The frequency and size of deceleration are important indicators as well as the nature of the FHR between contractions and trends over time. doi: 10.1016/j.ajog.2016.10.003, McEwen, B. S., Nasca, C., and Gray, J. D. (2016). How yawning switches the default-mode network to the attentional network by activating the cerebrospinal fluid flow: how yawning switches the DMN to the attentional network. Drugs 5, 615627. Anatomy and Physiology. Stages of labor, in StatPearls (Treasure Island, FL: StatPearls Publishing). Doc Preview. doi: 10.1371/journal.pone.0104193, Rodgers, S. K., Chang, C., DeBardeleben, J. T., and Horrow, M. M. (2015). These late decelerations were not associated with fetal acidosis. The role of gut microbiota in the effects of maternal obesity during pregnancy on offspring metabolism. Satoh, T., Sakurai, E., Tada, H., and Masuda, T. (2009). The cardioacceleratory center increases heart rate directly via sympathetic cardiac nerves which interact with the sinoatrial node to increase the heart rate. An antenatal marker of neurodevelopmental outcomes in infants with congenital heart disease. Sleep patterns and sleep disturbances across pregnancy. Porges, S. W. (2011). A., Velez, M., Elko, A., Williams, E., Milio, L., et al. Cardiovasc. doi: 10.1016/j.earlhumdev.2010.05.018, Schneider, U., Frank, B., Fiedler, A., Kaehler, C., Hoyer, D., Liehr, M., et al. Monitoring fetal maturationobjectives, techniques and indices of autonomic function. Identified Q&As 100+ Solutions available. This affection ultimately interferes with cerebral fetal neurodevelopment, including the nucleus accumbens and hippocampus, that are involved in CAN (Seckl and Meaney, 2004). Rheumatol. 18, 14951506. Physiol. Electromagnetic field coming from the incubator power influences the ANS as revealed by HRV analysis as LF/HF increases, whereas HF decreases (Bellieni et al., 2008). (2012). The cervix undergoes biochemical changes that increase its elasticity. Orthop. Antonelli, M. C., Frasch, M. G., Rumi, M., Sharma, R., Zimmermann, P., Molinet, M. S., et al. Burgio, E. (2015). 86, 174180. Perinatal hemorrhagic shock after fetal scalp blood sampling. Homeostatic control of neural function can be mediated by the regulation of ion channel expression, neurotransmitter receptor abundance, or modulation of presynaptic release. (2021). J. Matern. Thorax 57, 555558. Although thalamocortical connections, which strongly increase around 2022 WGA, are usually required for pain experience and the hemodynamic-behavioral responses to nociceptive stimuli are usually detected around 26 WGA (Verriotis et al., 2016; Chen et al., 2021), several authors argue that fetuses could feel pain at least from 12 WGA, as the first superficial thalamic-subplate connections seem to be functionally equivalent to the later thalamocortical ones (Derbyshire and Bockmann, 2020). The human brain at stage 16, including the initial evagination of the neurohypophysis. 1781, 341352. 161, 771774. Women Birth 32, 12. Diseases 6:23. doi: 10.3390/diseases6020023, Vohr, B. R., Davis, E. P., Wanke, C. A., and Krebs, N. F. (2017). 1991 Nov 26;42(2):145-53. In particular, a steep rise in PNS tone can be detected around 3738 WGA and basal fetal cardiovascular function becomes more influenced by the PNS. 118, 487488. Male fetuses show a more reactive ANS and less complexity in control systems than female ones, with a more linear and significantly less complex fHR activity (Bernardes et al., 2008). BJOG Int. Smith J, Wells L, Dodd K. The continuing fall in incidence of hypoxic-ischaemic encephalopathy in term infants. About Med. 1032, 6384. doi: 10.1002/hbm.23340, Thoyre, S. M., Holditch-Davis, D., Schwartz, T. A., Melendez Roman, C. R., and Nix, W. (2012). Clin. Sci. 4, 167170. Front. American College of Obstetricians and Gynecologists. Influence of gestational age, heart rate, gender and time of day on fetal heart rate variability. 14:561186. doi: 10.3389/fnins.2020.561186, Christian, P., and Stewart, C. P. (2010). Neurosci. 