC11068021 DOI: 10.1515/jpm-2023-0413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 02/05/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES This study aims to show the relation between biomarkers in maternal and cord-blood samples and fetal heart rate variability (fHRV) metrics through a non-invasive fetal magnetocardiography (fMCG) technique. METHODS Twenty-three women were enrolled for collection of maternal serum and fMCG tracings immediately prior to their scheduled cesarean delivery. The umbilical cord blood was collected for measurement of biomarker levels. The fMCG metrics were then correlated to the biomarker levels from the maternal serum and cord blood. RESULTS Brain-derived neurotrophic factor (BDNF) had a moderate correlation with fetal parasympathetic activity (0.416) and fetal sympathovagal ratios (-0.309; -0.356). Interleukin (IL)-6 also had moderate-sized correlations but with an inverse relationship as compared to BDNF. These correlations were primarily in cord-blood samples and not in the maternal blood. CONCLUSIONS In this small sample-sized exploratory study, we observed a moderate correlation between fHRV and cord-blood BDNF and IL-6 immediately preceding scheduled cesarean delivery at term. These findings need to be validated in a larger population.
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Affiliation(s)
- Luis Mercado
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Shannon Rose
- Department of Pediatrics, Arkansas Children’s Research Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Diana Escalona-Vargas
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Pediatrics, Arkansas Children’s Research Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Eric R. Siegel
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Julie R. Whittington
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Hubert Preissl
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, German Center for Diabetes Research (DZD), Tübingen, Germany
| | - Melissa Helmich
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Hari Eswaran
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Zhong M, Yi H, Lai F, Liu M, Zeng R, Kang X, Xiao Y, Rong J, Wang H, Bai J, Lu Y. CTGNet: Automatic Analysis of Fetal Heart Rate from Cardiotocograph Using Artificial Intelligence. MATERNAL-FETAL MEDICINE 2022. [DOI: 10.1097/fm9.0000000000000147] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Semeia L, Sippel K, Moser J, Preissl H. Evaluation of parameters for fetal behavioural state classification. Sci Rep 2022; 12:3410. [PMID: 35233073 PMCID: PMC8888564 DOI: 10.1038/s41598-022-07476-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 02/07/2022] [Indexed: 11/09/2022] Open
Abstract
Fetal behavioural states (fBS) describe periods of fetal wakefulness and sleep and are commonly defined by features such as body and eye movements and heart rate. Automatic state detection through algorithms relies on different parameters and thresholds derived from both the heart rate variability (HRV) and the actogram, which are highly dependent on the specific datasets and are prone to artefacts. Furthermore, the development of the fetal states is dynamic over the gestational period and the evaluation usually only separated into early and late gestation (before and after 32 weeks). In the current work, fBS detection was consistent between the classification algorithm and visual inspection in 87 fetal magnetocardiographic data segments between 27 and 39 weeks of gestational age. To identify how automated fBS detection could be improved, we first identified commonly used parameters for fBS classification in both the HRV and the actogram, and investigated their distribution across the different fBS. Then, we calculated a receiver operating characteristics (ROC) curve to determine the performance of each parameter in the fBS classification. Finally, we investigated the development of parameters over gestation through linear regression. As a result, the parameters derived from the HRV have a higher classification accuracy compared to those derived from the body movement as defined by the actogram. However, the overlapping distributions of several parameters across states limit a clear separation of states based on these parameters. The changes over gestation of the HRV parameters reflect the maturation of the fetal autonomic nervous system. Given the higher classification accuracy of the HRV in comparison to the actogram, we suggest to focus further research on the HRV. Furthermore, we propose to develop probabilistic fBS classification approaches to improve classification in less prototypical datasets.
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Affiliation(s)
- Lorenzo Semeia
- IDM/fMEG Center of the Helmholtz Center Munich at the University of Tübingen, University of Tübingen, German Center for Diabetes Research (DZD), Otfried-Müller-Str. 47, 72076, Tübingen, Germany. .,Graduate Training Centre of Neuroscience, International Max Planck Research School, University of Tübingen, Tübingen, Germany.
