title: Electrocardiographic intervals in foetuses with CHD.
abstract: OBJECTIVE
  To assess foetal electrocardiographic intervals across gestational age among foetuses with and without congenital heart disease, and to investigate differences between groups.
  
  
  METHODS
  A prospective observational cohort study.
  
  
  METHODS
  Center for Prenatal Pediatrics, Morgan Stanley Children's Hospital of New York-Presbyterian. Population or sample A total of 92 participants with singleton pregnancies, 41 with normal anatomy and 51 with congenital heart disease were included in this study.
  
  
  METHODS
  Using a maternal abdominal monitor, foetal electrocardiogram was obtained serially from foetuses with and without congenital heart disease at 20-24 weeks (F1), 28-32 weeks (F2), and 34-38 weeks (F3) of gestation. A signal-averaged waveform was calculated, and PR, QRS, and QT intervals were measured. Intervals from controls were compared with gestational age norms. Using Pearson's correlation coefficient, we analysed the relationship between gestational age and foetal electrocardiographic intervals. Intervals from control and congenital heart disease foetuses were compared by Student's t-test.
  
  
  RESULTS
  PR (r=0.333, p=0.02) and QRS (r=0.248, p=0.05) intervals correlated with gestational age only among controls. QRS intervals in foetuses with congenital heart disease were significantly longer than controls at F1 (63 ± 6 versus 52 ± 5 ms, p<0.001), F2 (61 ± 8 versus 56 ± 7 ms, p=0.02), and F3 (64 ± 10 versus 56 ± 9 ms, p=0.007).
  
  
  CONCLUSIONS
  PR and QRS intervals lengthen across gestational age among foetuses with normal cardiac anatomy but not in foetuses with congenital heart diseases. As early as 20 weeks of gestation, differences between foetuses with and without congenital heart disease are discernible, with congenital heart disease foetuses demonstrating longer QRS intervals compared with controls.
authors.affiliation: 1Department of Pediatrics,Division of Pediatric Cardiology,Morgan Stanley Children's Hospital,Columbia University Medical Center,New York,United States of America.
authors.forename: Betul
authors.initials: B
authors.lastname: Yilmaz
authors.affiliation: 1Department of Pediatrics,Division of Pediatric Cardiology,Morgan Stanley Children's Hospital,Columbia University Medical Center,New York,United States of America.
authors.forename: Hari K
authors.initials: HK
authors.lastname: Narayan
authors.affiliation: 2Department of Psychiatry,Columbia University,New York,United States of America.
authors.forename: Abigail
authors.initials: A
authors.lastname: Wilpers
authors.affiliation: 1Department of Pediatrics,Division of Pediatric Cardiology,Morgan Stanley Children's Hospital,Columbia University Medical Center,New York,United States of America.
authors.forename: Christina
authors.initials: C
authors.lastname: Wiess
authors.affiliation: 1Department of Pediatrics,Division of Pediatric Cardiology,Morgan Stanley Children's Hospital,Columbia University Medical Center,New York,United States of America.
authors.forename: William P
authors.initials: WP
authors.lastname: Fifer
authors.affiliation: 1Department of Pediatrics,Division of Pediatric Cardiology,Morgan Stanley Children's Hospital,Columbia University Medical Center,New York,United States of America.
authors.forename: Ismée A
authors.initials: IA
authors.lastname: Williams
mesh_terms: D015331:Cohort Studies; D004562:Electrocardiography; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis* / Q000503:physiopathology*; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011446:Prospective Studies
keywords: Foetal electrocardiography; congenital heart disease; electrocardiographic intervals