Key result
Lipopolysaccharide alters heart rate variability within 2 to 4 hours before tachycardia in fetal sheep.
Why the study?
Current methods to diagnose fetal inflammatory response syndrome (FIRS) are inadequate, prompting investigation into whether fetal heart rate variability (HRV) analysis can detect FIRS.
Does intravenous lipopolysaccharide alter heart rate variability indices in a near-term fetal sheep model of acute fetal inflammatory response syndrome?
Does intravenous lipopolysaccharide alter heart rate variability indices in a near-term fetal sheep model of acute fetal inflammatory response syndrome?
p-value: p=<0.05
Heart rate variability changes indicating a loss of signal complexity may enable the early detection of acute fetal inflammatory response syndrome before clinical signs like tachycardia appear.
HRV changes may precede tachycardia in fetal inflammation; leaves open utility for early detection in human pregnancies.
INTRODUCTION: Fetal infection during labor with fetal inflammatory response syndrome (FIRS) is associated with neurodevelopmental disabilities, cerebral palsy, neonatal sepsis, and mortality. Current methods to diagnose FIRS are inadequate. Thus, the study aim was to explore whether fetal heart rate variability (HRV) analysis can be used to detect FIRS. MATERIAL AND METHODS: In chronically instrumented near-term fetal sheep, lipopolysaccharide (LPS) was injected intravenously to model FIRS. A control group received saline solution injection. Hemodynamic, blood gas analysis, interleukin-6 (IL-6), and 14 HRV indices were recorded for 6 h. In both groups, comparisons were made between the stability phase and the 6 h following injection (H1-H6, respectively) and between LPS and control groups. RESULTS: Fifteen lambs were instrumented. In the LPS group (n = 8), IL-6 increased significantly after LPS injection (p < 0.001), confirming the FIRS model. Fetal heart rate increased significantly after H5 (p < 0.01). In our FIRS model without shock or cardiovascular decompensation, five HRV measures changed significantly after H2 until H4 in comparison to baseline. Moreover, significant differences between LPS and control groups were observed in HRV measures between H2 and H4. These changes appear to be mediated by an increase of global variability and a loss of signal complexity. CONCLUSION: As significant HRV changes were detected before FHR increase, these indices may be valuable for early detection of acute FIRS.
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Chevalier et al. (2023) studied Fetal inflammatory response syndrome (FIRS) (n=15). Lipopolysaccharide (LPS) vs. Saline solution (0.9% NaCl) was evaluated on Heart rate variability (HRV) indices over 6 hours (p=<0.05). In a near-term fetal sheep model of acute fetal inflammatory response syndrome, lipopolysaccharide injection induced significant changes in five heart rate variability indices between 2 and 4 hours, before the onset of fetal tachycardia.
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