Fetal cardiac sympathetic activation is linked with maternal body mass index.
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.
Ojala
Tiina
T
Department of Pediatrics, Division of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland. tiina.h.ojala@hus.fi
Aaltonen
Jonna
J
Siira
Saila
S
Jalonen
Jarmo
J
Ekholm
Eeva
E
Ekblad
Ulla
U
Laitinen
Kirsi
K
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