Key result
Non-invasive fetal electrocardiography demonstrated acceptable reliability for time domain parameters SDNN and RMSSD (CV < 15%, ICC > 90%) from gestational week 28 onwards.
Why the study?
Fetal heart rate variability has shown potential in fetal surveillance, prompting evaluation of the reliability of time domain and spectral domain parameters based on non-invasive fetal electrocardiography.
What is the reliability of time domain and spectral domain parameters of fetal heart rate variability using non-invasive fetal electrocardiography in healthy pregnant women?
Cross-Sectional (n=75)
No
What is the reliability of time domain and spectral domain parameters of fetal heart rate variability using non-invasive fetal electrocardiography in healthy pregnant women?
Non-invasive fetal ECG provides reliable time domain and spectral domain parameters of fetal heart rate variability from gestational week 28, particularly when using stationary RR-intervals.
Supports reliable HRV assessment in moderate preterm neonates; leaves open generalizability to other gestational ages.
OBJECTIVES: Fetal heart rate variability (FHRV) has shown potential in fetal surveillance. Therefore, we aimed to evaluate the reliability of time domain and spectral domain parameters based on non-invasive fetal electrocardiography (NI-FECG). METHOD: NI-FECG, with a sampling frequency of 1 kHz, was obtained in 75 healthy, singleton pregnant women between gestational age (GA) 20+0 to 41+0. The recording was divided into a) heart rate pattern (HRP) and b) periods fulfilling certain criteria of stationarity of RR-intervals, termed stationary heart rate pattern (SHRP). Within each recording, the first and the last time series from each HRP with less than 5% artifact correction were analyzed and compared. Standard deviation of normal-to-normal RR-intervals (SDNN), root mean square of successive differences (RMSSD), high frequency power (HF-power), low frequency power (LF-power), and LF-power/HF-power were performed. A multivariate mixed model was used and acceptable reliability was defined as intraclass correlation coefficient (ICC) ≥ 0.80 and a coefficient of variation (CV) ≤ 15%. Based on these results, the CV and ICC were computed if the average of two to six time series was used. RESULTS: For GA 28+0 to 34+6, SDNN and RMSSD exhibited acceptable reliability (CV < 15%; ICC > 90%), whereas GA 35+0 to 41+0and 20+0 to 27+6 showed higher CVs. Spectral domain parameters also showed high CVs However, by using the mean value of two to six time series, acceptable reliability in SDNN, RMSSD and HF-power from GA 28+0 was achieved. Stationarity of RR-intervals showed high influence on reliability and SHRP was superior to HRP, whereas the length of the time series showed minor influence. CONCLUSION: Acceptable reliability seems achievable in SDNN, RMSSD and HF-power from gestational week 28. However, stationarity of RR-intervals should be considered when selecting time series for analyses.
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Zizzo et al. (2022) conducted a cross-sectional in Healthy singleton pregnancy (n=75). Non-invasive fetal electrocardiography (NI-FECG) was evaluated on Reliability (intraclass correlation coefficient and coefficient of variation) of time domain and spectral domain FHRV parameters. Non-invasive fetal electrocardiography demonstrated acceptable reliability for time domain parameters SDNN and RMSSD (CV < 15%, ICC > 90%) from gestational week 28 onwards.
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