Increased fetal heart rate variability in periventricular leukomalacia.
OBJECTIVE
This study used quantitative analysis to determine whether increased variability in fetal heart rate (FHR) is related to the risk of developing periventricular leukomalacia (PVL).


METHODS
We analyzed 124 FHR traces of neonates delivered preterm at 27-33 weeks' gestation to 105 mothers. FHR traces 1-3h before delivery were translated into power-spectrum curves using a fast Fourier transformation. The total power (the area under the curve of 1-10 cycles per minute), segmental power of every cycle per minute, peak power, and frequency edges were calculated, and their relationship with the subsequent development of PVL was examined.


RESULTS
Total power was significantly higher in the PVL group (n=9, median 1813, range 1064-2426) compared to the non-PVL group (n=114, median 1383, range 381-3324, p=0.029). Infants in the PVL group had greater segmental power in segments with 1-2, 2-3, and 9-10 cycles per minute, than those in the non-PVL group. Total power of ⩾1550 was significantly correlated with the subsequent development of PVL and premature rupture of membranes. Furthermore, the frequency of pregnancy-induced hypertension was significantly reduced in the fetuses with a total power of ⩾1550.


CONCLUSIONS
Our study suggests that a fetus with increased FHR variability is at risk of developing PVL. This study provides additional evidence supporting the contribution of antenatal factors to the subsequent development of PVL.
Department of Pediatrics, Aichi Medical University, Nagakute, Aichi, Japan; Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Hirokazu
H
Kurahashi
Department of Pediatrics, Aichi Medical University, Nagakute, Aichi, Japan; Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan. Electronic address: okumura.akihisa.479@mail.aichi-med-u.ac.jp.
Akihisa
A
Okumura
Department of Pediatrics, Anjo Kosei Hospital, Anjo, Aichi, Japan.
Tetsuo
T
Kubota
Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Pediatrics, Anjo Kosei Hospital, Anjo, Aichi, Japan.
Hiroyuki
H
Kidokoro
Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Koichi
K
Maruyama
Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan; Maternity and Perinatal Care Center, Nagoya University Hospital, Nagoya, Japan.
Masahiro
M
Hayakawa
Maternity and Perinatal Care Center, Nagoya University Hospital, Nagoya, Japan; Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan.
Atsuo
A
Itakura
Department of Gynecology and Obstetrics, Anjo Kosei Hospital, Anjo, Aichi, Japan.
Katsuji
K
Matsuzawa
Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Hiroyuki
H
Yamamoto
Department of Pediatrics, Okazaki City Hospital, Okazaki, Aichi, Japan.
Toru
T
Kato
Department of Pediatrics, Okazaki City Hospital, Okazaki, Aichi, Japan.
Fumio
F
Hayakawa
Department of Pediatrics, Anjo Kosei Hospital, Anjo, Aichi, Japan.
Kazuyoshi
K
Watanabe
D005260:Female; D005865:Gestational Age; D006340:Heart Rate, Fetal / Q000502:physiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007969:Leukomalacia, Periventricular / Q000503:physiopathology*; D008297:Male; D011247:Pregnancy; D012307:Risk Factors
Fast Fourier transform; Fetal heart rate; Long-term variability; Periventricular leukomalacia