4, 569577. Semin. Gynecol. Towards a definition of life. Microbiomemicroglia connections via the gutbrain axis. Midwifery 56, 102111. doi: 10.1371/journal.pone.0200799, Schneider, U., Fiedler, A., Schrder, B., Jaekel, S., Stacke, A., Hoyer, D., et al. doi: 10.1038/sj.jp.7200445, Aidy, S. E., Dinan, T. G., and Cryan, J. F. (2015). Inserted sensors measured blood pressure, heart rate and acid base status duringthe experiments. (1980). doi: 10.3945/jn.109.116327, Christifano, D. N., Taylor, M. K., Carlson, S. E., Colombo, J., and Gustafson, K. M. (2020). Saving the brain one heartbeat at a time: perspectives. Surv. It is possible, therefore, to assume that the mother, considering the limited light-dark variation during intrauterine life, entrains the developing circadian rhythm of the fetus to this cycle (Mirmiran et al., 2003). Figure 3: Two proposed pathways with late decelerations, adapted from Freeman et al. Physiotherapy 104, 338346. Area postrema undergoes dynamic postnatal changes in mice and humans: dynamic postnatal changes of area postrema. Porges, S. W., and Furman, S. A. Obstet Gynecol. Fetal Diagn. Furthermore, the diminished vagal cardiovascular capacity to respond to hypoxic and hypercapnic states in the fetus, due to the abolishment of the serotonergic neurotransmission to cardiac vagal neurons caused by PNE, has been hypothesized as a likely link to SIDS (Kamendi et al., 2006, 2009). Analg. (2010). Fetal heart rate and motor activity associations with maternal organochlorine levels: results of an exploratory study. A clinical perspective of necrotizing enterocolitis: past, present, and future. Continuous positive airway pressure (CPAP) for respiratory distress in preterm infants. 78, 17881798. Rochester, NY: Social Science Research Network. Psychobiol. Baan J Jr, Boekkooi PF, Teitel DF, Rudolph AM. 40, 445456. Homeostatic plasticity is thought to be crucial for preventing synaptic saturation, thus allowing for new memory formation, and may be disrupted in several neurological disorders, including Alzheimer's disease (14) and ASD (15-18). Migration and diversification of the vagal neural crest. doi: 10.1016/S1701-2163(15)30382-0, Newbern, J. M. (2015). Nutr. doi: 10.1111/aogs.13437, Boehm, F. H., Woodruff, L. F., and Growdon, J. H. (1975). 92, 691693. The cardioinhibitory center slows the heart rate via the parasympathetic vagus nerve which can slow heart rate by modulation at various levels, including the sino-atrial node. As the 3rd trimester advances, specific nociceptive event-related potentials in the brain increasingly develop until 3537 WGA (Verriotis et al., 2016). Notably, this effect is limited to inhibitory-onto-excitatory neuron . (2018). Anat. The fetal heart rate pattern we observe is the combined results of many physiological actions. With the passing of the weeks, however, sex-specific differences in the sympathovagal balance start to be detected. Recently, placenta calcifications samples collected at delivery have been speculated to act as a memory of prenatal maternal stress and diseases exposure, hence highlighting the potential role of placenta in regulating the offspring's future cardiovascular and metabolic health, even through the in utero modulation of the developing ANS (Wallingford et al., 2018). Dev. In particular, we will study what events can interfere with the correct development of these two systems by analyzing the evidence from preclinical and clinical studies in this regard, with the aim of preventing potential complications with long-term consequences. Reflex control of immunity. Both sexes demonstrate an evolutionary pattern with increased entropy indexes until 34 WGA, with a slight decrease after 37 WGA. (2013). Rep. 6:e13620. Maternal pathologies influence the onset of altered neurodevelopment patterns during fetal life, which could lead to actual neurologic disorders during childhood (Faa et al., 2016; Vohr et al., 2017). Neuroscience 338, 207219. 