Specific change in spectral power of fetal heart rate variability related to fetal acidemia during labor

Comparison between preterm and term fetuses

Ji Young Kwon, In Yang Park, Jong Chul Shin, Juhee Song, Reza Tafreshi, Jongil Lim

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: Spectral analysis of fetal heart rate (FHR) variability is a useful method to assess fetal condition. There have been several studies involving the change in spectral power related to fetal acidemia, but the results have been inconsistent. Aims: To determine the change in spectral power related to fetal umbilical arterial pH at birth, dividing cases into preterm (31-36. weeks) and term (≥ 37. weeks) gestations. Study design: Case-control study. The 514 cases of deliveries were divided into a low-pH group (an umbilical arterial pH < 7.2) and a control group (pH ≥ 7.2). Subjects: FHR recorded on cardiotocography during the last 2. h of labor. Outcome measures: The spectral powers in various bands of FHR variability. Results: In preterm fetuses, the total, low (LF), and movement (MF) frequency spectral powers and LF/HF ratio were significantly lower in the low-pH group than the control group (all P< 0.05). In contrast, in term fetuses, the total frequency, LF, and MF powers were significantly higher in the low-pH group than the control group (all P< 0.05). The area under the receiver operating characteristic of LF power to detect a low pH at birth was 0.794 in preterm fetuses and 0.595 in term fetuses. The specificity was 86.8% and 93.3% in preterm and term fetuses, respectively. Conclusions: The changes in spectral power responding to a low pH are different between term and preterm fetuses. Spectral analysis of FHR variability may be useful fetal monitoring for early detection of fetal acidemia.

Original languageEnglish
Pages (from-to)203-207
Number of pages5
JournalEarly Human Development
Volume88
Issue number4
DOIs
Publication statusPublished - Apr 2012

Fingerprint

Fetal Heart Rate
Fetus
Umbilicus
Control Groups
Parturition
Cardiotocography
Fetal Monitoring
ROC Curve
Case-Control Studies
Outcome Assessment (Health Care)
Pregnancy

Keywords

  • Cardiotocography
  • Fetal acidemia
  • Heart rate variability
  • Spectral analysis
  • Umbilical arterial low pH

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynaecology

Cite this

Specific change in spectral power of fetal heart rate variability related to fetal acidemia during labor : Comparison between preterm and term fetuses. / Kwon, Ji Young; Park, In Yang; Shin, Jong Chul; Song, Juhee; Tafreshi, Reza; Lim, Jongil.

In: Early Human Development, Vol. 88, No. 4, 04.2012, p. 203-207.

Research output: Contribution to journalArticle

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N2 - Background: Spectral analysis of fetal heart rate (FHR) variability is a useful method to assess fetal condition. There have been several studies involving the change in spectral power related to fetal acidemia, but the results have been inconsistent. Aims: To determine the change in spectral power related to fetal umbilical arterial pH at birth, dividing cases into preterm (31-36. weeks) and term (≥ 37. weeks) gestations. Study design: Case-control study. The 514 cases of deliveries were divided into a low-pH group (an umbilical arterial pH < 7.2) and a control group (pH ≥ 7.2). Subjects: FHR recorded on cardiotocography during the last 2. h of labor. Outcome measures: The spectral powers in various bands of FHR variability. Results: In preterm fetuses, the total, low (LF), and movement (MF) frequency spectral powers and LF/HF ratio were significantly lower in the low-pH group than the control group (all P< 0.05). In contrast, in term fetuses, the total frequency, LF, and MF powers were significantly higher in the low-pH group than the control group (all P< 0.05). The area under the receiver operating characteristic of LF power to detect a low pH at birth was 0.794 in preterm fetuses and 0.595 in term fetuses. The specificity was 86.8% and 93.3% in preterm and term fetuses, respectively. Conclusions: The changes in spectral power responding to a low pH are different between term and preterm fetuses. Spectral analysis of FHR variability may be useful fetal monitoring for early detection of fetal acidemia.

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