| | - Katrin Sippel
- IDM/fMEG Center of the Helmholtz Center Munich at the University of Tübingen, University of Tübingen, German Center for Diabetes Research (DZD), Otfried-Müller-Str. 47, 72076, Tübingen, Germany.,Department of Internal Medicine IV, University Hospital of Tübingen, Tübingen, Germany
| | - Julia Moser
- IDM/fMEG Center of the Helmholtz Center Munich at the University of Tübingen, University of Tübingen, German Center for Diabetes Research (DZD), Otfried-Müller-Str. 47, 72076, Tübingen, Germany.,Graduate Training Centre of Neuroscience, International Max Planck Research School, University of Tübingen, Tübingen, Germany
| | - Hubert Preissl
- IDM/fMEG Center of the Helmholtz Center Munich at the University of Tübingen, University of Tübingen, German Center for Diabetes Research (DZD), Otfried-Müller-Str. 47, 72076, Tübingen, Germany.,Department of Internal Medicine IV, University Hospital of Tübingen, Tübingen, Germany.,Department of Pharmacy and Biochemistry, Interfaculty Centre for Pharmacogenomics and Pharma Research, University of Tübingen, Tübingen, Germany
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Escalona-Vargas D, Coker JL, Ray-Griffith S, Siegel ER, Lowery CL, Stowe ZN, Eswaran H. Fetal assessment in buprenorphine-maintained women using fetal magnetoencephalography: a pilot study. Addiction 2018; 113:1895-1904. [PMID: 29781091 PMCID: PMC10091850 DOI: 10.1111/add.14266] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 11/22/2017] [Accepted: 05/04/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS In-utero exposure to opioids including buprenorphine (BUP) has been shown to affect fetal activity, specifically heart-rate variability (FHRV) and fetal movement (FM). Our objective was to extract simultaneous recordings of fetal cardiac and brain-related activity in BUP-maintained and non-opioid exposed pregnant women using a novel non-invasive biomagnetic technique. DESIGN A pilot study was conducted, recording and analyzing biomagnetic data from fetuses of BUP-maintained and non-opioid exposed pregnant women. Signals were acquired with the non-invasive 151-channel SARA (SQUID-Array for Reproductive Assessment) system. Advanced signal-processing techniques were applied to extract fetal heart and brain activity. SETTING University of Arkansas for Medical Sciences (UAMS, Little Rock, Arkansas, USA). PARTICIPANTS Eight BUP-maintained pregnant women from UAMS Women's Mental Health Program between gestational ages (GA) of 29-37 weeks who were treated with 8-24 mg of BUP daily. Sixteen pregnant women with no known opioid exposure in the same GA range were also included. MEASUREMENTS Outcome measures from the fetal heart and brain signals included: heart rate (FHR), FM, FHR accelerations, FHR-FM coupling, FHRV, fetal behavioral states (FBS) and power spectral density (PSD) of spontaneous brain activity. These measures were analyzed at three GA intervals. FINDINGS Fetal heart and brain activity parameters were extracted and quantified successfully from 18 non-opioid and 16 BUP recordings. Overall analysis in both groups show that: FHR and FM ranged from 131 to 141 beats per minute (b.p.m.) and 5 to 11 counts, respectively. In the 35-37 weeks GA, the coupling duration (~9 s) was the shortest, while three of the FHRV parameters were the highest. The PSD of brain activity revealed highest power in 0.5-4 Hz bandwidth. Transitions in FBS from quiet to active sleep were > 50% of sessions. CONCLUSIONS This pilot study showed that a novel biomagnetic technique allows simultaneous quantification of cardiac and brain activities of a group of buprenorphine-exposed and non-exposed fetuses in the third trimester.
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Affiliation(s)
- Diana Escalona-Vargas
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jessica L Coker
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Shona Ray-Griffith
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.,Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Eric R Siegel
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Curtis L Lowery
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Zachary N Stowe
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Hari Eswaran
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Vairavan S, Ulusar UD, Eswaran H, Preissl H, Wilson JD, Mckelvey SS, Lowery CL, Govindan RB. A computer-aided approach to detect the fetal behavioral states using multi-sensor Magnetocardiographic recordings. Comput Biol Med 2015; 69:44-51. [PMID: 26717240 DOI: 10.1016/j.compbiomed.2015.11.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 11/26/2015] [Accepted: 11/28/2015] [Indexed: 11/26/2022]
Abstract
We propose a novel computational approach to automatically identify the fetal heart rate patterns (fHRPs), which are reflective of sleep/awake states. By combining these patterns with presence or absence of movements, a fetal behavioral state (fBS) was determined. The expert scores were used as the gold standard and objective thresholds for the detection procedure were obtained using Receiver Operating Characteristics (ROC) analysis. To assess the performance, intraclass correlation was computed between the proposed approach and the mutually agreed expert scores. The detected fHRPs were then associated to their corresponding fBS based on the fetal movement obtained from fetal magnetocardiogaphic (fMCG) signals. This approach may aid clinicians in objectively assessing the fBS and monitoring fetal wellbeing.
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Affiliation(s)
- S Vairavan
- Graduate Institute of Technology, University of Arkansas at Little Rock, AR, USA
| | - U D Ulusar
- Computer Engineering Department, Akdeniz University, Antalya, Turkey
| | - H Eswaran
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, AR, USA; Division of Biomedical Informatics, University of Arkansas for Medical Sciences, AR, USA
| | - H Preissl
- Division of Biomedical Informatics, University of Arkansas for Medical Sciences, AR, USA; MEG Center, University of Tubingen, Tubingen, Germany
| | - J D Wilson
- Graduate Institute of Technology, University of Arkansas at Little Rock, AR, USA
| | - S S Mckelvey
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, AR, USA
| | - C L Lowery
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, AR, USA
| | - R B Govindan
- Division of Fetal and Transitional Medicine, Fetal Medicine Institute, Children׳s National Health System, 111 Michigan Ave, NW Washington, DC 20010, USA.
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Belich AI, Konstantinova NN, Pavlova NG. About mechanisms of triggering of primary excitation rhythms in vertebrates (Phylo- and ontogenetic aspects of the problem). J EVOL BIOCHEM PHYS+ 2010. [DOI: 10.1134/s0022093009060118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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