160, 127133. doi: 10.1016/j.smrv.2018.03.004, Weber, A., and Harrison, T. M. (2019). Heart rate variability in sleeping preterm neonates exposed to cool and warm thermal conditions. Acidemia at birth, related to obstetric characteristics and to oxytocin use, during the last two hours of labor. Moreover, the prolonged administration of MgSO4 seems to be associated with a change in fetal breathing movements (Peaceman et al., 1989) and to affect fHRV dose-dependently (Cardosi and Chez, 1998; Kamitomo et al., 2000). Lastly, early pain reactivity measured through HRV in alcohol-exposed newborns seems to be blunted, suggesting different responsiveness to environmental stimuli even after birth (Oberlander et al., 2010). Moreover, some studies have highlighted that the same factors can differently affect development based on the exposure period (i.e., early vs. late gestation) (Schulz, 2010; Gartstein and Skinner, 2018; Kasahara et al., 2020, 2021). (2021). Rev. J. Nutr. Clin. This results in an overexposure of the fetus to maternal cortisol, that in turn may produce an overactive fetal cortisol response and may be a predisposing factor to develop disorders related to elevated HPA axis activity, which could lead to impairments in environmental stimuli adaptability by ANS in newborns (Nugent and Bale, 2015). 86, 672677. Paediatr. (2018). doi: 10.1088/1361-6579/ac010e. Sex differences in fetal heart rate and variability assessed by antenatal computerized cardiotocography. Meas. Birt. (2018). doi: 10.1016/j.mehy.2008.09.033, Cahill, A. G., Mathur, A. M., Smyser, C. D., Mckinstry, R. C., Roehl, K. A., Lpez, J. D., et al. (2020). (2019). The fetal heart, devoid of any sympathetic and parasympathetic influences, showed decelerations suggesting thatintrinsic myocardial depression was the deceleration mechanism in the presence of severe acidosis and hypoxia.12. Nutrients 7, 30673077. Nevertheless, prone sleeping is considered a risk factor for SIDS and it shows a lower short-term variability in HRV (Lucchini et al., 2016). Cardiovascular physiology of pregnancy. J. Clin. In the course of pregnancy, mother and fetus could undergo a variety of drug administrations, many of which can cross the placenta affecting fetal development in several ways (Miljkovi et al., 2001). The following review is by no mean an exhaustive discussion of the thousands of published articles on fetal heart rate monitoring. Media Coverage Adrenaline and the Inner World: An Introduction to Scientific Integrative Medicine. Based on their experiments in sheep, this group of fetal physiologists has proposed a different sequence of events to explain decelerations: namely contractions induce a reduction in uteroplacental blood flow and/or cord compression causing a reduction in fetal pO2 that triggers the chemoreflex whose magnitude is related to the degree of hypoxia. Delivery without labor or preterm birth is associated with lower cortisol, angiotensin, and catecholamines levels compared to labored or full-term delivery. Fetal Diagn. doi: 10.1515/jpm-2016-0414, Morris, G. S., Zhou, Q., Hegsted, M., and Keenan, M. J. Intern. 68, 811824. 134, 396408. (2019). Moreover, a recent pilot study described that in utero ZIKV-affected babies display HRV metrics abnormalities. Clin. Scand. Such hypoxic states can also be secondary to infections, including chorioamnionitis, leading to several hemodynamic abnormalities, and cardiovascular compromise (Frasch, 2018). All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. The discomforts of pregnancy. Comput. Alcohol easily crosses the placenta and can disrupt maternalfetal hormonal interactions, leading to long-term impairments on neuroendocrine and immune competence (Zhang et al., 2005). Microbiol. 371, 7584. Integr. 2009 Sep;36(3):655-72. doi: 10.1016/j.clp.2009.06.009. Hence, further research is needed about these drugs' impact on fetal vagus nerve development. 