ArticlePhysiological measurement2019
Heart rate variability categories of fluctuation amplitude and complexity: diagnostic markers of fetal development and its disturbances.
Article in Physiological measurement, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A Review on the Vagus Nerve and Autonomic Nervous System During Fetal Development: Searching for Critical Windows.Frontiers in neuroscience · 2021Pooled it
- Non-linear Methods Predominant in Fetal Heart Rate Analysis: A Systematic Review.Frontiers in medicine · 2021Pooled it
- Metabolic expenditure, neurodevelopment, and weight gain into early childhood after fetal growth restriction.Scientific reports · 2026Article
- The maternal-fetal communicatome: a scoping review and network physiology perspective on a unified, adaptive, and multiscale interaction network.Frontiers in network physiology · 2026Review
- Investigating asymmetry in fetal and maternal heart rate accelerations and decelerations.Scientific reports · 2025Article
- Antenatal Noninvasive Fetal Electrocardiography: A Literature Review.Maternal-fetal medicine (Wolters Kluwer Health, Inc.) · 2024Review
- A Small Scale Optically Pumped Fetal Magnetocardiography System.Journal of clinical medicine · 2023Article
- Assessing the cardiac autonomic response to bicycle exercise in Olympic athletes with different loads of endurance training: new insights from statistical indicators based on multilevel exploratory factor analysis.Frontiers in physiology · 2023Article
- Osteopathic Manipulative Treatment Regulates Autonomic Markers in Preterm Infants: A Randomized Clinical Trial.Healthcare (Basel, Switzerland) · 2022Article
- Fetal growth restriction and stillbirth: Biomarkers for identifying at risk fetuses.Frontiers in physiology · 2022Review
- Heart Rate Variability in the Perinatal Period: A Critical and Conceptual Review.Frontiers in neuroscience · 2020Review
- A Proxy for Detecting IUGR Based on Gestational Age Estimation in a Guatemalan Rural Population.Frontiers in artificial intelligence · 2020Article
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Authors and funding
9 authors.
Funding
Abstract
objectiveIn fetal diagnosis the myriad and diversity of heart rate variability (HRV) indices prevents a comparable routine evaluation of disturbances in fetal development and well-being. The work aims at the extraction of a small set of HRV key indices that could help to establish a universal, overarching tool to screen for any disturbance. APPROACH: HRV indices were organized in categories of short-term (prefix s) and long-term (prefix l) amplitude fluctuations (AMP), complexity (COMP), and patterns (PATTERN) and common representatives for each category were extracted. This procedure was done with respect to the diagnostic value in the evaluation of the maturation age throughout the second and complete third trimester of pregnancy as well as to potential differences associated with maternal life-style factors (physical exercise, smoking), nutrient intervention (docosahexaenoic acid (DHA) supplementation), and complications of pregnancy (gestational diabetes mellitus (GDM), intra-uterine growth restriction (IUGR)). MAIN
resultsWe found a comprehensive minimal set that includes [lAMP: short term variation (STV), initially introduced in cardiotocography, sAMP: heart rate increase across one interbeat interval of phase rectified averaged signal - acceleration capacity (ACst1), lCOMP: scale 4 multi-scale entropy (MSE4), PATTERN: skewness] for the maturation age prediction, and partly overlapping [lAMP: STV, sAMP: ACst1, sCOMP: Lempel Ziv complexity (LZC)] for the discrimination of the deviations. SIGNIFICANCE: The minimal set of category-based HRV representatives allows for a screening of fetal development and well-being. These results are an important step towards a universal and comparable diagnostic tool for the early identification of developmental disturbances. Novelty & Significance Fetal development and its disturbances have been reported to be associated with a multiplicity of HRV indices. Furthermore, these HRV indices change with maturation. We propose the abstraction of HRV categories defined by short- and long-term fluctuation amplitude, complexity, and pattern indices that cover all relevant aspects of maturational age, behavioral influences and a series of pathological disturbances. The study data are provided by multiple centers. Our approach is an important step towards the goal of a standardized diagnostic tool for early identification of fetal developmental disturbances with respect to the reduction of serious complications in the later life.
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