Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Department of Mathematics and Department of Statistical Science, Duke University, Durham, NC, USA.
Dev Psychobiol. 2021 Jul;63(5):945-959. doi: 10.1002/dev.22118. Epub 2021 Mar 25.
Despite prolonged and cumulative exposure during gestation, little is known about the fetal response to maternal sleep. Eighty-four pregnant women with obesity (based on pre-pregnancy BMI) participated in laboratory-based polysomnography (PSG) with continuous fetal electrocardiogram monitoring at 36 weeks gestation. Multilevel modeling revealed both correspondence and lack of it in maternal and fetal heart rate patterns. Fetal heart rate (fHR) and variability (fHRV), and maternal heart rate (mHR) and variability (mHRV), all declined during the night, with steeper rates of decline prior to 01:00. fHR declined upon maternal sleep onset but was not otherwise associated with maternal sleep stage; fHRV differed during maternal REM and NREM. There was frequent maternal waking after sleep onset (WASO) and fHRV and mHRV were elevated during these episodes. Cross-correlation analyses revealed little temporal coupling between maternal and fetal heart rate, except during WASO, suggesting that any observed associations in maternal and fetal heart rates during sleep are the result of other physiological processes. Implications of the maternal sleep context for the developing fetus are discussed, including the potential consequences of the typical sleep fragmentation that accompanies pregnancy.
尽管在妊娠期间存在长时间和累积的暴露，但对于胎儿对母体睡眠的反应知之甚少。84 名肥胖孕妇（基于孕前 BMI）在妊娠 36 周时进行了基于实验室的多导睡眠图（PSG）检查，并进行了连续胎儿心电图监测。多层次模型揭示了母体和胎儿心率模式之间的一致性和不一致性。胎儿心率（fHR）和变异性（fHRV）以及母体心率（mHR）和变异性（mHRV）在夜间均下降，01:00 前下降速度更快。胎儿心率在母体入睡时下降，但与母体睡眠阶段无关；fHRV 在 REM 和 NREM 期间不同。睡眠后常有母体觉醒（WASO），这些事件期间 fHRV 和 mHRV 升高。交叉相关分析显示，母体和胎儿心率之间的时间耦合很少，除了在 WASO 期间，这表明睡眠期间母体和胎儿心率之间观察到的任何关联都是其他生理过程的结果。讨论了母体睡眠环境对发育中胎儿的影响，包括伴随妊娠的典型睡眠片段化的潜在后果。
