Kapaya Habiba, Broughton Pipkin Fiona, Hayes-Gill Barrie, Loughna Pamela V
Department of Oncology and Metabolism, Academic Unit of Reproductive & Developmental Medicine, 4th Floor Jessop Wing, Tree Root Walk, Sheffield, S102SF UK.
Division of Child Health, Obstetrics and Gynaecology, School of Medicine, University of Nottingham, Nottingham, NG7 2RD UK.
Matern Health Neonatol Perinatol. 2016 Sep 2;2(1):9. doi: 10.1186/s40748-016-0037-6. eCollection 2016.
Previous researchers have studied circadian changes in the fetal heart rate (FHR) on small sample sizes and in a strictly controlled environment. This study was undertaken to investigate these changes during the late second and third trimesters, using a portable fetal electrocardiogram recording device (Monica AN24) in pregnant women in home and hospital environments with unrestricted mobility.
This was a prospective cohort study of 54 pregnant women with uncomplicated singleton pregnancies between 25 and 40 weeks gestation. FHR recordings were made up to 16 h at home or in the hospital setting in the United Kingdom. FHR data over 90 min periods were averaged and the day (7:00 am-11:00 pm) and night (11:00 pm-7:00 am) data from the same individual were compared. Data were examined for evidence of sex-related differences.
During the night, there was a significant reduction in basal heart rate (bFHR) and a significant increase in short term variation (STV) and long term variation (LTV) (P < 0.05). Basal FHR decreased (P < 0.002), whereas LTV increased (P = 0.014) with advancing gestation. Male fetuses showed greater day: night variation than females regardless of gestation (P = 0.014). There was a higher bFHR in fetuses monitored during the day in hospital (P = 0.04).
This study demonstrates that there are sex-, environment and time-related differences in the FHR parameters measured. These differences may need to be considered taken when interpreting FHR data.
以往的研究人员在小样本量且严格控制的环境中研究了胎儿心率(FHR)的昼夜变化。本研究旨在使用便携式胎儿心电图记录设备(Monica AN24),在家庭和医院环境中对活动不受限的孕妇进行研究,以调查妊娠晚期第二个三月期和第三个三月期的这些变化。
这是一项对54例单胎妊娠、妊娠25至40周且无并发症的孕妇进行的前瞻性队列研究。在英国,在家中或医院环境下进行长达16小时的FHR记录。对90分钟时间段内的FHR数据进行平均,并比较同一个体的白天(上午7:00至晚上11:00)和夜间(晚上11:00至上午7:00)数据。检查数据以寻找性别相关差异的证据。
夜间,基础心率(bFHR)显著降低,短期变异性(STV)和长期变异性(LTV)显著增加(P < 0.05)。随着孕周增加,基础FHR降低(P < 0.002),而LTV增加(P = 0.014)。无论孕周如何,男性胎儿的昼夜变化均大于女性(P = 0.014)。白天在医院监测的胎儿bFHR较高(P = 0.04)。
本研究表明,所测量的FHR参数存在性别、环境和时间相关差异。在解释FHR数据时可能需要考虑这些差异。