Doppler‐based fetal heart rate analysis markers for the detection of early intrauterine growth restriction

Lisa Stroux; Christopher W. Redman; Antoniya Georgieva; Stephen J. Payne; Gari D. Clifford

doi:10.1111/aogs.13228

journal article Sep 27, 2017

Doppler‐based fetal heart rate analysis markers for the detection of early intrauterine growth restriction

Lisa Stroux

Christopher W. Redman Antoniya Georgieva

Stephen J. Payne Gari D. Clifford

Acta Obstetricia et Gynecologica Scandinavica Vol. 96 No. 11 pp. 1322-1329 · Wiley

View at Publisher Save 10.1111/aogs.13228

Abstract

AbstractIntroductionOne indicator for fetal risk of mortality is intrauterine growth restriction (IUGR). Whether markers reflecting the impact of growth restriction on the cardiovascular system, computed from a Doppler‐derived heart rate signal, would be suitable for its detection antenatally was studied.Material and methodsWe used a cardiotocography archive of 1163 IUGR cases and 1163 healthy controls, matched for gestation and gender. We assessed the discriminative power of short‐term variability and long‐term variability of the fetal heart rate, computed over episodes of high and low variation aiming to separate growth‐restricted fetuses from controls. Metrics characterizing the sleep state distribution within a trace were also considered for inclusion into an IUGR detection model.ResultsSignificant differences in the risk markers comparing growth‐restricted with healthy fetuses were found. When used in a logistic regression classifier, their performance for identifying IUGR was considerably superior before 34 weeks of gestation. Long‐term variability in active sleep was superior to short‐term variability [area under the receiver operator curve (AUC) of 72% compared with 71%]. Most predictive was the number of minutes in high variation per hour (AUC of 75%). A multivariate IUGR prediction model improved the AUC to 76%.ConclusionWe suggest that heart rate variability markers together with surrogate information on sleep states can contribute to the detection of early‐onset IUGR.

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Citations

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References

Details

Published: Sep 27, 2017
Vol/Issue: 96(11)
Pages: 1322-1329
License: View

Authors

L

Lisa Stroux

Institute of Biomedical Engineering Department of Ethics approval to use this database was givenEngineering Science University of Oxford Oxford UK

C

Christopher W. Redman

Nuffield Department of Obstetrics & Gynecology University of Oxford Oxford UK

A

Antoniya Georgieva

Nuffield Department of Obstetrics & Gynecology University of Oxford Oxford UK

S

Stephen J. Payne

Institute of Biomedical Engineering Department of Ethics approval to use this database was givenEngineering Science University of Oxford Oxford UK

G

Gari D. Clifford

Departments of Biomedical Informatics and Engineering Emory University and Georgia Institute of Technology Atlanta GA USA

Funding

National Institutes of Health

Action Medical Research

Eunice Kennedy Shriver National Institute of Child Health and Human Development Award: 1R21HD084114‐01

Fogarty International Center

Henry Smith Charity

Cite This Article

Lisa Stroux, Christopher W. Redman, Antoniya Georgieva, et al. (2017). Doppler‐based fetal heart rate analysis markers for the detection of early intrauterine growth restriction. Acta Obstetricia et Gynecologica Scandinavica, 96(11), 1322-1329. https://doi.org/10.1111/aogs.13228

Doppler‐based fetal heart rate analysis markers for the detection of early intrauterine growth restriction

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