Fetal Heart Rate Analysis in Pregnancies Complicated by Gestational Diabetes Mellitus: A Prospective Multicentre Observational Study

IF 4.7 1区医学 Q1 OBSTETRICS & GYNECOLOGY

Bjog-An International Journal of Obstetrics and Gynaecology Pub Date : 2024-11-25 DOI:10.1111/1471-0528.18010

Sian Chivers, Caroline Ovadia, Tharni Vasavan, Maristella Lucchini, Barrie Hayes-Gill, Nicolò Pini, William Paul Fifer, Catherine Williamson

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引用次数: 0

Abstract

Objective

Establish whether pregnancies complicated by gestational diabetes mellitus (GDM) are associated with a fetal cardiac phenotype that predisposes to arrhythmia; utilising measurements derived from non-invasive abdominal fetal ECG.

Design

Prospective observational study.

Setting

Three tertiary obstetric units, United Kingdom.

Population

Women aged ≥ 16 years with either GDM or uncomplicated pregnancy (control) who were > 20 weeks gestational age.

Methods

The MonicaAN24 non-invasive abdominal fetal ECG monitor was fitted for overnight recording.

Main Outcome Measure

Calculation of the fetal heart rate (FHR) and fetal heart rate variability (HRV) time domain metrics standard deviation of normal-to-normal intervals (SDNN), root mean square of successive differences (RMSSD) and the PR, QRS, QT intervals was performed. Groups were compared using linear regression models (stratified by sleep state) and adjusted for fetal sex and ethnicity.

Results

Ninety-six participants were included. For HRV in sleep state 1F, SDNN was higher for GDM than control participants 12.56 (10.45–16.62)ms versus 8.58 (5.83–9.73)ms [p = 0.01] [median (IQR)]. There were no differences in SDNN in sleep state 2F. No differences were identified in RMSSD in either sleep states or in the cardiac time intervals. We observed a negative correlation between HRV and body mass index/HbA1c and a positive correlation between FHR and body mass index/HbA1c in sleep states 1F/2F.

Conclusions

Alterations of HRV and FHR rate may be associated with a diagnosis of GDM, likely secondary to altered autonomic function in utero.

Abstract Image

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妊娠合并糖尿病孕妇的胎儿心率分析：一项前瞻性多中心观察研究

利用无创腹部胎儿心电图的测量结果，确定妊娠期糖尿病（GDM）并发妊娠是否与易导致心律失常的胎儿心脏表型有关。

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来源期刊

Bjog-An International Journal of Obstetrics and Gynaecology 医学-妇产科学

CiteScore

10.90

自引率

5.20%

发文量

345

审稿时长

3-6 weeks

期刊介绍： BJOG is an editorially independent publication owned by the Royal College of Obstetricians and Gynaecologists (RCOG). The Journal publishes original, peer-reviewed work in all areas of obstetrics and gynaecology, including contraception, urogynaecology, fertility, oncology and clinical practice. Its aim is to publish the highest quality medical research in women''s health, worldwide.