Quantification of maternal-fetal cardiac couplings in normal and abnormal pregnancies applying high resolution joint symbolic dynamics

Abstract

Maternal psycho-physiological activities affect the fetal development and its heart rate variability. In this work, the short-term maternal-fetal cardiac couplings in normal and abnormal fetuses were investigated by using the high resolution joint symbolic dynamics method. The analysis was applied on maternal and fetal beat-to-beat intervals of 66 normal and 19 abnormal fetuses that includes different types of congenital heart defects, tachycardia, Atrioventricular block and other types of abnormalities. Results showed that the weak decrease in maternal beat-to-beat variations associated with the strong increase in fetal beat-to-beat variations was found to be significantly higher for the abnormal cases compared to normal cases despite the heterogeneity of abnormality and gestational age (abnormal: 0.032 ±0.013, normal: 0.014 ±0.007, p < 0.01). These differences could be interpreted as impairment in the autonomic nervous system in abnormal cases. The atrioventricular block cases showed a rise in the strong increase and decrease fetal beat-to-beat variations compared to the normal cases while the tachycardia cases showed a decay in these coupling patterns.

Keywords

• fetal electrocardiogram
• fetal heart rate variability
• maternal-fetal autonomic interaction
• nonlinear coupling
• joint symbolic dynamics