37, 95110. doi: 10.1007/s00213-010-1955-z, Oyebode, F., Rastogi, A., Berrisford, G., and Coccia, F. (2012). Gynecol. Health Perspect. Our current clinical management of fetal and maternal health is not individualized and intermittent, suffering from a pattern of catching up with clinical symptoms instead of using biometric data to predict and steer developmental trajectories and health outcomes for the pregnant mother and her fetus during the delivery and after to their fullest potential. Figure 1. (2016). Polyvagal theory and developmental psychopathology: emotion dysregulation and conduct problems from preschool to adolescence. Microbiota and neurodevelopmental windows: implications for brain disorders. In the presence of very severe acidemia (pH=6.96) they could not be eliminated by vagal blockade. Proc. Biol. A growing body of evidence suggests that chemicals exposure can impact fetal growth (Dejmek et al., 1999; Snijder et al., 2012; Desrosiers et al., 2015) and is a risk factor for congenital heart diseases (Gong et al., 2017), preterm birth and severe neurodevelopmental abnormalities (Zhang et al., 1992; Lacasaa et al., 2006; Langlois et al., 2012; Yurdakk, 2012). Res. Fed. Alterations in maternally perceived fetal movement and their association with late stillbirth: findings from the Midland and North of England stillbirth casecontrol study. Development of the ovine fetal cardiovascular defense to hypoxemia towards full term. doi: 10.1161/HYPERTENSIONAHA.109.129098, Cerritelli, F., Cardone, D., Pirino, A., Merla, A., and Scoppa, F. (2020). Diminished perception of this motor activity, could therefore be worrisome for the mother, leading to an increased amount of stress, which in turn may have an impact on fetal neurodevelopment (Bryant et al., 2020). (2020). 92, 5155. Nonlinear properties of vagal and sympathetic modulations of heart rate variability in ovine fetus near term. Fetal Neonatal Med. Meas. Development of fetal and neonatal sleep and circadian rhythms. JAMA. (2007). Timeline of fetal and postnatal development that shows the main events related to ANS development in order to define the main critical windows clinicians should pay attention to. Infant stress reactivity and prenatal alcohol exposure. In-house obstetrical coverage, drills to increase the rapidity of emergency cesarean, safer oxytocin management protocols also contribute to better outcomes. Fetal origin of sensorimotor behavior. While all of the mechanisms described above modulate heart rate, it is important to underline that the overarching mission of the cardiovascular system is to deliver sufficient oxygen to key organs. Development of the gonad in normal and anencephalic human fetuses. Nutrients 7, 69246937. Since, according to the Polyvagal theory (Beauchaine et al., 2007), the social/emotional development is related to the vagal system, any insult such as maternal distress suffered during the autonomic trajectory development will interfere with the maturation of the cerebral cortices structures and of the ANS disrupting the development of the Social Engagement System of the child (Porges and Furman, 2011). Around 20 WGA and for the rest of the 2nd trimester, myelination occurs (Borsani et al., 2019). doi: 10.1002/jlb.63.3.281, Bystrova, K. (2009). A., Davis, M. F., Costigan, K. A., and Barr, D. B. 2013 Aug; 209(2):89-97. Biol. 10, 134144. Br J Obstet Gynaecol. The effect of diazepam administration during pregnancy or labor on the heart rate variability of the newborn infant. Comp. Maternal obesity, in particular, both before conception and during pregnancy, is associated with impaired fHRV and poorer ANS development (Christifano et al., 2020). Allergy Immunol. Neurosci. General movements allow fetuses to experience their bodies and the surrounding space, hence exploring the consequences their movements have on their bodies and environment (Fagard et al., 2018). Eur. A qualitative exploration of the views and experiences of women with pregnancy related pelvic girdle pain. Machine learning model on heart rate variability metrics identifies asymptomatic toddlers exposed to Zika virus during pregnancy. doi: 10.1523/JNEUROSCI.3846-13.2013, Khedun, S. M., Maharaj, B., and Moodley, J. Gender-specific evolution of fetal heart rate variability throughout gestation: a study