Zöllkau Janine, Dölker Eva-Maria, Schmidt Alexander, Schneider Uwe, Hoyer Dirk
Department of Obstetrics and Gynecology, Jena University Hospital, Jena, Germany.
Biomagnetic Center, Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany.
J Perinat Med. 2019 Apr 24;47(3):323-330. doi: 10.1515/jpm-2018-0221.
Background Disturbances in maternal physiology can cause changes in the fetal condition that may lead to impaired fetal development. Synchronous monitoring of cardiac autonomic tone via the assessment of the fetal and maternal heart rate (HR) and heart rate variability (HRV) may provide an appropriate diagnostic window. Methods Partial rank correlation coefficients between the maternal and fetal HR and HRV indices were calculated and verified by testing surrogate data in 315 magnetocardiographic (MCG) recordings from 141 healthy women pregnant with singleton fetuses [18+6 to 39+2 weeks gestational age (WGA)]. We assessed maternal self-perceived depression, anxiety and stress by means of the Depression, Anxiety, Stress Scales self-reporting instrument (DASS42G) questionnaire. Results The maternal HRV correlated positively with the fetal HRV, but negatively with the fetal HR. Correlation was |r|<0.2 in state-independent and gestational age (GA) <32 weeks, but |r|>0.2 in active sleep and GA ≥32 weeks. The DASS42G results correlated with the maternal HRV and HR, while the fetal HR and HRV were not influenced. Conclusion Correlations between maternal and fetal autonomic activation were statistically confirmed. They depend on the GA and active fetal state. As far as healthy subjects are concerned, maternal self-perceived stress, anxiety or depression is mirrored in maternal but not in fetal autonomic tone.
背景 母体生理紊乱可导致胎儿状况发生变化，进而可能影响胎儿发育。通过评估胎儿和母体心率（HR）及心率变异性（HRV）同步监测心脏自主神经张力，可能提供一个合适的诊断窗口。方法 计算了141名单胎健康孕妇（孕龄18 + 6至39 + 2周）的315份磁心动图（MCG）记录中母体与胎儿HR及HRV指标之间的偏秩相关系数，并通过检验替代数据进行了验证。我们通过抑郁、焦虑、压力量表自评工具（DASS42G）问卷评估了母体自我感知的抑郁、焦虑和压力。结果 母体HRV与胎儿HRV呈正相关，但与胎儿HR呈负相关。在非依赖状态且孕龄（GA）< 32周时，相关性|r| < 0.2，但在活跃睡眠且GA≥32周时，|r| > 0.2。DASS42G结果与母体HRV和HR相关，而胎儿HR和HRV未受影响。结论 母体与胎儿自主神经激活之间的相关性得到了统计学证实。它们取决于孕龄和胎儿活跃状态。就健康受试者而言，母体自我感知的压力、焦虑或抑郁反映在母体而非胎儿自主神经张力中。
