Gerstner T, Sprenger J, Schaible T, Weiss C, Koenig S
Universitätskinderklinik Heidelberg, Heidelberg.
Z Geburtshilfe Neonatol. 2010 Jan;214(1):11-4. doi: 10.1055/s-0029-1225642. Epub 2010 Feb 10.
Heart rate variability (HRV) reveals information on the functional state of the autonomic nervous system (ANS). This study was initiated to assess the physiological and maturational development of the ANS by comparing HRV data of a large number healthy foetus of different gestational ages from the 24(th) to the 42(nd) week.
Cardiotocogram (CTG) recordings of HRV of 172 healthy foetus (24-42 weeks' gestation) were performed to establish normative data. Frequency domain HRV parameters were computed in three frequency bands.
The gestational ages of the foetuses correlate with HRV. Lower gestational age in weeks showed lower frequency domain parameters than higher gestational age in weeks. The most significant differences were discerned for HRV parameters reflecting sympathetic activity in LF (low frequency) and VLF (very low frequency), due to the adrenergic system.
Maturation of the ANS is accompanied by increasing HRV with a pronounced increase of sympathetic activity. These changes are measurable by CTG recordings with a computer algorithm which can calculate short-term variability on the basis of CTG data. Problems of the CTG signal, as shown before, were the parameters of the time domain, which could only be well detected by ECG or foetal magnetocardiography (FMCG).
心率变异性（HRV）揭示了自主神经系统（ANS）的功能状态信息。本研究旨在通过比较24至42周不同孕周的大量健康胎儿的HRV数据，评估ANS的生理和成熟发育情况。
对172例健康胎儿（孕周24 - 42周）进行心率变异性的胎心监护（CTG）记录，以建立正常数据。在三个频带中计算频域HRV参数。
胎儿的孕周与HRV相关。孕周数越低，频域参数越低，孕周数越高，频域参数越高。由于肾上腺素能系统的作用，反映交感神经活动的低频（LF）和极低频（VLF）的HRV参数差异最为显著。
ANS的成熟伴随着HRV的增加以及交感神经活动的显著增加。这些变化可以通过计算机算法的CTG记录来测量，该算法可以根据CTG数据计算短期变异性。如前所述，CTG信号的问题在于时域参数，而时域参数只能通过心电图或胎儿磁心动图（FMCG）才能很好地检测到。