of 8823 cases. Animal labs provide an opportunity to measure exactly what is happening internally as external conditions are manipulated. Raczyska, A., and Gulczyska, E. (2019). https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1016/j.ijgo.2015.06.017 Sleep in late pregnancy predicts length of labor and type of delivery. J. Calif. Perinat. Neurosci. J. Perinat. At 2629 WGA, fetuses become able to efficiently control body temperature (Moore et al., 2016). Commentary: Computerised interpretation of fetal heart rate during labour (INFANT): a randomised controlled trial. Neural crest cells also contribute to spleen development (Barlow-Anacker et al., 2017). 27, 12451250. The placenta harbors a unique microbiome. 41, 662669. A., Lieblich, S. E., Bodnar, T. S., Weinberg, J., and Galea, L. A. M. (2019). (Paris). Frauenh. Hon, E. H., and Lee, S. T. (1963). Fish intake during pregnancy and foetal neurodevelopmenta systematic review of the evidence. Antenatal interventions based upon fetal surveillance of the daily opioid-exposed fetus: a descriptive analysis. 86: . Rep. 9:11020. doi: 10.1038/s41598-019-47306-1, Mulkey, S. B., Kota, S., Swisher, C. B., Hitchings, L., Metzler, M., Wang, Y., et al. Autonomic nervous system activity in premature and full-term infants from theoretical term to 7 years. doi: 10.1016/j.clinthera.2015.03.002, Aita, M., Johnston, C., Goulet, C., Oberlander, T. F., and Snider, L. (2013). Sci. Expert Help. (2020b). doi: 10.1111/j.1471-0528.1998.tb10206.x, Senturk, M. B., Cakmak, Y., Gndogdu, M., Polat, M., and Atac, H. (2015). Figure 1: Schematic outline of heart rate control mechanisms. J. Physiol. 27, 223232. J. Clin. Placental vascular calcification and cardiovascular health: it is time to determine how much of maternal and offspring health is written in stone. (2016). Behav. Biol. 181:108894. doi: 10.1016/j.envres.2019.108894, Bhide, A., and Acharya, G. (2018). Practice bulletin no. Neurobiol. Midwifery 29, 13461351. Also, you can take certain steps to treat late decelerations and improve fetal oxygen supply. The long-term consequences of developing cardiac control systems and ANS are hence under investigation (Frasch and Giussani, 2020). (2008). a. Indian Pediatr. J. Obstet. doi: 10.1002/bdra.23045, Lattimore, K. A., Donn, S. M., Kaciroti, N., Kemper, A. R., Neal, C. R., and Vazquez, D. M. (2005). PeriGens EFM Scholarship Program, Basics of Electronic Fetal Monitoring ( EFM ). While intracellular Ca 2+ has long been hypothesized to be a feedback control signal, the molecular machinery enabling a network-wide homeostatic response remains largely unknown. Cogn. Gynecol. Provided the repetition of these episodes was relatively infrequent, the healthy fetus could adapt for many hours. 1981 Dec 1; 141(7):797-806. doi: 10.1017/S2040174420000653, Chung, W. C. J., and Auger, A. P. (2013). Horne, R. S. (2018). Effects of antenatal betamethasone administration on fetal heart rate and behavior in twin pregnancy. Front. Anat. Autonomic nervous system impairment may have consequences on the global development that persist during infancy, adolescence, and adult life. Ingemarsson, I., and Lamont, R. F. (2003). doi: 10.1016/j.ejogrb.2014.02.032, Baker, T. G., and Scrimgeour, J. In particular, the subplate (a central hub for cortical connectivity) becomes visible and begins to receive connection from the thalamus, basal forebrain, and brainstem. doi: 10.1111/mono.v80.3, DiPietro, J. Such a failure in maintaining cardiac output during labor could facilitate brain injury in newborns and can be detected on the individual basis using fHRV analysis from EFM (Gold et al., 2021; Roux et al., 2021). Autonomic nervous system impairment, maybe through impaired cardiocirculatory and ventilatory regulation, can increase the risk of apparent life-threatening events or sudden infant death syndrome (SIDS) and, thus, of death in the first 612 months of postnatal life. Gynecol. The effect of magnesium sulfate tocolysis on the fetal biophysical profile. doi: 