title: Fetal cardiac sympathetic activation is linked with maternal body mass index.
abstract: BACKGROUND
  Sympathetic over activity has been suggested to impact on the risk of cardiovascular diseases. The origin of abnormalities in the autonomic nervous system is unknown, but it is susceptible to environmental influences during the critical periods of human development.
  
  
  OBJECTIVE
  To examine the influence of maternal characteristics on fetal cardiac autonomic nervous activation.
  
  
  METHODS
  Prospective, observational study.
  
  
  METHODS
  41 fetuses from normal pregnancy born after 36 gestational weeks.
  
  
  METHODS
  Maternal characteristics that affect fetal intrauterine well-being intrauterine environmental factors were evaluated, including pre-pregnancy body mass index as well as GHbA1c, blood pressure and 3-day food diaries from each trimester of pregnancy. To assess intrapartum fetal cardiac sympathovagal activation fetal ECG was recorded for 1 h during delivery. Heart rate variability was measured using power spectrum analysis of low-to-high frequency ratio of fetal heart rate variability.
  
  
  RESULTS
  Cardiac sympathetic activation measured during delivery was associated with maternal pre-pregnancy body mass index (r=0.33, p=0.03), placental weight (r=0.4, p=0.008) and the immaturity of the fetus (r=-0.3, pb0.05).
  
  
  CONCLUSIONS
  Early intrauterine environmental factors such as maternal pre-pregnancy body mass index are associated with fetal sympathetic activation with a potential for cardiovascular programming.
authors.affiliation: Department of Pediatrics, Division of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland. tiina.h.ojala@hus.fi
authors.forename: Tiina
authors.initials: T
authors.lastname: Ojala
authors.forename: Jonna
authors.initials: J
authors.lastname: Aaltonen
authors.forename: Saila
authors.initials: S
authors.lastname: Siira
authors.forename: Jarmo
authors.initials: J
authors.lastname: Jalonen
authors.forename: Eeva
authors.initials: E
authors.lastname: Ekholm
authors.forename: Ulla
authors.initials: U
authors.lastname: Ekblad
authors.forename: Kirsi
authors.initials: K
authors.lastname: Laitinen
mesh_terms: D001341:Autonomic Nervous System / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D016022:Case-Control Studies; D036861:Delivery, Obstetric; D004562:Electrocardiography; D005260:Female; D005318:Fetal Heart / Q000294:innervation* / Q000502:physiology; D006340:Heart Rate, Fetal / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies