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Patterns of fetal heart rate response at ∼30 weeks gestation predict size at birth

Published online by Cambridge University Press:  13 June 2011

C. A. Sandman ,
C. J. Cordova ,
E. P. Davis ,
L. M. Glynn  and
C. Buss
C. A. Sandman*
Affiliation:
Women and Children's Health and Well-Being Project, Department of Psychiatry and Human Behavior, University of California, Irvine, Orange, CA, USA
C. J. Cordova
Affiliation:
Women and Children's Health and Well-Being Project, Department of Psychiatry and Human Behavior, University of California, Irvine, Orange, CA, USA
E. P. Davis
Affiliation:
Women and Children's Health and Well-Being Project, Department of Psychiatry and Human Behavior, University of California, Irvine, Orange, CA, USA Department of Pediatrics, University of California, Irvine, CA, USA
L. M. Glynn
Affiliation:
Women and Children's Health and Well-Being Project, Department of Psychiatry and Human Behavior, University of California, Irvine, Orange, CA, USA Crean School of Health and Life Sciences, Chapman University, Orange, CA, USA
C. Buss
Affiliation:
Women and Children's Health and Well-Being Project, Department of Psychiatry and Human Behavior, University of California, Irvine, Orange, CA, USA Department of Pediatrics, University of California, Irvine, CA, USA
*
*Address for correspondence: C. A. Sandman, Women and Children's Health and Well-Being Project, Department of Psychiatry and Human Behavior, University of California, 333 City Drive, Suite 1200, Orange, CA 92868-3205, USA. (Email casandma@uci.edu)
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Abstract

There is evidence that fetal exposure to maternal stress is associated with adverse birth outcomes. Less is known about the association between fetal responses to a stressor and indicators of fetal maturity and developmental outcomes. The purpose of the present study was to determine whether fetal heart rate (FHR) patterns in response to a startling stimulus at ∼30 weeks of gestation were associated with gestational age at birth and birth weight. FHR was measured in 156 maternal–fetal dyads following a vibroacoustic stimulus. All pregnancies were singleton intrauterine pregnancies in English-speaking women who were primarily married, middle class, White and at least 18 years of age. Group-based trajectory modeling identified five groups of fetuses displaying distinctive longitudinal trajectories of FHR response to the startling stimulus. The FHR group trajectories were significantly associated with birth weight percentile (P < 0.01) even after controlling for estimated fetal weight at the time of assessment and parity, which are the known factors influencing birth weight (P < 0.01). Post hoc analyses indicated that two groups accounted for the association between FHR patterns and birth weight. The group (n = 23) with the lowest birth weight exhibited an immediate FHR deceleration followed by an immediate acceleration that does not recover. An FHR pattern characterized by immediate and fast acceleration to the peak and a slow discovery to baseline was associated with the highest birth weight. This is the first direct evidence showing that low birth weight and the resulting neurological consequences may have their origins in early fetal development.

Keywords

birth weightfetal heart ratefetal programminggroup-based trajectory modeling
Type
Original Articles
Information
Journal of Developmental Origins of Health and Disease , Volume 2 , Issue 4 , August 2011 , pp. 212 - 217
Copyright
Copyright © Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2011

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