10.1016/s0022-2828(05)82386-7, Morrison, J. L., Berry, M. J., Botting, K. J., Darby, J. R. T., Frasch, M. G., Gatford, K. L., et al. Sci. In some cases, insular injuries do not significantly change ANS tone; or, despite the effects on ANS tone, systemic hemodynamic meters (e.g., diastolic and systolic blood pressure) do not seem affected by brain injuries (Schneebaum Sender et al., 2017; Reich et al., 2019). A., Jenkins, J. M., Ozdas, A., and Norris, P. R. (2011). Catecholamine C. Sympathetic - CORRECT ANSWERS A. Baroreceptor During the 1st trimester, there are significant negative correlations between the amount of maternal cigarette smoking and fHRV metrics, highlighting the disrupted temporal organization of autonomic regulation before birth (Zeskind and Gingras, 2006; Kapaya et al., 2015). 22, 337358. Fetal cholinergic anti-inflammatory pathway and necrotizing enterocolitis: the brain-gut connection begins in utero. Doussard-Roosevelt, J. doi: 10.1016/j.neuropharm.2018.10.009, Gernand, A. D., Schulze, K. J., Stewart, C. P., West, K. P., and Christian, P. (2016). doi: 10.1016/j.biopsycho.2010.11.006, Nugent, B. M., and Bale, T. L. (2015). Int. 57:101. doi: 10.3345/kjp.2014.57.3.101. Believed to be an abnormal FHR pattern, late decelerations indicate a reduction in heart rate, usually after a uterine contraction. doi: 10.1006/drev.1998.0452, Koletzko, B., Cremer, M., Flothktter, M., Graf, C., Hauner, H., Hellmers, C., et al. The placenta and neurodevelopment: sex differences in prenatal vulnerability. (2011). doi: 10.1016/j.clp.2016.04.001, Mowery, N. T., Morris, J. Obstet Gynecol. Also, fetal microglia from the bone marrow invade the CNS, while gray and white brain matters keep on developing: the cerebral lobes with all their sulci and gyri, cortexes such as the insula, the cerebellum, the pons, and many other structures increasingly resemble their adult counterparts (Moore et al., 2016). The degree of hypertension and the amount of deceleration were closely related, although some deceleration remained when the transient hypertension was prevented by adrenergic blockade. Gynecol. (2009). doi: 10.1111/aji.12355, Simkin, J. E., Zhang, D., Stamp, L. A., and Newgreen, D. F. (2019). Moreover, prophylactic antibiotic use during vaginal or cesarean delivery may indirectly lead to epigenetic changes in the fetus, with possible implications in the immune system and stress response (Tribe et al., 2018), consequently involving vagus nerve development and suggesting, therefore, the utility to consider potential alternative approaches (Ledger and Blaser, 2013). (2017). 114, 11941201. In neonatal life activation of these centers induces strong stimulation for breathing. At 46 WGA the primitive diaphragm appears (Hill, 2021d) and, by 7 WGA, the four chambers of the heart have formed, thus connecting the heart to the aorta and the pulmonary trunk. (2016). J. Obstet. Regul. Heart Assoc. Fine scale differences within the vagal neural crest for enteric nervous system formation. Cell Dev. Biol. PLOS ONE 8:e74431. Psychol. Since the ANS requires 37 weeks in utero to fully develop, preterm newborns can experience difficulties in regulating their internal milieu in the face of environmental factors (Praud et al., 2017). doi: 10.1196/annals.1314.006, Sehmbi, H., D'Souza, R., and Bhatia, A. 41, 323. BMJ Open 8:e020031. Neurorobotics 12:23. doi: 10.3389/fnbot.2018.00023, Fairchild, K. D., Srinivasan, V., Randall Moorman, J., Gaykema, R. P. A., and Goehler, L. E. (2010). doi: 10.1016/j.yfrne.2015.09.001, Nuriel-Ohayon, M., Neuman, H., and Koren, O. Gynaecol. Drugs Used to Manage the Timing of Delivery. Sci. Prenatal alcohol exposure alters biobehavioral reactivity to pain in newborns. Reducing cardioinhibitory activity increases heart rate. Res. Environmental stimuli, per se, induce motor reactions, as the sensory system maturation proceeds. doi: 10.1002/14651858.CD002271.pub3, Holsti, L., Grunau, R. E., Whifield, M. F., Oberlander, T. F., and Lindh, V. (2006). During the 3rd trimester, distinct fetal behavioral states (i.e., quiet sleep, active sleep, quiet awake, and active awake) become increasingly recognizable through the analysis of heart rate (HR), eye movement, and GMs, as corticothalamic and brainstem areas develop more complex interactions (Brndle et al., 2015; Borsani et al., 2019). doi: 10.1088/1361-6579/aa5fca, Hutchins, E. J., Kunttas, E., Piacentino, M. L., Howard, A. G. A., Bronner, M. E., and Uribe, R. A. 41, 928939. Infant Child Dev. This phenomenon has the potential of altering ANS in three ways, especially in preterm or vulnerable infants. Heart rate variability in hypertensive pregnancy disorders: a systematic review. Off. Even if the effects on the vagus nerve are still to be defined, the hazards exposure may affect the fetal motor activity (DiPietro et al., 2014) and be related to delayed neurobehavioural development in neonates (Handal et al., 2008). 1983 Jun 15;146(4):456-62. Dev. 7, 321334. Can. Analg. Drugs including theophylline, caffeine, and methylxanthine, used to support respiratory functions have the potential of altering sleep quality and induce drowsiness. Placental microbial colonization and its association with pre-eclampsia. 39, 769783. Studies in fetal behavior: revisited, renewed, and reimagined. 128:1443. doi: 10.1111/1471-0528.16674, Gold, N., Herry, C. L., Wang, X., and Frasch, M. G. (2021). Pediatr. Top. (2014). Standards of measurement, physiological interpretation, and clinical use. doi: 10.1007/BF00315698, Multon, O., Senat, M.-V., Minoui, S., Hue, M.-V., Frydman, R., and Ville, Y. doi: 10.1016/j.earlhumdev.2017.07.003, Desrosiers, T. A., Lawson, C. C., Meyer, R. E., Stewart, P. A., Waters, M. A., Correa, A., et al. Off. Firstly, by directly affecting brain development, as the skull has a low bone density that fails in adequately protecting newborns' brain from EMF (Besset et al., 2020). The central autonomic network: functional organization, dysfunction, and perspective. Environ. As the ANS is controlled by several brain areas (e.g., amygdala, hypothalamus, insula, cingulate cortex, and several brainstem nuclei) that constitute the central autonomic network (CAN), paying attention to their development is fundamental for studying the fetal ANS. doi: 10.1016/0378-3782(86)90187-8, Shuffrey, L. C., Myers, M. M., Odendaal, H. J., Elliott, A. J., du Plessis, C., Groenewald, C., et al. Dev. Table 2. J. Autism Dev. Environment and fetal programming: the origins of some current pandemics. J. Pediatr. Psychopathol. B. Pediatr. J. Low back pain in pregnancy: investigations, management, and role of neuraxial analgesia and anaesthesia: a systematic review. doi: 10.1016/0378-3782(79)90002-1, Yee, J. R., Kenkel, W. M., Frijling, J. L., Dodhia, S., Onishi, K. G., Tovar, S., et al. Variations are also observed for SDNN, SDNN/RMSSD, LFn, and HFn (Zizzo et al., 2020). Sorokin, Y., Dierker, L. J., Pillay, S. K., Zador, I. E., Schreiner, M. L., and Rosen, M. G. (1982). In the human literature, four recent and independent studies using various definitions of acidosis and examining the last 30-60 minutes of the tracing reported that the percentage of babies with acidosis who had moderate variability ranged from 15% to 91%.35-40 Even with near lethal levels of uterine artery base deficit (>=16 mmol/L), a full 15 to 32% of fetal tracings had moderate baseline variability in the portion recorded just before birth.35 In a recent expert review of 120 cases of term babies born with base deficit >12mmol/L levels only 13 % showed minimal or absent variability.39 Most recently a review of fetal heart rate patterns in term babies with a uterine artery pH >7.1 foundthe most predictive FHR parameters were cumulative deceleration area with any amount of tachycardia. Lear CA, Galinsky R, Wassink G, Mitchell CJ, Davidson JO, Westgate JA, Bennet L, Gunn AJ. (2012). 524, 12591269. Dynamic touch reduces physiological arousal in preterm infants: a role for c-tactile afferents? Pediatr. Physiol. Front. doi: 10.1176/appi.ajp.2007.06071172, Tan, C. M. J., and Lewandowski, A. J.
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